buddy5630

I am an RN and have been in LTC for 20 years. Not long ago I "helped out" at a tiny out of the way place where the residents did NOT wear briefs and the pads were all cloth, no chux allowed; in addition to the great turning done by the CNA's (or nurses), I never saw such beautiful skin! It was surreal and I never forgot that.

When I first graduated in 1984, there were no nursing jobs and I ended uo going Agency and sustained myself for many years on agency work. I loved it, people were always nice and helpful to me; I made lots of friends and get lots of job offers. Now I have been a FT RN at several facilities (LTC) and when agency nurses come in, I am ALWAYS glad to see them.I think even if I had not been an agency nurse myself, I appreciate the help! I currently work at such a money pinching place that they refuse to utilize agency staff relief, have NOT ENOUGH staff of their own and it is becoming increasingy worse and worse. Were it not for that the agencies out there now are so often fly-by-night and crappy, I am wishing I could go back to it.

The Facility's budget/income is NOT your concern! Your concern is your patient's well being and his/her wishes (family's too). Your concern is doing within your scope what you should do and abiding by the (ridiculous) supervisor's monetary guidelines is ludicrous. Aren't some people NUTS?

At the LTC facility where I work, this kind of omission is par for the course. I don't know what to do anymore. No one seems to care about anything except whether or not their relief shows up. I have been in a quandry about this for some time: I have patients who are ordered 10 and 12 mg Coumadin each evening, get a PT/INR back of 1.3 and 10. What?? I have brought this to the attention of Administration and invariably nothing is done. I have changed jobs already twice just this year alone because I keep dreaming that somewhere things are the way they're supposed to be. I am at the point where I give up. Must decide if I am going to play the game and ethically live with myself or starve (nursing is all I know) because the BS that goes on is making me wonder about my OWN intergrity..thanks for the thread and thanks for listening.

:uhoh3: staffing situations so often now the norm, I have always held to the principle that CNA-LPN-RN Supervisor distinction (Except for the obvious) is out the window...we have 120 patients who need us able bodied clear thinking human beings to help them with what they are no longer able to do independently. Forget rank! If an RN Supervisor thinks for one second that she or he is too elite to change a brief or help the LPN with treatments of maybe do the accuchecks for the morning, then get another job because this situation promises only to worsen with time. Soon we may all find ourselves in the kitchen cooking and serving the trays! I am so passionalte about this lately. Of course we always are mindful of our designated positions and attendant responsibilities, but we are all people too and should we ever willing to pitch in to help one another and the patients. PS: I do not know what ncc means, what is that?

All I have to add to the overwhelmingly ABSOLUTELY YESes that have already been posted to your query is that now a days, with the pitiful nurse-patient ratios that we must contend with in LTC- almost do the documentation BEFORE you worry about getting the meds passed if time is your issue;the entire scene has become surreal and nightmarish, hasn`t it? Families will not hesitate to go to court over such things as grandma`s bruise that becomes evident 2-3 days following a fall. Chart your butt off and make those phonecalls-the meds can wait (they do anyway, what`s another 20 minutes). What a mess this all is anymore...

To you who was terminated after having your baby: It`s all about the money and your PRN Position cost your employer more than if you signed on as Part Time or Full Time. Please don`t be offended if I seem to insult your intelligence by pointing this fact out to you. That you have been such a willing, flexible, and apparently dependable quality care deliverer does NOT rate anymore. This is my conflict anymore about our profession... God blessed you with your new baby and I believe there is a reason for everything that happens to us. Good luck to you and keep your heels dug firmly in the snow.