Need advice

[gatlingt]

I'm an RN, working in LTC. Started a new job a month ago, and have unfortunately found the facility management to be very unprofessional. Being new to the nursing home environment (after having worked in a doctors office the last 4 years since I became an RN), I received 3 days of orientation. In this time, I had very little actually training, as my preceptor was an LPN who has only been at the facility herself for a couple of months. Despite this, after a month of mostly figuring it out on my own or asking questions of my co-workers when I could not, I experienced a horrible shift last evening that now has me questioning whether or not to even return to work on my next scheduled shift tomorrow evening. I work on a skilled nursing hall where we typically have 20 patients per nurse (3 of us on 3-11 shift) with 4 CNAs total. So last night, halfway through the shift one of my fellow nurses became very ill and left to go to the ER. Our unit manager was made aware and after calling around with no success on a replacement, told the remaining two of us to split the hall (giving us 30 patients each) for the remaining 4 hours. Despite this, where the shift went wrong for me is thankfully not patient related. Instead, as I walked out of a patient room (at the end of the hall, where I had just set a patient up an iv pump, given an injection, a nebulizer treatment, and oral meds), I was blind sighted by the Facility Director, who came towards me yelling about how the phone had been ringing for 20 minutes (he was calling) and saying someone should have answered it. (There is no receptionist at the facility after 430pm on M-F or all day on weekends/holidays) Without giving me a chance to even respond, he stormed out of the facility. While I certainly understand his point, I do feel that his behavior was completely unprofessional. (There were patient's families visiting and several CNAs in the hall during his outburst). How should I approach him regarding this issue?

[Tait, MSN, RN]

Personally it sounds like he was unaware of the situation, took it out on the first person he saw, and probably had other unknowns on his plate. I would schedule a time with him, sit down and address the issue as professionally as possible. Perhaps see what he knew, and make sure he is aware that there was a shortage issue and that you didn't appreciate him coming down on you like that.

It sounds like two bad situations that unfortunately collided on top of you. I wouldn't condemn the entire facility just yet over it, though the orientation sounds pretty sketch.

Tait

[Esme12, ASN, BSN, RN]

Don't.....consider the source is my first response. I would go to your manager and discuss this with her and then ask for a meeting with the director. My experience is that your concerns will fall upon deaf ears.

[proud nurse, BSN, RN]

One thing for sure..I wouldn't go to the facility director alone. I hate when I need to go to people and I'm full of emotion, I just feel like they have the upper hand.

The other things you described are quite the norm for LTC, unfortunately.

[TheCommuter, BSN, RN]

How should I approach him regarding this issue?

I wouldn't approach the facility director (a.k.a. facility administrator) about his behavior after the fact. If you approach him alone, I can almost guarantee you'll be targeted in the future. This advice is coming from someone who spent six years in various LTC facilities and has seen crazy politics play out.

Next time, confront professionally and coolly as soon as it happens (for instance, "Please do not talk to me in that manner," or "Please do not yell at me in front of people"). I'll bet top dollar that the facility director (a.k.a. administrator) doesn't even remember you or the yelling incident.

Now that the incident has already happened, follow your facility chain of command and report to your unit manager, ADON, or DON. Good luck to you.