CometLPN

At our facility it's 1 hour before or 1 hour after. That's your window. There's always going to be exceptions, someone dies, falls, etc. But if people are just doing it because they're lazy and don't want to be on the cart that long that's their problem and they need to learn how to manage their time better. I'm a fairly new nurse as well, and even though your day can be flipped. You should pretty much have somewhat of a routine. I would check the resident's chart. Some meds are made time specific by the MD. Otherwise I would definitely notify your ADON or DON. And don't worry about those saying you're anal. Just remember.."it's better for them to respect you, then like you." also, if you're doing it for the right reason, meaning in the resident's best interest, you're doing the right thing. I do have one lady in our facility that every night at 2230 or 2300 requests her PRN morphine and an ambien and unfortunately it's her right to request it and since she's in her "right" mind we are unable to do anything about it even after discussing her past dependency on morphine and the current risk of trauma it could do to her. And for the ultram thing we do have a few people in our facility where the doctor has prescribed routine ultram as two tabs instead of using plain tylenol or a narc.

I work in a SNF/LTC and you're kind of stuck b/w a rock and a hard place. Your license is on the line, however, if you leave, you have in the back of your mind those people and the horrible care they're getting without you there. Have you gone to your administration about this? ADON? DON? ED? Or are they like this to? If so, you always have the option WHETHER you leave or not to call your state's hotline. That DEFINITELY needs to be reported. I don't know if EVERYONE at your facility is like this or if a few are. If it's just a few I say go to higher authorities and ensure that they respect you not like you which is so much more important. YOU are the patient's advocate and whatever is best for the resident is the right thing to do. However, if you are unfortunately surrounded by these imbeciles then I'd find a different job but MOST DEFINITELY notify the proper authorities.

I work in geriatrics and to be honest with you, ONE of the things I love most about being a nurse is that my day is never the same. At any given moment my entire shift can be flipped upside down and inside out. It kind of always seems that "when it rains, it pours" Not to discourage you of course, but it definitely exciting. At times like that you don't know whether to cry or laugh, but you alway know that it can't get any worse; however, then it always does. Overall any general nurse given pt care (giving meds, helping with ADLs, etc) Since I work in geriatric care I've noticed I tend to do a little more than I ever did working in ACU. Right now we're building on to our Alzheimer's Unit and a lot of the nearby psych wards have closed, therefore, we're getting their patients. Not only that but we get a lot of acute care patients that transfer from the hospital for just a few weeks or months. You do get a lot of one on one time. At least at my work we do. We are a 165 bed facility and I'm in charge of the 26 residents on my hallway. But I can tell you that I know them like the back of my hand. And remember more of what they did 6 months ago than I do about myself 2 days ago. When you're a nurse you get to see people at their worst and see people at their best and especially when you are the one that helps them with either of their transitions it makes you feel wonderful. Especially with working in geriatrics we obviously do a lot of end of life care and sometimes you're closer to them than their family are. They become your family and they look forward to seeing you everyday.