I am currently employed as a direct caregiver at a LTC facility for adults with disabilities. I am not certified as a CNA, but the job I have is meant for CNA's (as in you either had to be certified or had to have atleast 1 year of related expereince. I had the one year of related experience).
My duties are similar to what a CNA would do. ADL'S, documentation, etc. Since it is a longterm care facility with a patient care tech, I don't get to do anything with documentation and we don't really take vitals. Still it's good exposure with transfers, helping with feeding, toileting, etc.
I love the work. I love the clients and feeling like I'm doing something useful in the world.
What I don't like: the politics. The other people who are in my same position. they gossip constantly, are catty, and are just plane rude.
Here's the other thing that really bothers me. Some of the rules at this place are messed up.
For example, there are two pagers that rotate between staff that the patients can press and you have to go answer the page if you are one of the staff with the pager. If you ahve a pager and you don't answer the page you can get written up. And, you can't refuse a pager unless you are 1/2 hour away from the end of your shift, or leaving the building (to take clients to therapies, or into the community), or 1/2 hour from your assigned break.
Here's the thing though. There are a few clients that we have that are 1:1, which means that you have to be an armslength away from them at all times if you are assigned to them. If you are not an armslength away from them, you can be written up.
The dumb thing? If you are 1:1 and someone asks you to take the pager you have to take it. So either way, you can get in trouble. If you ansewr hte page and leave yoru 1:1 that is a violation. If you don't answer the page and stay with your 1:1 that is a violation.
This is only one example of many of the double standards that are here. I feel like they do this just so their liability is covered...no matter what happens, you are to blame, not management.
I like my job and I don't want to quit because i've grown really attached to the patients there. What scares me, is that is this the way it is going to be when I"m a nurse? I mean, as a nurse, you have even more responsibilites to worry about.
It's really wearing me down. I love the work, but I don't know if I can stand the environment. I was written up for using my best judgement when I got a page. I left my 1:1 (who was asleep, in bed, with the bedrails up and in my opinion doesn't really need a 1:1 as she can't really move herself out of bed) to go and answer a page of a client who I know is impatient and gets really, really upset if she has to wait.
I guess my question is are there double standards at most places in healthcare? Does this sound normal? It scares me because I am really frustrated and Im doubting wanting to be a nurse because of this. Which is sad, becasue really, I love the patient care.
I can only speak for myself and my workplace. We have "convenience policies" that change depending upon the weather. I'll give you some examples:
There are to be two RN's for the first 15 minutes of a post surgical patient in PACU - however, this only applies if it is Monday through Friday, day shift IF there is adequate staffing. If your called in, after hours, awe, too bad.
For all ICU patient, there is to be two RN's to one patient. See above exceptions.
For pediatric patients, two RN's per patient - see above exceptions.
No p.o meds to be given in PACU, NONE - except p.o motrin for children. This is not actually written as a policy, just a RANT from anesthesia because one patient choked on a Vicoden.
The others are actual policies, without the exceptions noted in the policy. Management will state "use your OR circulating nurse as your second nurse after hours" - well, it's been reported that the majority of the OR nurses just want to get the HECK out of there, and after cleaning their rooms, they are GONE typically within 15 to 30 min, while you still have your ICU patient in PACU with one nurse.
Mangement does nothing about this. If anything goes wrong, they will blame it on the PACU nurse and the OR nurse. "Why didn't you ask the OR nurse to stay" or "Why did you leave knowing the PACU nurse had an ICU patient". Or, if something went wrong and you needed extra hands, press the code button. More than one person got nailed for that, but management still uses it. Management is covered - we get nailed.
There is the policies, and then reality. Needing second signatures for some medications ie: PCA's, insulin for example, again, difficult after hours. I've tried calling the nursing supervisor for a second signature, to be told "I'm too busy, just call around to the floors and try to get another nurse". Yeah, I have nothing to do except make numerous calls for a second signature while my patient is writhing in pain. All of us PACU nurses will usually start the PCA anyway. So far, we haven't gotten dinged, but it's gotta happen sooner or later.
In reality, the nurses on the other floors are just a busy as you - I've been told "Okay, I'll be there in a few", 20 minutes later, no one shows up, so I start the PCA anyway.
There is real life, and Management's "pretend" life. I'm not saying the policies aren't necessary and most of the policies make excellent sense for the patient safety and the nurses, but only if they can be followed WITH cooperation 24/7. Otherwise, they aren't worth the paper they are printed on.
Babs0512
846 Posts
I can only speak for myself and my workplace. We have "convenience policies" that change depending upon the weather. I'll give you some examples:
There are to be two RN's for the first 15 minutes of a post surgical patient in PACU - however, this only applies if it is Monday through Friday, day shift IF there is adequate staffing. If your called in, after hours, awe, too bad.
For all ICU patient, there is to be two RN's to one patient. See above exceptions.
For pediatric patients, two RN's per patient - see above exceptions.
No p.o meds to be given in PACU, NONE - except p.o motrin for children. This is not actually written as a policy, just a RANT from anesthesia because one patient choked on a Vicoden.
The others are actual policies, without the exceptions noted in the policy. Management will state "use your OR circulating nurse as your second nurse after hours" - well, it's been reported that the majority of the OR nurses just want to get the HECK out of there, and after cleaning their rooms, they are GONE typically within 15 to 30 min, while you still have your ICU patient in PACU with one nurse.
Mangement does nothing about this. If anything goes wrong, they will blame it on the PACU nurse and the OR nurse. "Why didn't you ask the OR nurse to stay" or "Why did you leave knowing the PACU nurse had an ICU patient". Or, if something went wrong and you needed extra hands, press the code button. More than one person got nailed for that, but management still uses it. Management is covered - we get nailed.
There is the policies, and then reality. Needing second signatures for some medications ie: PCA's, insulin for example, again, difficult after hours. I've tried calling the nursing supervisor for a second signature, to be told "I'm too busy, just call around to the floors and try to get another nurse". Yeah, I have nothing to do except make numerous calls for a second signature while my patient is writhing in pain. All of us PACU nurses will usually start the PCA anyway. So far, we haven't gotten dinged, but it's gotta happen sooner or later.
In reality, the nurses on the other floors are just a busy as you - I've been told "Okay, I'll be there in a few", 20 minutes later, no one shows up, so I start the PCA anyway.
There is real life, and Management's "pretend" life. I'm not saying the policies aren't necessary and most of the policies make excellent sense for the patient safety and the nurses, but only if they can be followed WITH cooperation 24/7. Otherwise, they aren't worth the paper they are printed on.