yep..first job and i choose ltc..guess i didn't really choose it, it's the only place i could get. the facility i work for is the only one in the state of indiana that still takes residents to smoke (just one of my gripes). to keep this as short as possible right now i'll only list my most urgent problems. #1 medpass from hell. i am the charge nurse for the whole dang facility (i so didn't know this when i hired on..guess it's because i'm on the skilled unit)..and on my wing alone i have 32 patients. 5 which are very frequent fallers. i get to work a little before 6 so i can fill up my ice chest and stock my cart. i get report and count meds. from then on i do not stop moving unless i'm stopped popping pills and signing the mar. first thing i do after ice/supplies and such is giving my insulins and doing bs's and sliding scale insulins. then i'm popping pills like a crazy woman..trying to remember to sign the narcs out when i get them. i've cut back on my time a little by combining a few medications that i know can safely be taken together. i cheat a little bit by giving meds before and after the "hour long" window. window? i need a dang garage door. anyway...i have 2-3 aides..some are good...some completely suck. either way, they are hardly around. we have a quad on our unit that needs turned every 2 hours which requires three people and takes forever. they use that as an excuse for everything, but i also know they take breaks, they go eat, they go linger and talk, and they go smoke. i'm doing good if i get to go to the bathroom by the time noon comes along. one thing that really burns me up is when i see one of my young and very pregnant aides just sitting behind my desk drinking and eating when i haven't had one darn thing to eat or drink. even combining the meds i still have just enough time to get to the dining hall to feed those that need it. i was late once and was wrote up by the kitchen manager!! even though i'm stressed, i am getting all of my meds passed by the end of my shift and able to fill out my charting and skilled charting. now i'm getting "talks" on why my treatments aren't getting completed. how the hell am i suppose to do all of those on top of everything else. i'm answering call lights, toileting those that needs it..and taking an hour or so up to three times out of the day to feed people. i can help the cna's...but they can't help me with the meds, the bs checks, the insulin, the g-tube care or the colostomy that some guy just loves to rip off all the time. what can i do?? i'm short changing these people...they aren't getting the proper care, not even close. i'm only there for the experience and money..but i feel horrible. advice?? i'm at the edge and getting ready to go over!
You can tell pg aide that this one did her job and more through 2 pregnancies. Lifts and all. If she is not put on LD by her MD she should be doing her job.
I recommend that you get a copy of the CNA job requirements from your DON. Discuss how the facility goes about correcting lazy behaviors. No precedent? Be kind, but firm. You are a nurse and you know the reasons for what is being done when. Explain that in one sentence and move on. If an aide choose to be disrespectful-direct to supervisor and move on.
Penholder
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You can tell pg aide that this one did her job and more through 2 pregnancies. Lifts and all. If she is not put on LD by her MD she should be doing her job.
I recommend that you get a copy of the CNA job requirements from your DON. Discuss how the facility goes about correcting lazy behaviors. No precedent? Be kind, but firm. You are a nurse and you know the reasons for what is being done when. Explain that in one sentence and move on. If an aide choose to be disrespectful-direct to supervisor and move on.