Major shakeups at my ltc

Monica RN,BSN · Aug 4, 2005

I went into work today to find that the state review had come in and lo and behold they said there needed to be more nurses on each shift that it was impossible for 1 nurse to do all the meds and chart, etc... Now they are going to try and have 3 nurses and 2 omt's or 2 nurses, 2omt's, and an extra aide. One nurse does the daily vitals, tx, and charting. The other 2 are charge at each station. Omt's will pass meds. It will be nice as long as it lasts. The DON was in a tizzy about the paperwork not being done. Sorry passing meds to 70+ patients doesn't leave you much time to run around and take vitals, do treatments, take phone orders, admits etc....We will get a new administrator next week. He is coming from another facility in town and doesn't have a good reputation for supporting his staff. I have to say I love my job and am so glad I went back to work.

Just curious in which state you could be allowed to have 70+ patients. In Florida it is against nurse practice law to have more than 40. In my building, I will not allow any of my nurses to have over 25, ever.. I am wondering if OMT's (never heard that name before) are unlicensed? I hope you get your extra staff. Your building sounds like major liability.

Bird2 · Aug 4, 2005

Passing meds to 70+ residents is a med error waiting to happen!!! Thank God the State stepped in. Once the State insists that a change be made it is difficult for the facility to back slide. So, good luck to you. Hopefully the changes will be for the better.

barefootlady, ADN, RN · Aug 4, 2005

one nurse to pass meds for 70 pts, no wonder the state suggested these changes. No matter a new administrator is coming, it would be better to make a solid attempt to follow these suggestions from the state before they become written in stone, or the facility is closed down for unsafe conditions.

dinkymouse · Aug 4, 2005

Med errors do abound. An OMT is an oral med tech. They have to be certified. I live in Iowa and will have to check on our nurse/pt ratio. I think they thought they could get away with it because some of the aides were also omt's and so it would look like they were staffed okay. I had an omt tell me she had signed out meds on a patient but hadn't given them. I gave them but at noon found out that she hadn't given them to 6 other people.

chunnice · Aug 7, 2005

Med errors do abound. An OMT is an oral med tech. They have to be certified. I live in Iowa and will have to check on our nurse/pt ratio. I think they thought they could get away with it because some of the aides were also omt's and so it would look like they were staffed okay. I had an omt tell me she had signed out meds on a patient but hadn't given them. I gave them but at noon found out that she hadn't given them to 6 other people.

Thats what I don't like about the OMT's. If I'm not mistaken they are under the Nurses License. I don't like the idea of someone giving meds for me...

Laura

letina · Aug 7, 2005

Hi dinkymouse, sounds like this visit was way overdue from reading your posts about the problems you've been having with wound care. I see that the patient with the horrendous decubiti got sent to the hospital with sepsis

Hope she's OK. You sound like a great advocate, by the way.

dinkymouse · Aug 8, 2005

:angryfire I went to work yesterday and the usual 2 aides came strolling in at 9am-shift begins at 7. I had 5 aides for 5 halls and 3 of those halls are full of 2 person transfers. I had to have them team up to get everyone up, although we had some get room trays and many went in their pj's and robes.

At about noon these 2 informed me they were leaving at 1:30. I don't usually lose it but I asked one why he thought he could come when he wanted and leave when he wanted. Didn't he have any respect for his co-workers feelings and their opinion of him. "No I don't like it here so I don't care" :angryfire :angryfire I was so far behind from having to pass room trays cuz we had to have 1 aide in the dining room for the feeders. 2 of the girls had to stay 4 hours over cuz we had 2 call ins after running their butts off all day. I wrote those 2 up but they do it all the time because they are friends with the admin. Well she is gone at the end of the coming week so I hope they go too.

Reigen · Aug 8, 2005

:angryfire I went to work yesterday and the usual 2 aides came strolling in at 9am-shift begins at 7. I had 5 aides for 5 halls and 3 of those halls are full of 2 person transfers. I had to have them team up to get everyone up, although we had some get room trays and many went in their pj's and robes.
At about noon these 2 informed me they were leaving at 1:30. I don't usually lose it but I asked one why he thought he could come when he wanted and leave when he wanted. Didn't he have any respect for his co-workers feelings and their opinion of him. "No I don't like it here so I don't care" :angryfire :angryfire I was so far behind from having to pass room trays cuz we had to have 1 aide in the dining room for the feeders. 2 of the girls had to stay 4 hours over cuz we had 2 call ins after running their butts off all day. I wrote those 2 up but they do it all the time because they are friends with the admin. Well she is gone at the end of the coming week so I hope they go too.

I hope the next thing you did was report those two aides to the licensing board for nursing assitants in your state: for patient abandament. I also hope you called your staffing department and DON and told them that they left and that someone needed to come and work to maintain the staffing levels for safe patient care. It doesn't matter if "they are friends with the admin" as you stated, it does matter that the patients were jepordized in safe and reasonable care. This is the very least you should do. Failure to report this (to a Licensing Board) can make you liable under a nurse practice act, for aides do work under the direct supervison of the Lic. Nurse.

As for the two that stayed- :saint: :saint: they need to know how very much their efforts, care and concern for the welfare of those residents is appreciated.

dinkymouse · Aug 10, 2005

Reporting them to the DON doesn't do anygood, she came with the admin from the other facility. Didn't think about the board. Good idea. I really praise my good aides. I also know that they appreciate the fact that I answer call lights, help them with transfers and pass room trays. They will do anything for me. The facility doesn't acknowledge their dedication but I think I may get ice cream cone certificates from the DQ for those who are consistantly super!!!!