This is the first time I let out a pure personal venting on this site.
My facility is undergoing a stressful stage of preparing for re-survey, so consultants are often hanging around with hawk-eyes. I was followed by one today. One of the many mistakes I made: I drew several syringes of insulin, labeled by their room numbers as trays were being passed. I was caught with handful of them. The consultant said, "What are you doing? What's that in your hand? Go show them to your DON." I meekly opened my hand and showed those syringes to my DON who was sitting nearby. She looked at me and asked "Who oriented you? Is this how you were taught?"
To feel like a child caught doing something naughty, at my age...
Now, I love working there. I still can proudly say I don't regret a thing after working there for several years. However, the nursing practice as I envision it as opposed to what I'm expected to do from the corporate, there's so much disconnect that I sometimes want to say "The hell with it all!"
Is any of you working in LTC capable of doing everything by the book when you're responsible for the number of residents under your care? It's an open secret that we all take shortcuts. Do you actually take BP before every single BP meds every single day? Do you check placements of GT every time? Do you give meds to GT patients by gravity every single time?
For the 30-something number of residents I'm responsible for, it would be a miraculous day if I finish passing meds in two-hour period, doing all those above. And of course there's always something happening with residents that require me to engage in yelling contest with pharmacy people, lab people, doctors' offices, etc, on top of the frustrating amount of redundant paperwork. Then there are your superiors constantly on your back regarding overtime.
They talk of time management, so we learn to manage our time. We somehow learn how to do all the impossible things in the given amount of time. What I did -- drawing up all the insulin at once for the seven or eight people who needed coverage -- was one of them.
I worked telemetry floor prior to this job where any insulin had to be double-checked with another nurse. Believe me, I take insulin very seriously. Also, I take any med error seriously. And I'm always on guard, watching myself, second-guessing myself because I would not forgive myself if I made a med-error. So I devise my own way to do things correctly in the least amount of time.
Now, by taking shortcuts, do I make time to have my lunch? For idle-chat? To sit around? Ugh... I'm running around answering call lights, talking to the family, more importantly, talking to the residents. I have several residents who suffer from uncontrollable outbursts, panic attacks, to name a few. Every day I'm amazed how their symptoms disappear when some one-on-one time is provided, like this elderly lady who constantly calls out "Help Help!" with no apparent reason, but immediately calmed when I take her out to the patio or just wheel her around, talking.
Does the corporate want automatons of nurses who shove the impeccably prepared cups of medicine down the throats of the residents and no rapport? The perfect care plans and the correctly charted entries full of pretty words when none of it took place?
I'm not saying we should be allowed to take shortcuts. I'm saying we should be given the realistic amount of assignment for ideal nusing care, survey or not. Why must I be cornered into having to take shortcuts and then be punished for it without any real solution to do otherwise?
