Beary-nice

And thank-you too. I am supposed to be doing staff education but am met with everyday roadblocks of just trying to keep afloat. It will come in time if I am patient. My relationship with the nurses has improved since my last posting. I agree it is important to let staff know that they are appreciated because they don't hear it near as much as they should. We are to the point right now that the nurses come to me for assistance and are starting to make very good judgement calls on their own, and I let them know that I am proud of them for that. I try to make pitfalls into learning experiences for all of us. Seems to be working.

Thanks will have to check these out!

thanks for the info. i would like to see something like this for us down the pike. we are very, very small potatoes and everything is on paper. i came from a place that was highly computerized, so big change there back to old style for me.

You're right some of it isn't you and I know I don't mesh with everybody. I feel you are laying the groundwork to build yourself up and take this head on. I am glad that you stand for pt/res care, that is what is most important and this person in question can either get on the boat or not. I would hope that the DON would do something about this person and possibly needs documentation so she can have some grounds. This DON I think has a few false beliefs. That if she watches and waits hoping this person that is creating a horrible work atmosphere just uses her and her alone for her doormat, that sends a rather poor message in my book. I know assistants are scarce but is this person indispensable??? Sleeping on the job???? C/O others when her work maybe just isn't up to snuff???? ARrrrgh! I do believe that you assist the aides when you can and that is good because they need to see that side of you. Just don't let your work pile up because you are bailing them out constantly, I have had that bite me in the butt too.

Hugs to (((((you)))))). There are always those pts out there that we don't click with. Possibly this man was upset about something else and unfortunately remembers you so lies his unfound complaints. You did nothing wrong and you are being supported by your NM and coworkers. Your NM is just doing her job, and I think you realize that. Don't give up. Continue to do the wonderful job you are doing. Learn and let go.

I very much believe in this statement.

That is too bad. Just remember that wherever you go there will be another one of her, just a different name and face. If you like where you are and what you are doing don't let her rain on it. I was 19 when I first had my LPN license and dealt with pretty much the same thing you are, I feel for you.

I am confused. You are very worried about not knowing what to do and you want to go to ICU. That is what I am getting from your post. I think somewhere in your heart you are burning a candle for an ICU position and that is fine. But, if you are so scared in med-surg, I would be very worried about you in the ICU. In my opinion you need to be on your game in the ICU, they are not going to wait for you there to fret over lab values or fritter about when to call the doc. You need to have some of that under your belt and feel some sort of comfort with it to make hasty yet sound judgement calls. I see some new grads walk right into ICU and do a phenomenal job, in my opinion they are the exception. I also see new grads who go into ICU that struggle initially because they are still learning the "whole" of nursing and are still working on getting some really good assessment skills under their belts. They do well, but not without some real hard work and what seems to be alot of stress at times. It is unsettling to be off orientation, very scary. Are you looking at transferring to another unit just to get some more orientation because it is that scary of a thought? It is scary, but at some point you need to jump in and the rest will come together. Know the nurses you can go to for resources and who are willing to help you learn. Think before you leap. I don't know of an orientation that I ever completed that made me feel "comfortable" with everything I was having to face. I have always seen orientation as a get you going type thing and the rest is what you make of it. Believe me, I had to learn alot the hard way. I have had a few docs yell, a few nurses get upset with me, made decisions I wish I wouldn't have, etc...etc. It has all made me who I am now. Orientation was just the puffy part of it all. I wish you the best of luck.

I am slowly getting a handle on the interruptions. If I think about it, it is better than it was. Usually it is the floor nurses coming in the office wondering how to do this or that, generally it is simple stuff like changing med times etc. I am flattered that they want my advice but sometimes it seems like they can't make any decisions on their own, somehow they do when I'm not there. Other times me thinks they want me do their job and mine too. I do need to remind myself that I do get told often how "awesome" of a job I am doing. I only got told that maybe once a year at my eval at my previous place of employment and then again when I was leaving. I just don't always feel like I'm doing well since I am still learning and so overwhelmed. Thanks for the advice and encouragement!

No ADON, all of the LPNs and RNs on the floor are considered "charge nurses", no supervisors really, yes we have an MDS nurse who is a LPN. I have taken over alot of what the MDS nurse was doing because she is now also doing medicare billing. Medical records? I am medical records. :chuckle Yes the DON is my direct supr. Definately agree on the sit down. Just need to get her time and attention, not having much luck there.

Thanks for the support Suzy. I agree I need to sit down with the DON. I have been trying to do that for the past 3 weeks. She is hard to corner. Her and I get along fine. I have worked for her before in the past, just on a different level. My greatest fear is disappointing her. I just can't come to terms with her about the education thing. Maybe now is not the time to push about it, I don't know. I just don't feel it is right to resolve that "nothing can be done" and that "no one will get it it's not worth the time." She doesn't seem to have alot of faith in the nurses, and in some terms I can see what she is saying, but why let them continue on if you are not happy with what they are doing. My thing is throw a little education out there, hopefully it will help, if even a little, if not they or we can't say that it was never offered. I am afraid that is what will come up. The nurses just seem like they either can't or are afraid to think just a little bit out of the box. Alot of these people, it is the only place they have ever worked, and many of them have been there for 15 plus years. (I think I just answered part of my question) Thank you and bless you!

Sometimes I wonder about the ADON thing, but no one has indicated that and I don't know what ADON pay is, I think I make not too bad of a wage, not near what I was getting but I was working every weekend for that wage. Thank you for encouraging me and telling me I play a vital role. Sometimes I just don't feel it or see it through the overwhelming stress. It has as I said earlier been a challenge and a learning experience. I guess that what keeps me going otherwise I would have bugged out some time ago. I agree about talking to someone about the dictation. It isn't alot of dictation but it is just "one more thing." I wish we had someone whose job was to do that and jockey around with the charts. I know squat about charts. Spent over two week trying to get 38 charts back into order. I just think my services would be better spent on other things and its frustrating. Thank you with all my heart for your response.

Bless you and thank you for responding. I was giving up. I become disappointed when I come here which isn't very often anymore just out of busy-ness, and I leave feeling ignored. I am really stressed right now, I am sorry. I wish something was on paper, I tried to get that to happen, but the administrator said no. So first and foremost, my bad for proceeding on with a job with too much gray area...clearly my fault. I offered some educational services at the last nurses' meeting. Not one soul spoke up in interest. I guess they know what they are doing??? I just think it would help, even if it were simplified. I can do that and put it in terms that maybe could be better understood. I don't know why we have to wait for ultimate badness to happen. What will happen is the State will be coming and all the sudden it will become an issue and dumped in my lap. I took over and revamped the skin program per the DON's request as we were not even close to meeting the standard of practice on anything including documentation. Most of the groundwork I have been trying to lay gets so screwed up that I just have to make certain things are done. I don't know how to make things any simpler. I wish someone could transcribe besides me, the secretary was doing it for awhile, but I guess it wasn't good enough, she didn't like it...I don't know...now it is my problem. You are right, I need to make a prioritize, I need to make a plan. My "title" is clinical coordinator/QA coordinator. I think if anything, I came into the place at a bad time. It is bound to get better, I hope. If anything I clearly enjoy the residents. If I can make anything work for their benefit because they deserve it, I will do it.

Okay, I figured out it is just me. Thanks to all who took the time to at least read this. I made my bed, I shall lie in it or move on.

So, a little over 4 months ago I took a RN position at a long term care facility close to my home and my children...littlest just started kindergarten. When I was looking at this position and then had agreed to it, I had an understanding with the DON that I was interested in using the RN education that I worked so hard for. She said she would work it out so that I could do some QA type work, which I am doing and that I would really have to work very little on the floor. Okay, this much is true. I have really nice hours, can come and go if I wish during the week though really haven't taken much advantage of that and I work on the floor every 3rd weekend. So, you may be wondering what the deal is??? This is what's up. I am enjoying the challenge of doing QA. It is a new experience for me and I'm learning alot, however I am extremely overwhelmed. I am supposed to be taking on infection control at some point. I do the employee health stuff, the monthly med sheets, the incident investigations etc...the list goes on and on. Oh, and I am like the medical records person including typing out dictation. You name it, I do it. It is way plenty. I have written policies, made flow sheets on and on. The thing that bothers me the most is I feel I get nothing done partially because I'm still figuring out what is going on and part because of constant interuptions. I also do all of the weekly skin assessments. We are small potatoes compared to some places. I wish I could feel real good about things, but I don't. I want so bad to do this job but get irritated about being overwhelmed and I feel like I am always having to play back up for the nurses on the floor. The DON comes to me to ask me to get an order for this or an order for that, or check this res. O2 sat, or assess this res. or make sure this nurse did this or that. I hate that! I ask myself when are these nurses going to be accountable for their practice? Because I feel that is what it amounts to. I don't mind pitching in when stuff is crazy on the floor, don't get me wrong, but I feel I am caught between the DON and the nurses she doesn't feel she can trust. I am all about education. I have offered to do some education, but have been encouraged yet shot down in making this happen. The DON feels that the majority of the nurses are beyond help she says. Big things keep getting missed and I have to go pick up the pieces. I am no stranger to long term care. Have been in and out of it many times in the past but most of my experience is acute care. I don't know what else to say, I think I bantered on long enough. I just feel like ....nothing more.