Please, someone tell me how to stay out of trouble and keep my job.

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Specializes in Med/Surge, Psych, LTC, Home Health.

...... that's all I want to know.

I work my butt off at my job, I have 54 residents to watch over, I try to do my best job 99 percent of the time at least... I really do try very hard to get my work done, get my charting done, plus just make sure everyone is okay.

Last night I received a write up... because one of my residents, a lady with known behavior issues, dementia, non-compliance with meds... just returned from a stay at a psychiatric facility... called her roommate a *****, and I didn't report it RIGHT AWAY, at 6 o clock in the morning while I'm doing my med pass, to the DON. Attached to the write up was a post it note that said, essentially, "I'll decide what your consequence is after I review your file".

I would understand reporting say, two men having a heated verbal altercation. Two women calling each other names.

Anyway.... I just would never have guessed that this was reportable. I feel like I don't know anything sometimes. I feel like I completely lack that CYA mentality. I have a hard time seeing details; I see big pictures. It's the kind of person I am.

I've been at this job almost six months and though I hate to, I've just got to find another job. I'd really love to go back to psych. *sigh* But as long as I'm in LTC, HOW do I stay out of trouble????????

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Specializes in Gerontology, Med surg, Home Health.

I report just about everything,but I would NOT report one resident calling another resident a *****. If a staff member had said it for sure, but one resident to another? Nope.

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I would write a progress note in this situation. What your interventions were (separate the two for example) Document that. I would speak with whoever talked to you again and spin a good light on it, meaning for example something like "Im very interested in learning/reviewing our policies and protocols. This lets them know you want to learn and are dedicated to your residents wellbeing. In that talk, clarify who needs to be called so you can show them you dont want this to happen again. This approach saved my butt : )

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I report just about everything,but I would NOT report one resident calling another resident a *****. If a staff member had said it for sure, but one resident to another? Nope.
Absolutely agree. On our Alzheimers unit, curse words go flying and unless it gets phtsical, we simply intervene, separate the 2, and di behavioral charting.
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Specializes in Rehab ER post/op pediatrics.

As unfortunate as that situation is.... It's an epidemic in nursing at this point. Chief/Indian ratio which can be sooo dangerous when the self-proclaimed chiefs don't know their head from their ass. But my advice is to job hunt and really investigate the place. Idk where your from but I'm in south bend in and we have 8 nursing programs. So nursing jobs are a dime a dozen with RNs coming out of the wood works on regularly scheduled 3 month intervals.

I wouldn't say you don't have a cya mentality though because you acquire it with experience. Idk how long you've been a nurse but as this flood of nurses comes, there will be a stupendous amount of RNs in positions they really aren't cut out for Maybe there should be some training after school to prepare you for the area your the strongest in. What an idea! I remember the first day of nursing school where ya go around the room and everyone says what area they are interested in working in.... Well I rolled my eyes the entire time because how did anyone know what they would excel in? Nursing school has a time frame, but the career is lifelong. Take time and put thought into what your strengths are and be humble about your weaknesses. If for anything your patients sake. Good luck!!

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Specializes in Trauma Surgical ICU.

54 residents to watch over... You have lasted 6 months, pat yourself on the back and find a new job.

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Specializes in Med/Surge, Psych, LTC, Home Health.

Thank you so much for the replies. I'm still trying to decide what to do. I've been a

nurse for 9 years and have had just about that many jobs, or at least it seems. I'm

tired of switching jobs and always being the "new kid".

I actually really love what I do, I love my coworkers, I love my residents.

BUT.... I truly get paranoid that I'm not going to ever be able to keep from doing

something to get myself fired. I see people get fired all the time, for what seem like

stupid reasons. Common sense goes flying out the window in LTC, sometimes it

seems.

I can't AFFORD to get fired again. I was just fired from a job about a year and

three months ago, and I'm trying to rebuild my career. I feel like, if I get fired

again, my career is as good as over.

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Specializes in LTC, home health, critical care, pulmonary nursing.

I worked LTC for almost 8 years, and I never could find a way to stay out of trouble.

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I feel your pain! I once had a job where it seemed like I was always getting in trouble for unpredictable things. Better to move on to bigger and better things than keep getting in trouble. Gotta find a place that understands you're one person taking care of multiple people. Big deal some lady called another lady a *****. I would have documented something about inappropriate language and resident was redirected, etc. But a write up over that? Yea, maybe find a facility that will treat their employees with a little more respect.

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I worked LTC for almost 8 years, and I never could find a way to stay out of trouble.
I totally agree. I see nurses getting in trouble or fired on a regular basis in LTC. Keep doing your best and that's all you can do. You can do things right 99% of the time but that doesn't seem to matter in LTC. Any little thing can get you in trouble or fired in LTC.:(
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I know a nurse in a local LTC who was suspended for administering Advair to a resident for two days after the order ran out. And the stop date wasn't even listed on the MAR. This same facility suspended a nurse for missing two boxes in the treatment book. I really can't imagine what's going through the heads of such managers.why would you go through the expense of hiring someone only to suspend/fire nurses for such trivial BS?

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Specializes in Geri-psych Nursing.

I posted the "combative dementia pt" thread, so I feel your pain. It's almost impossible to stay out of trouble because, as someone mentioned, they're cranking out new nurses at a furious pace (so you can be replaced cheaper) and it seems that new rules are being added daily. Common sense doesn't seem to be at a premium, either. Some places are worse than others. Around here, nursing homes are the worst, while, at the hospital, they at least have a protocol and you get to say your piece. Don't get down on yourself; I can tell you're a great nurse.

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