Need to vent!

[NurseQT]

I am getting so frustrated with the place where I work and with many of the nurses I work with... I am the newest nurse on staff, have been working there for a little over a month now. But I am a seasoned nurse with over 10 years experience, and not to toot my own horn but I'm a damn good nurse, I give credit to the awesome mentors I've had along the way! Unfortunately many of my coworkers are on the lazy side but act like they know all and god forbid should their way be question at all!

Last week it was a resident who fell out of his, after he managed to raise it all the way up! The other nurse that I was working with says "well at least he landing on his mat so we don't have to write it up as a fall!" Say what?! How could anyone say it wasn't a fall?! I made out an incident report but nobody did any sort of monitoring on him (I was off for the next few days)! On Tues a resident had N/V, emesis x3, and less than 100cc out in her foley for the shift, nothing documented in the nurses notes! Last night a resident had a decline in condition, pulse in the 30s, decreased responsiveness it goes through two shifts and nobody updates the doc or family, no one even checked her POLST! And nobody charts anything! Then there's two residents with significant weight gain and increased edema, we're talking 17lbs since the first of the month on one and 10 pounds in a week on the other! No one updates the docs or places them on 24 hour report to monitor. During report I bring up the weight gain and increased edema and the other nurse responds "the practitioner just saw her the other day about the weight gain. We all talked about it yesterday." Ok that's fine and dandy but it needs to be documented! There's not a word in the nurses notes about the doc being updated or that the weight gain was being addressed!

I feel like I'm met with resistivness every time I attempt to do something correctly and I don't even want to think about when state shows up which could be at any time.

Ok, that's it. Just needed to complain a little bit. I'm off to bed!

[VivaLasViejas, ASN, RN]

Sounds like a really unsafe situation to me. Any LTC nurse worthy of the name knows that any unanticipated change in planes = fall. And someone needs to teach your co-workers what, where, why, when, and how to document condition changes.

But, you are not that person, and you can't worry about what State will do when they enter your building. All you can do is perform YOUR job correctly and allow the powers that be to handle the staff that aren't. That, and come here to vent anytime. :)

[bluegeegoo2, LPN]

I have worked for facilities that will care plan certain resident's to end up on their floor mat and not consider it a fall. Their alarms must be on, in place and functioning, the bed must be in the lowest position, and they must not suffer an injury of any kind to qualify for a "no fall". Those facilities are few and far between. Any resident that falls from the stratosphere (highest bed position? Yikes!) or otherwise should be written, imo. The State of Texas defines a fall as (paraphrased as I could not find the actual definition): An unintentional change in elevation. Or something like that. I always write the I/R because I know my luck. The resident would break a hip not to be found until days later, then when the investigation found they fell on me and I didn't write it there goes my job and maybe my license. No thank you.