No fleets! The sky is falling!

[garciadiego]

I'm in LTC, morning med pass takes me till 1030 sometimes, policy is give supp in morning if no bm x 2 days, its done in am cause management thinks falls on Eve and night falls mite be caused by patients getting supp/fleets on those shifts, there is less staff, so they can't get to them in time when they make unsafe transfers. Day Nurse must give supp., if no BM in 2 hr then CNA can give fleets. Well, I don't have time sometimes to give a bunch of suppositories in the am when I have 10 Trillion meds to pass,/so they might get it at 1300, but if they don't poop, and 4 some reason the fleets can't b givenn on days then the Eve nurse has to get one and give it to the Aids to give. When the regular Eve nurses is on and the fleets has to be given on her shift, she Freaks,rants and raves and then I feel bad about my self. How do I respond to her? how do I let her rants not affect me?

This applies to any thing that I could get done, how do I cope with her behavior?

[casi, ASN, RN]

Tell her to stick it where the sun don't shine and give it a good hard squeeze.

Nursing is a 24/7 job. Sometimes poop happens and sometimes things just have to be passed on. Don't let her get to her. Also tell her this.

Another thing to do is to get into the groove of giving suppositories at a set time. Maybe make that the first thing you do. Come on shift, check bowel records, give a couple of supps while people are still in bed, and then start PO meds. Also if you see someone is getting suppositories frequently call the MD/NP and get orders to increase bowel medications. This saves everyone so much work.

[garciadiego]

Great reply both for dealing with Nurse Ratchet and my performance

[CapeCodMermaid, RN]

Your aides give Fleets? Mine aren't allowed to.

Our protocol for no BM in 3 days:

Night shift gives Milk of Magnesia (unless contraindicated). If no BM

Day shift gives suppository. If no BM

Evening shift gives Fleets.

It all works out in the end.

[garciadiego]

Yes, aides give fleets but not suppositories. If our Night shift gave MOM no one would get it, they are sleeping. Eve used to give supp. but management has a theory that falls are related to the shift residents get the supp and fleets and in there judgement, days shift is the safest shift to give them, but it is difficult for the RN, I guess it all works out in the end.

Thanks for your response.

[Donnagg123]

How many people are you guys responsible to give the lax to and how many do you usually leave for her? Depending on how many I would say that she probably feels like you are doing it on purpose at 1300 so then she is responsible for the next step at beginning of her shift. Not saying you are but that might be why she is getting angry. You say your med pass ends at 10:30 is there any way you could stagger some of them out after that instead of waiting till 1300? But I also agree that it is a 24 hour facility so sometimes she will have to understand that some things will get passed on. JMHO

Also i as well am surprised that Aides can give a fleets. I would think you would have to assess, what if it inadvertently triggers the vagus nerve?