LTC REHAB new RN graduate

[La'sBlueSky]

Was on the floor dispensing medication when the nurse at the desk comes to me to tell me she can not find my CNA and patient-A needs help with toileting. She said since she could not find the CNA she was informing me as I was her nurse. I nodded and she turned around and sat down at the nurses station. I continued dispensing the medication I had pulled and began the next patient's-B medication. This patient-B had expressed a 8/10 pain. My preceptor came to me and said to come and help with the toileting of patient-A. Preceptor told me when I was told I should have went immediately to help patient-A with toileting. So toileting comes before pain?

[heronurse]

From what I learned in ltc yes, because theres a risk for falls.

[Been there,done that, ASN, RN]

This all depends on the culture of your facility. The desk nurse could have toileted the patient, or should have directed another nursing assistant.

Passing any medication would not be YOUR first priority. Yes, toileting comes first. As heronurse describes, it is a safety issue. Pain can wait... the need for elimination cannot.

As your preceptor is giving you hindsight on prioritization,you MUST follow your preceptor's guidance.

Welcome to the wonderful world of nursing... where you are pulled in a gazilllion directions at once.

I wish you the best of luck, it's a jungle in there.

[TheCommuter, BSN, RN]

In the LTC/skilled nursing facility/post-acute rehab setting, a sizable number of patient falls are attributable to toileting needs.

If someone does not put patients on the pot in a timely manner, they will attempt to get to the bathroom on their own. They often cannot make it because their knees buckle from weakness and they fall.

The nurse who informed you about the request to use the bathroom could have toileted the patient, but she wanted to turf the duty off onto someone else in an effort to avoid wiping butt crack. Since the patient was yours, any falls that resulted would have been your responsibility.

It seems you work at a short-staffed facility with a workplace culture in which employees are out for themselves.

[La'sBlueSky]

I love nursing and I love this job. I am learning so much. The only experience I have is clinical experience during nursing school and being an RN is not anywhere close to what I was taught in nursing school! LOL! Prioritization is something I need to work on. The CNA's are wonderful and work really hard. TheCommuter is right about the desk nurse. This desk nurse tells everyone at the beginning of shift that she will not be doing this and not be doing that (i.e. entering doctors orders in the MAR) . I am at a loss because I do not know what she is responsible for completing. I have not heard another desk nurse state that at the beginning of shift. Thanks for all your answers!

[TheCommuter, BSN, RN]

I love nursing and I love this job. I am learning so much.

I'm glad you're liking LTC rehab. It is an underrated, underappreciated area of nursing that also happens to be very important.