catlvr

Hi, I've been an LPN for ten years, and was fortunate to work at a great nursing home for five; moved home to help with family, and cannot find a decent place to work. I have a lot of family responsibilities, and 12 hour shifts allow me to manage them - but the only place that I could find is so awful, it is ludicrous...surveyors stayed for six solid days and we have so many tags that I'm truly amazed that they didn't shut us down (as we well deserve). I've been there for three weeks; I don't want to be branded as a bad nurse for working in such a terrible place. Better to jump ship now, before I have to list it on my resume? (I knew that the place was a mess before I started, but had no idea that we would have patient rooms without hot water, inability to flush bed pans, and that it would be a daily hunt/peck/beg for supplies like tube feedings.) Thanks for any insight.

Thanks for all of the advice and support; I really appreciate it. To the best of my knowledge, we don't have a Group One here, but it is a fairly small city where everyone seems to know everyone else. Fortunately, I have a bit of savings and am not totally adverse to some time off to be sure that I land in a better place for my next job. I don't ask for much - just a facility where I don't get so stressed that I vomit before i start my shift!

I did an incredibly foolish and unprofessional thing: I quit without notice. I just couldn't make myself go back to the awful place where I was working (long story behind this, did submit my resignation a few months ago and they refused to accept it; they agreed that they would not turf me to be a CNA more than one shift a week, the other nurses told me that I should be dumb enough to believe them, and boy, were they right!). So now I am looking for a new position, with this horrible blot on my record. The hospital where I worked prior to this closed, so my record looks quite unstable. I'd be grateful for any advice on how to explain this - I know that I can be nothing but truthful while not being derogatory about the place, and it is helpful that they have such a lousy reputation in our region - and I'd be even more grateful for encouragement; I'm horrified that I may never work as a nurse again. TIA, catlvr

Well done! While the goal is to not make a mistake, honesty and analysis are the best path after it is made. We've all doe it, and it will make you a better nurse. And yes, we've all known about other errors that were not reported, and that does little to help the patient or work relationship.

I'm an LPN but I'll take a stab at this. Start with your assessment; then call the MD, who will make the decision whether or not to transfer. I really like the interact act program INTERACT - Interventions to Reduce Acute Care Transfers - very helpful, especially for newer nurses! The "when in doubt, send out" attitude is going away since there are financial penalties. If you want to be successful in your SNF, you will want to develop the skills that let you give the MD enough accurate information to make the decision. Also, there's plenty of evidence that elders do really poorly in hospitals, so that is another reason to treat their condition at the SNF if it is possible.

>I realize that you are looking for a specific scenario that is similar to yours, but I have been out of school for a while and don't have one to relate. However, I do think that you were treated pretty shabbily - it seems only decent to be instructed in advance if there is a serious problem. I hope that you get some good insight from other nurses and can rise above this.

LauriePat, what you said doesn't sound corny to me; I consider it an honor to spend time with someone in their last hours and to make sure that they are comfortable as they transition to whatever comes next. When I worked in LTC, I had quite a few patients decline and die - I did everything possible to make them comfortable and encourage their family to participate; helps them to feel more positively about the death. Thanks for the care that you give!

Wow, that's a horrible management style. What was the reaction of other people he was standing there with? I envision them mentally updating their resumes, thinking that they would not trust him either. I"m sorry that this happened to you; and hope that you find somewhere better, quickly.

Iceland is my dream; but I'm going to Toronto for a few days in September.

I don't think that you can paint all LTC facilities with the same brush: some are truly horrific, some are so-so, and some are great. It comes down to the DON. If you are fortunate to work in a facility with a DON like CapeCodeMermaid who advocates for both the staff and residents, you are pretty fortunate (and the residents are as well). As far as loving the residents, hell yeah. Some of those folks I saw more than my own family and I grew to love them, and I'm honored that they grew to love me. I had the privlige to work in THEIR HOME, and it isn't unusual for genuine love to develop. Now that i work in a hospital, I really miss that aspect of LTC.

NurseCard, I can certainly relate to not wanting to take care of a particular resident; we had one who would flat out tell you that she didn't care if others needed help, she wanted all of your attention for the shift. And if you didn't give it, she would throw herself on the floor (how? she was a hoyer lift and couldn't feed herself, but she always managed to find the strength to hurl herself to the floor). *Every* long term care facility has (at least) one of these challenging patients. And in an acute care psych facility, sadly the same folks will continue to rotate thru; they might get discharged, but they will come back. Just something to think about.

I, too, am grateful for your inclusive message, and I say that as an agnostic! I don't believe that I am doing god's work simply because I don't believe in god, but I strongly believe that I am doing what is just and right for humanity. When I think that I want to quit, or to care less, or learn how to skate thru my work day, I try to remember why I entered this profession, and I am again humbled by the opportunity to do what is right to the best of my ability.

I've done so, but so many docs don't want a pt to become "addicted" to narcs or don't want to be perceived as the doc who dopes up their pts. I know a lot of nurses who feel this way as well, so sometime I think that I am the odd ball on it, but there are so few pleasures in a LTC setting...why should someone have to live in pain? My other concern is the potential of "masking" a sign of infection...some folks don't look or sound like they have pneumonia and the only clue is an elevated temp...but if they are on temp suppression via lots of tylenol...that concerns me, but maybe I don't understand the drug's method of action properly.

I, too, think that a little fever is a good thing, as long as they are not uncomfortable (I work in LTC). We have a lot of residents who are one the max daily dose of tylenol for pain management, so I get pretty concerned when they spike a temp; am I being paranoid in this?

AmberEyes, I am so sorry that you lost your job; I am glad that you were honest about your mistakes but I wish that your boss had been more supportive and given you more time orienting. I would put the job on my resume and just say that it wasn't a good fit for you. Get back on the horse as quickly as possible, and find a new job. While you are looking, you could review some pharmacology etc to keep your knowledge fresh. Good luck!