ResponseNurse1987

IF the patient felt moved to nominate you, they would do it whether you asked them or not. No, in my humble opinion, it is not okay. Almost like pressure tactics to score an extra bonus off of their misfortune / poor health. I'm sure that you weren't being malicious, but, it could be perceived that way by your patient or his/her family. I will playfully / laughingly say "well make sure you tell the boss" if a patient brags on my care or diligence, but never would I shove a nomination form in their faces and say "here fill this out and make sure you say how good I was". The idea of a Daisy is okay, but, let's not focus on the rewards......rather..... focus on the reason. Why do you go to work everyday? Why do you put up with abusive patients, egotistical doctors, and complaining families? You do it hopefully to make a difference, and because you care. Do you need a Daisy to prove that? I think not. ? Focus on the care and healing, and your patients will let it be known. They will request you as their nurse on each admission or ER visit. They will tell their families, who will tell their friends, who will tell someone else. It will get back to your supervisors if you are doing a good job, and/or if you are deserving of any awards.

If MAR was recreated for whatever reason, the dates prior to that rewrite are not transcribed onto the new one. The new MAR should begin from the date that the person rewrote it (I.e> MAR rewritten on 1-21-19 should only reflect does given on or after 1-22-19). At my last facility, and prior to the electronic record, we wrote on the top of each MAR "transcribed on: date" OR "Re-Written:Date:Time:Signature:Initials. This will let others know who rewrote it, why, when, and on what date. At no point should MAR's be back dated or back logged. This is a BIG NO NO. Ultimately, someone is going to be on thin ice because they wrote in your initials for dates/doses that had already been given from what I can tell. I understand not wanting holes in the MAR, but, at no time should someone be given permission to insert your initials into a form unless that person is you! I would suggest keeping copies of your communications with supervisory staff, and date/time them, along with their response(s). Why did they have to re-write the MAR to begin with? Also, refer to your facilities policy/procedure manual. All of the info you need should be there regarding your facility specific policy on MAR and med reconciliation. I am not familiar with LTC, only ER and MedSurg, but, I can tell you that what you said happened would NOT fly in a hospital setting. LTC's are at higher risks for litigation as is simply do to the demographic being served and their families. As long as you reported this off, you should be fine, but, how do you know it won't happen again? Also, if they did this with an MAR, what would stop them from doing it with your documentation or assessments? I would say RUN TO A NEW JOB.....THEY ARE EVERYWHERE!!! You may land in a much better spot when you do!

Rural areas will hire you quicker vs metropolitan areas, simply due to lack of access to nurses. I have worked many years in ER, floating to ICU, and on MedSurg as an LPN. I can now use my experience as a bargaining tool for potential employers. I.E) Recently got hired in a major hospital near my home for an ER position with actual patient care. Most LPN's at this facility simply take vitals and function as glorified CNA's, but, because of my knowledge base and technical prowess, I landed a spot on the actual ER floor oing direct patient care. I am currently going through the steps to get my RN, only because I'm sick of fighting for jobs, and sick of doing the same amount of work for half the pay as my RN peers. Many of the RN's I work with seemed shocked when they flipped my ID Badge over and read "LPN". The most common response is "Dang...I thought you were an RN...you know your stuff". Don't let your title hold you back in your quest for knowledge and development of your nursing skills. Work medsurg for a few years, as this will most likely open up doors for you to broaden your practice. MedSurg led me to ER, which led to ICU float pool, which then led to a spot as a Seniored Staff nurse and Helath Informatics Specialist role. Also, don't stop at LPN! GO ON AND GET THAT BSN..... this way, you don't have to worry about being "phased out". Even though it has been said for many years that LPN's will soon be a thing of the past, I don't see that happening in the coming future. We are in too high of a demand and we can do the job for half the cost to the employers. That's just my personal experience. Hope it helps.