I have been back doing MDS's for about 2 years, after doing med-surg for a couple of years (I did MDS for about 5 years previously). I just started a this postion, MDS casemix and PPS for a 50 bed SNF. I can't believe the additudes of some of the staff here!! The job is pretty much the same as before I left, not much you can do with the RAI proess to make it different at different facilities in the same state, but I just don't know if I can work with some of these people.
What happened today by far was the worst . I went to do a admission assessment on a resident. I usually check the treatment sheet, count the meds on the MAR (I always wait until nurses are done with their med passes), check the CNA sheets, grab the chart, then go to the room to assess/interview the resident.
Today I went to grab a chart on the person I was doing and the floor nurse stopped me, saying "you can't have that". I said, "oh, do you need it first for a while? What time do you think I could have it" She says "I don't have time for you today, you can have it tommorrow, maybe". Well, at this point I was flabbergasted. I basically asked if she was joking, and she said "nope". The DON was sitting right there, her office is literally 2 feet behind where this took place, and she never said a word. She looked up a couple of times, but never commented.
I returned to my office to calm down, then went and talked with the DON. She basically told me that the nurse was having a bad day, and I better just do that resident another day, and oh, BTW, maybe you shouldn't do anyone on that hall today. I tried to explain the importance of doing these assessments timely, and that I was NOT going to back date just b/c the floor nurse was having a bad day, but got no where.
I am still the new kid on the block, I hate to start making waves so soon, and I'm at a loss on how to handle this. Is it not bad enough we have to deal with no charting/documentation, trying to follow all the guidelines, make sure careplans are prefect, keeping track of all the timeframes, etc, etc, but now I have to worry about not being able to do my job b/c a nurse is having a bad day?
Any advice welcomed............please help!!
Jun 2, '09
It appears your DNS doesn't understand the importance of the MDS. Try talking to her about it. It's been my experience that most DNSs are lacking in MDS knowledge. If that doesn't work, you might have to speak to the ED. You can't wait to do MDSs...and I'm sure your facility needs the revenue.
Jun 2, '09
Yeh, better talk to the administrator soon. I don't envy you. If that happened in my facility, somebody would have been clocking out and going home, maybe for good!
Jun 3, '09
sounds weird, I am hoping it is a one time thing, I have worked with great nurses who were lousy at paperwork and needed to be treated with kid gloves in that area, can you ask the previous MDS coordinator for any tips?
You might want to consider giving an inservice explaining what you do and why you need cooperation and what the nurses need to do to ensure optimal results.
Does the DNS realize the implications of you not doing your work on time..financially, I mean.
Its not worth making waves but definitely write a memo to the DNS that you were unable to do this admission assessment on time due to lack of cooperation from the staff (no need to spell out who) and availability of the pt chart. This way you cant be blamed later on.
Keep records of such incidences as they will probably come up again. and of course never back date your paperwork.
Jun 3, '09
I had a situation like this on Monday. A nurse was mad b/c weekend shift hadn't done the MARs for the new month for 3 new residents (understandable mad), and just was in a bad mood. She refused to let me look at a residents meds on the MAR, a literally 30 second peek so I could finsh her 5 day. She was also finished with her med pass and was punching holes in the new mars and behavior sheets. She actually grabbed my shoulders and moved me to the side. And said "I don't care about your job today". Same deal with the DON here, she was sitting right there and didn't say anything. I have been here for not quite 4 weeks. Maybe its a virus going around or something, lol.
Jun 3, '09
She grabbed your shoulders???? OH NO WAIT JUST A DAMN MINUTE HERE! I may be old and mellow but the feces would have hit the fan! What nerve! :angryfire
Jun 4, '09
I agree, the physical manipulation is a symptom of something worse and if the DON says nothing, I would ask for a meeting,
What would she have said if it were YOU who pushed another staff member...
While it is wrong - but I have encountered nurses who think that the MDS nurse is getting paid for doing nothing,,,,I expect the DON to know better and enlighten her staff...
Jun 9, '09
I have to say I agree. There is no way I would have stood there and let that happen. As a matter of fact, the nurses I work with all know that aspect of their care. You are a department head. That is a write up. Let NO one place their hands on you, and if the ED doesn't agree, call corporate compliance...there is someone over their heads....absurd
Jun 10, '09
All of that ran through my mind at the time, but I have only been there a short time and couldn't figure out how I should handle it.
Jun 14, '09
I worked in a place that was the opposite of what you are going through. The upper management thought the MDS nurse was the be all and end all because she knew how to work the system and always made money for the company. She was rude to the families, demeaning to the staff nurses, and was the cause of 2 doctors leaving the facility. Yet, she was allowed to act that way. There's got to be a happy middle point and we ALL need to be valued for the jobs we do.
Jun 15, '09
Yeah I worked in a place where a bookkeeper pulled something and helped make things profitable, but she cursed and was nasty, smoked where she wanted- even in front of the signs stating this is a no smoking facility. I stayed far away from her....
Oct 6, '09
-very good point and yes too many people think we do nothing but sit at the computer all day. I helped work the floor saturday cause someone's kid was sick made me really miss the resident's loved sitting there and feeding them. It is sad that some DON's dont understand. Today have been working my tail off getting careplans just right for thursday while people are out smoking, 2 hour lunch breaks very aggravating but I must worry about what I need to do just tired of feeling the the whole interdisciplinary team!!! Social worker-once a month-Dietician- once a month, Occasionally a DM to careplan meeting, The activity director I give her kudos she always brings her section N to me and is now doing her own careplan. I put the CP's in a folder and heck there have been days she misplaced them. anyways, could be worse I am sure.
Oct 9, '09
Was teaching a few new nursing students some rudiments of the MDS/RAI process today. They were very impressed that there is one tool that designates reimbursement, helps begin the care planning process and gives the state our QI information. Makes me realize how important what I do really is. Yes, I am the most important nurse in the building at times. I can still run a code blue, I CAN, but WON'T do a floor shift, CAN and WILL do an occasional supervisory shift, but to me: Seeing the facility get paid what we deserve is just as important. My Med A daily rate was $60 over budget for September, and even though only the Administrator, Rehab Manager and Business Office Manager and myself were privy to that, I can look at the patients, the staff and the building and know, KNOW, that I am as good as it gets. I have a very important job, and I do it to the best of my ability. The IDT management is like herding feral cats. Nasty nurses who hate my care plans
and their own jobs don't bother me at all. If I did my job the way they do theirs, our facility would close. I don't care, I've found my bliss.