Rizpah

I too have been there, done that. My son was in a MVA last October - his Ford Taurus sideswiped a semi-truck. He's a miracle. I was able to lay aside my "nurse" roll and be mom, (as a nurse I know how staff freaks out when they find out a family member is a nurse and I didn't want people to act differently because of it) I did tell the ICU nurse that I'm an RN, but know absolutely nothing about ICU work as I've only worked in LTC - she was very gracious and told me if I had any questions to ask. The road to recovery has been long, but he is alive and will make a full recovery - and that is my prayer for your daughter - a full recovery without any lasting effects, that she will come to realize how fortunate she is to have a mom who loves her and especially I pray for strength for YOU, mom, you will need it - seek the peace that only He can provide and trust in Him that all will work out ok. Take care of you so you can help take care of her....

Yup - totally agree. We do the same with our CNAs - a mix of full and part time.

Have you considered CNA? Then you could continue to work in the field while going to school (if that's in you plans), continue to make an income while gaining valuable experience. That's what I did and when in LPN school and those of us who were CNAs first seemed to have a little bit of an easier time when it came to some of the clinical aspects of nursing. Good luck!

If the hospital isn't concerned about lawsuits, they aren't going to be concerned about your license. I'd leave. Sad for the patients though.

Keep your feet at least shoulder width apart to have a good base for balance. Always bend at the hips and knees. Never use the muscles in the small of your back - once you injure them, they remain highly susceptible to future injuries. Raise the bed to a comfortable working height. Move the patient closer to the side of the bed on which you will be working from to prevent overreaching. Have the patient help as much as they are able. Use assistive devices whenever possible and appropriate. Do not attempt to do the work of 2 people by yourself (assist of 2 transfer alone). Use a gait belt - they really do help. Do not allow the patient to grasp you behind your neck during the transfer. Sorry - no tips for IVs - rarely do them in LTC so am reeeaaaly rusty at them! Good luck!:monkeydance:

You'd be surprised at the little things we do in the course of a day that we think nothing of, that mean the world to our patients. I had a lady in for rehab after open heart surgery. She couldn't shower for a few days and was really upset over how her hair looked. So I took a few minutes and did the best I could to "freshen" her up, fixed her hair to look presentable and went on about my day. A couple of years later she stopped back at the nursing home to visit some of the other residents and we greeted each other. She brought up that episode from the past and how much it meant to her - I'd forgotten all about it. The little things really DO count.

What is the name of the book, where'd you get it? or are you just speaking of anger management in general?

From what you've described, it sounds like you've walked into a nightmare. You sound like you know your stuff. Yes, there are regulations that require timely assessments, plans of care, interdisciplinary approach, etc. Do you have access to a regulation book? You could look up the specific regulations related to care plans and conferences and present this info to your administrator along with your concerns. Is he/she even aware of what's happening out on the floor? (one would think that the adm. would know there is SOME kind of problem if the surveys are bad). I would have to question if the administration end of patient care is as messed up as you are describing, how is the actual patient care? staffing? environment? Regarding CP in the pt. charts - we don't keep ours in each individual chart, they are kept in a separate binder for easy access and the CNAs get a flow sheet copy of the care plan for their documentation. We also have "care plan face sheets" behind each closet door for "point of contact information". We do everything on computer so we also have access to the CP via computer - could that be where yours are (if they are done of course ) You have your work cut out for you! Keep us updated on how things are going! Oh, and by the way - WELCOME to AllNurses!:welcome:

Reading these posts..... I LOVE, LOVE, LOVE my doc....:icon_hug::1luvu::loveya: I've worked with her in the LTC setting for the past 11 years and she's my family doctor as well. I've been yelled at once and it wasn't even regarding MY actions - it was more of a "vent" regarding something someone else did. I'm really grateful to be working with her.

cold lips - blue; HOT #ss - red

From what you've described, it sounds like you did exactly what you needed to do for the resident and family. Discharges are supposed to include continuation of care and it sounds like that is what you did. Good Job! Unfortunately, something sounds fishy at the higher up level. ("recharting something to get it right?") Given your level of integrity, I don't think they deserve you. There is something better out there for you. I agree with caliotter3. Don't beat yourself up over the problems of that facility. Find one where they appreciate honesty and integrity. As far as what to say in interviews as to why you were terminated, that could be tough without finger pointing back at the other facility. As an interviewer, a red flag always goes up when an interviewee starts bashing a former employer. :lol_hitti Maybe start with all the things you loved :redpinkheabout your job for the time period that you were there and end with something to the effect that you were terminated due to a difference of opinion between yourself and the company. What do the rest of ya'll think? Good luck and God Bless shug:icon_hug:

Last night before leaving work, we had some bad weather kicking up. Everyone was doing their duties when the front door exit alarm sounded. One of the CNAs looked in the visual monitor and yelled, "someone fell!" So half a dozen people ran for the front door. I checked the alarm and the monitor before heading down there. At first glance it certainly looked like someone was sprawled out on the sidewalk in front of the entry way. Then one of the CNAs yelled, "It's just the garbage can!" :roll I'm glad to know my staff has such quick response time! Just for the heck of it and a giggle, I'm going to fill out an incident report and turn it in to my DON. Should lighten the day!

can't get it to come up

I teach CNA class and use the following tricks for my students: For ROM instead of using all the technical terms: flex / extend of the shoulder/arm - the "hallelujah"; abduction/adduction of shoulder/arm - the snow angel; rotation of the shoulder - the policeman; flex/extend of the bicep - the muscle man; pronation/supination of the forearm - soup and dump (holding a bowl of soup in the palm of hand and dumping it out); flex/extend of wrist - bye,bye; radial/ulnar deviation - queen's wave; rotation of the wrist - "dah, I don't know" (like a ditz swirling her hair on her fingers) - nothing special for the fingers. Then lower extremities - hip/knee flex/extend -riding a bicycle; abd/aduction - snow angel again; rotation of the hip (inversion/eversion)- "let's do the twist, like we did last summer."; flex/extend of the ankle - gas pedal; inversion/eversion of the ankle - "ow, I turned my ankle!" and nothing special for the toes. To help them remember systolic / diastolic for blood pressures - sky over dirt. Right eye vs left eye (OD / OS) I always think of putting medication in the right eye - if you put too much you "OD" the "Right" eye. The other one gets what's "left".

Prayer sometimes helps me, but if I still can't get to sleep, reruns of Gilligan's Island does it for me. My mind focuses on what's on the TV, no thinking (like trying to follow the plot of a movie or something). I think some call it brain popcorn...I set the sleep timer on the TV and DVD player so the sounds don't wake me up later. Most of the time it helps shut off the events of the day or the upcoming day and I sleep well. If I do have a sleepless night, I just start the DVD again - usually the second time does it. Good luck.

Sandlewood, Have you ever tried other avenues of nursing? With so many other specialties out there in nursing, perhaps there would be one that would fit your needs perfectly? I have worked in LTC - that's it. The stressful situations I witnessed while doing clinical rotations in the hospitals during nursing school was enough for me to know the hospital was not where I wanted to be. Is my LTC position stressful? Yes, at times. Do I get frustrated? Yes, at times. Do I enjoy my job? Yes, most of the time. Do I ever want to leave and be a WalMart greeter? Sometimes. But for the most part the love and appreciation I get from most of the residents and families keeps me going back. I like the thought of being able to make some of our elder's last days on this earth better and more comfortable - if it's within my capability. Good Luck in whatever avenue you pursue!

Chat room sounds dangerous tonight! :chair:

Daytonite - wow, thank you for posting those links. I'm currently having problems with a "peer" with less seniority and I was told I have to stand up to her and assert myself. The links you have posted on assertiveness are awesome! Maybe I'll learn something!

CNAs are not allowed to remove fecal impactions in our facility - only licensed personnel are allowed, due to the bradycardia issue.

WOW! I've only read the last 2 posts, but geez I'm glad I'm not alone! Indy - thanks for the laugh - intubating a dog! LOL! I rarely dream about work anymore, but early on in my career I had a recurring dream. I worked 2nd shift and had my 4pm med pass to do. It was 9pm and I still had not left the med room and my anxiety ridden COPD resident was SO MAD because she still didn't get her 4:00 breathing treatment. I couldn't leave the med room because I accidently showed up to work in my pajamas and was afraid of getting in trouble for not being in proper uniform. The funniest part of this whole thing is that many years later, it actually came true - I have a pair of really large scrub pants that I use for loungers. I put them on by mistake one morning when I was in a hurry to get to work. As I walked into the building, I thought, "Geez, I must have lost some wt or something, these pants don't seem to be fitting right." That's when I realized I had actually WORN my PJs to work! So be careful out there......sometimes dreams DO come true!:chair:

There are minimum staffing requirements that have to be met. If the facility is not seeing that those minimums are met, it's not safe for the residents or the staff that are there. How does the facility do on annual surveys? Are there a lot of citations? Is there a lot of skin breakdown and dehydration? Wt loss? Functional declines? As charge nurse, you have to consider your license. I don't know about you, but I had to work mighty hard for mine to put it on the line with the circumstances like you are describing. I agree with RN4MERCY - this needs to be reported. In the facility where I work - the phone # for the state complaint hotline is prominently displayed for all to see, so ANYONE could make an anonymous phone call (if you make that call yourself, don't tell a soul that you work with - it will get out). Good luck and Bless you for caring for your residents!

I'm glad this was posted. Gets me fired up to try sewing my own tops. I've gone as far as purchasing the patterns and some nice material I found, but havent gone any further. I made one top a LONG time ago, but made the mistake of not checking material content and it was 100% cotton, not only did it shrink, was very hard to iron out. And I don't iron...:trout:

Oh yeah, and never answer "I don't know, ya-dah, yah-dah". The only thing the surveyor will write down is "staff member stated, 'I don't know'." Never mind what ever else you were saying. Best bet if you don't know an answer to something is to repeat the question back to them - "I just want to make sure I'm understanding what you are asking. You want to know where to find......... I will need a few minutes to get back to you on this." Then run like heck to find someone who DOES know, get the answer and go back to the surveyor with the info they were requesting.