The_thinker

Hi for all my friends in long term care, How much charting do you have to do. Some of our patients have a total of 3 to 4 notes per shift. SBARs for basically everything. The same patient could have many SBARS in the same day like for example sbar for fall charting, abt , other post incident. It could go on and on. The person could have a hang nail and SBAR time which goes over 9 shifts. We used to do the initial SBAR and then a nurse note. Although some people got away from it, my self-included at times. I know we must document to protect ourselves. The same patient could be on SBAR charting for the shift and also have an adl note and behavior note for the same day. We can not combine them due to them having to be numbered. Its driving me crazy. We even have to lock the book that tells us how to chart up now. If I sound frustrated, I am . I don't think administration really appreciates their staff. We had a change in administration and new everything. Maintenance used to assist us with getting our oxygen tanks and now we have to. They are outside. This is a task in the winter our basically any other day that I really don't have time for. Especially with the types of patients that we have. Nursing administration just seems to not remember what it is like to be on the floor and take care of people. I know change happens. Just venting and this is why I am desperately trying to leave long term care. I have been at my place of employment to long in actuality. The emphasis seems to be on the charting and very little of the patient.

Ok I will probably get blasted for this. I am doing a practicum and am an introvert (it really stinks sometimes but I am not going to change after 50 years). My preceptor calls me up today basically saying I don't ask enough questions and seem not interested. In theory she is right on I don't ask enough questions. In fact, it was questioned whether I was just doing this because I felt I had too. I may have an opportunity but pay wise it might not be good and hours could be long as it could involve setting up the health room. Um I am not in it for the money and surely could make more if I stayed long term care. I find the kids rewarding. I know I will have to advocate for them and isn't that what nursing entails. I am sure most of us have done so. I am just a little frustrated as it comes at the end of the term with 2 classes left and not midterm. I realize it is hard being a preceptor and they can't read my mind, but I am a little beyond irritated. Unfortunately, it takes me a little while to get comfortable in a setting but once I do, I shine. I wish I could be the extrovert. I am seeking my certification in school nursing. I work in a school already and love the kids. I love doing what I am doing and feel I can advocate just fine for the kids if I need too. I have been a nurse for over 22 years in long term care where doctors were not present, working the floor by myself, and taking care of anywhere from 24 to 46 residents. I have dealt with making decisions on having to send residents out and of course calling the doctor to get such orders after doing a detailed assessment. I know it is different from school nursing however I have not had people holding my hand there neither. I know when a patient is going bad. I have had to deal with several issues at once. It's not always slow in long term care. I just want to vent and have been tearful all afternoon. Just keeping the faith and I developed a list of questions for Monday.

Thank you just trying to find my spot in nursing.

So I have a question. I am a long term care nurse over 21 years. We do have hospice patients and I am familiar with end of life care. I prefer to give my patients a dignified death. Sometimes families keep on trying and trying when these patients are worn out. I am thinking of making a switch as I am burned out of ltc. One can get burned out with any job though, I know. I don't have anything keeping me to my current place. I actually entered nursing years ago hoping to do hospice but around here lpns were not welcomed. I am now an R.N. and would love to go in another direction. My question is weather concerns. In ltc I have to go in to work in blizzards. I am wondering if you are scheduled to do 4 o6 patients do you do that providing they are stable . Of course if actively dying , I feel that yes most definitely get yourself out there. Just curious. Thanks.