Published Oct 12, 2009
Katie5
1,459 Posts
Hello again everyone. I appreciate all the tremendous advice and support I get from here. Pls help me out on this again.
So last time, I wrote about working in a Long term acute care and trying to get the hang of it. Well one has only 3days to orientate on the floor and then you're done with it- nothing is totally explained and if you ask, the response goes something like this- "Weren't you told in nursing school that...." and on.
Ignorance is NOT bliss, so I accept responsiblity on a a few med errors I made. So now I'm to start on a new unit. My question is this, does being on a new unit solve anything? Or would an entire startover be the main thing. Pls advice.Thanks:)
CASTLEGATES
424 Posts
nursing homes are horrible; I'd definitely be killing some accidentally given the work load and chaos while they're trying to turn a buck. My med errors were all in chaotic, disorganized units. The system there obviously is conducive to errors so you're not the only one. Having said that the R's need to be adhered to like air!
My errors were when I'd fill two cups and hand em out. Luckily minor (as I panicked and fessed up) but someone could have died...someone could have DIED. If you can't give em accurately, don't give em. Make sure you're checking and checking then you can't go wrong.
nursing homes are horrible; I'd definitely be killing some accidentally given the work load and chaos while they're trying to turn a buck. My med errors were all in chaotic, disorganized units. The system there obviously is conducive to errors so you're not the only one.
Thank you so much for this post, I was seriously begining to have a rethink! The med cart is chaos in itself. I try( with what little time) to arrange the meds in order and put overstock in bottoms, it works for a while and then BAM**^^^!!! chaos again.
readytoroll
145 Posts
I learned from a CMA (I am a brand newLPN) at my first and only job so far that writing the patients last name or room number on the med cup will save you from giving the wrong meds if you have to pour more than one cup at a time (or if a alzheimers patient refuses and you need to try again in a few minutes). Our carts are pretty well organized (thank god the nurses are work with are anal retentive like me) so my biggest problem is holes (have to go back and check check check) Any great tricks for avoiding holes the first time. I am going to start running a ruler down the book I swear! :grn:
litbitblack, ASN, RN
594 Posts
Hints...if you know your resident is going to be difficult or take an extended amount of time save them for towards the end.
newtress, LPN
431 Posts
All of the above is exactly what I just experienced recently and just gave notice. I had to. The med cart situation was like going into someone elses house and trying to go through the junk drawer. Nothing was organized and most of the important items were not in there like the insulin necessities. The OTC bottle tops looked like they were labled by a fifth grader. I was moved to another unit and it was double the trouble, after I had just started to get the hang of the disorganized understocked med cart I was on originally. Yep.. med errors started to occur and with computerized MAR and charting it was a nightmare for me. I ended up most nights having to stay hours overtime to straighten out the shift I spent as a whirling dirvish. I interviewed the following morning for a hospital position and was hired. At the end of the interview I looked at my feet and said to myself "thank god I won't be going back to that place." I was only asked once why I felt that I needed to give notice at the current position and I told the Chief Nursing Officer "well last night, me and my license had a little talk and we decided it was best for both of us to be in a structured professional nursing environment" she just loved that and asked nothing further about my previous experience.
2liss
1 Post
I have been an LPN for 1.5 years. Just starting working in one of "those" long term care places. I have 43 patients on my long term care unit. I am the only nurse and only have 2 CNA's. We work together as best we can. Things were horribly disorganized when I first started working. The med room had seasonal decorations in it. Meds were expired. Carts were out of order. It was horrible. I just had to clean it myself so I knew where things were. Talked to unit manager about messiness. Things are cleaner and more organized now. Job is still hard though. It is this way with a lot of nursing homes. Hospitals have better staff ratios and home health care is a great place to get the confidence you need for a new nurse.
kieta2006
10 Posts
Wow this post came just in time need opinons i work in a RCF that holds 40 residents but now only have 27 i'm a we have 7 medications tech im one of them we do alot of paper work, wash res. cloths, now will start giving baths to residents,state only required us to have a nurse for only 8hr for the whole week not every day just to go over the paper work and to sgn off on orders i just feel were being overworked but now they are coming up with and almost miss has anyone heard of that out there is an med error and you are to write yourself up because you almost for got a medicine or took something back at the last minute i think this is crazy due to your resident got the right amount of medicine they needed PLEASE LET ME KNOW WHAT YOU THINK ABOUT THAT OR HEARD OF THIS ALMOST MISS BEING A WRITE UP
nicunana
90 Posts
Kieta,
Near misses need to be written up because they indicate a systems issue, not an individual error, and need to be corrected. By tracking the near misses, it's possible sometimes to see a specific trend & fix the problem. Most errors actually are as a result of a flawed system. The fact that you are able to catch the potential error before it happens shows that you are paying attention & doing a good job. Maybe the next person won't be able to catch the error in time & that's why it needs to be reported, tracked & hopefully fixed. Does that make sense? Otherwise, no one knows the potential pitfalls out there. It goes back to the "It's the squeaky wheel that gets oiled." I hope you see this as a positive thing now & don't feel so threatened by having to "write it up."
I love that last part, perhaps I could borrow it:)
I read your info and just have to say sometimes you just can't help feeling so threaten by such info we 7cmt's have been there for 10yrs or more we all really love what we do and care about the residents here with in the last 7yrs we have had 6 supervisor (LPN's) come through were i work at its just that we do so much and feel that the company just dont look at that part you just would not believe my employee i work with we fill in for each other our attendance is excellent no girl calls on the weekends plus its only one person on the weekend the last two shifts i would say out of a year most of the girls only call of none at all during the year.
thank for you info kieta2006
Yes please do tell whom ever is interviewing you how you feel about your nusing license being a part of you, something to protect. This way you're not left having to tell or explain the horrors of your last position. They will know you were trying to protect your license and there must have been safety issues (safety issues galore!)