nursing as a profession

Thanks NRSKarenRN those links were very velpful.

llg - I most certainly was not asking anyone to do homework for me. My assingment was mostly finished when I posted my question and has now been finalised. I was simply looking for a few more ideas or points, maybe something I hadn't thought about. I am aware that most nurses on here have many more years of experience than the 10 years that I have which is why I chose to ask on here! Please do not judge.

I have an issue, at my facility. I was wondering if a union would help. I read the posts about "the good, the bad, and the ugly," and I'm still confused about the situation.

I work in a long term care facility. A lot of our residents have behaviors. Violent, dangerous, vicious behaviors. My CNA's are punched, scratched, slapped, have soiled briefs thrown at them, and even I have scars on my stomach and wrist, from crazed residents, who goudged through my clothes. We complain, document, fill out mountains of incident reports, yet still, noone does anything.

I understand the state protecting our residents and looking out for THEIR safety, but who protects the staff and looks out for OUR safety?

Another shortfall, with my facility, is that there is no overtime allowed, there's not enough time to do our jobs, there's not enough staff, no patient/nurse ratio, and I feel like we're being set up to lose our licenses. Census should have nothing to do with staffing numbers. Acuity should. In our state, of KY, there is NO regulation on patient/staff ratio.

52 residents, 1 nurse, 2 CNA's. 2 CNA's can NOT possibly be able to answer call bells, monitor uncooperative, combative residents, turn, reposition, and change residents q 2 hours, with that many residents. Not to mention, passing meds, vitals, treatments, interacting with patients and relatives, answering phones, dealing with Dr.'s on issues that arise, chart, and actually DO OUR JOBS! I'm helping the CNA's a good portion of the time. I have a choice to nurse, chart, OR do treatments. Skin issues are getting worse. Assessments that could, potentially, be fatal, can't be done properly or in a timely manner.

Excoriation found on a resident's peri area requires assessing the resident, charting, notifying the Dr. and family, pain assessment, wound care assessment, care planning, incident report, writing an order and sending it to the pharmacy, sending a communication to the wound care nurse, filling out a VERY detailed report on the computer, and obtaining the specific cream from the med room. This takes a LOT of time. With short staff, creaming a resident, during a brief change, isn't a priority. Creams aren't allowed in the rooms, due to a resident using Anti-Fungal cream as Poligrip.

Skin tears, bruises, lacerations, patient-on-patient abuse, patient-on-staff abuse, falls, soft heels; we all know what can pop up, unexpectedly. Some have even MORE paperwork involved.

I'm at wits end. I really feel like, if State comes in, not just for me, but for ANY of the nurses, at my facility, we're in danger of missing ONE chart...and it'll be the one that was important. Yet, we're required to call the DON if we need more time, on the clock, to finish our work. We always get denied the time. We're REQUIRED to punch out for lunches that we don't have time to eat. We clock out, go back to work, clock back in, in 30 minutes (if we remember). Taking a 30 minute lunch can, realistically, set us back an hour or two.

Who do we complain to? Who is our "Omsbudsperson?" Do I call the state? I'm a VERY good nurse. I can see the shortfalls, in our facility, more clearly than anyone else. I'm the only floater, so I work ALL units, ALL shifts. I complain to deaf ears. The administators avoid me, at all costs. I'm probably getting a bad reputation, from complaining so much but what's it going to take? A resident dying, because we didn't have time to get away from a resident who's beating up a CNA because he doesn't want his pressure alarm on his wheelchair? It makes no sense to me.

I'm sure I'm going to get some responses, saying to quit this place, and get a job in a better environment, but to me, it seems like a simple fix if only someone would pay attention. It's all just falling on deaf corporate ears. At this point, I don't even WANT to be a nurse, anymore. If I stay, in this field, I'm thinking that there's a need for corporate consultants, that go from facility to facility, listening to staff, observing patients, seeing what's wrong with the way things are done and FIXING them.

I wish I had some word of encouragment but I do not. You need to take care of yourself as you are in a very unsafe environment and your BON will hold you responsible. My advice would be find another job elsewhere and contact your board to find out where to file complaints to the conditions you have seen. Good luck.

TuTonka