Nursenan0

Hi, I'm in west central Ohio. Originally from Indiana. I work long term care and Home health. Nursenan

We have 3 nurses on the floor each shift for a 98 bed facility. Only 1 nurse on my unit of 24 with 2 STNAs. No secretary. We al pitch in for admissions and discharges. I have been doing this for 6 months.

I am a Unit manager in our facility for our skilled unit. We also had 3 girls leave the job in less than 3 years time. When I took the position I asked for total control of my unit. I choose who works it and when, I do my own discipline following company guidelines. We have no charge nurse. I work flex hours. Sometimes another shift will need something specific or I will want to be involved with something hapening on another shift. We have an MDS nurse and a restorative nurse. The lpns give report to each other and I look at their "cheat sheets" and ask questions as I go thru the day. My nurses do an excellent job of keeping on top of everything including our STNAs. If they need me they come and get me,call me at home or leave me a note. I take care of our Utilization review meetings for skilling, work with the Drs on changes that need to be made, do routine skin rounds and attend QA meetings skin meeting, morning meetings, admission meetings. Do QA reports all incident reports and investigations, all letters to families about skilling days and discharge planning. The families come to me with complaints and praise. My staff also come to me for complaints, things they would like to see changed and ideas they have. I help on the floor as the STNAs need and as my nurses need. Sometimes I work 8 hours sometimes 10- 12. I get paid hourly. I do have the families that like to call and yell also. When I know Mrs Jones is going to complain.....I call the family first, before she can and tell them what is happening. ( Your mother is complaining her light is not being answered timely but she isnt using her light...do you have any suggestions???) This seems to help. I work with social services to resolve the bigger issues....family problems, room mate problems.... I have a charge nurse who handles the entire building on second and third shifts, if she doesnt get put on the floor because of a call off. Hope this helps you some.

Even as a supervisor I dont write the nurses up for a single med error. I do fill out an incident report if someone else hasnt. Mistakes happen. The write up comes when I keep getting incidents from the same nurse over and over. I have had nurses write an incident on themselves for a med error. Its a mistake, learn from it, and go on.

It takes 3 - 31/2 years at the colleges I went to for an ADN, thats if you can get in. After spreading courses out waiting, I transfered to a private college to get in. A decision I will never regret. Smaller classes, time for 1:1 with instructors. Instructors actually knew your name. A big difference compared to the college I started out with. The pay here seems to vary a great deal. If you to show up with an application, and an RN degree.... the chances of you getting what you want or close to it are pretty good....we dont see many RN applications around here. Nursenan

In the facility I work for now, everyone wears the colors they want. The last facility I worked for went so far as to send management nurses to a seminar to show us what colors and hairstyles are suppose to show "authority". (white is too virginal, and barretts and hair clips are childish, is pretty much what they told us) Our facility also has a scrub company that comes in about every 2 months for us to shop, and with the option of payroll deduction. The colored panty people.....I write them up and send them home to change....it seems to remind them not to do it again. Nursenan

In our facility, I just happen to live the farthest away. I have missed 1 day in 3 years d/t weather. I do understand that some people are terrified of driving in ice and snow. I think the real problem is when I drive 35 miles in it and the person living 3 blocks away calls in . Yes that really happened. In our facility, even those of us who are in management are expected to show up. We do have many great employees who are willing to cover for people who dont arrive. Our maintenance team also have 4 wheel drives and will pick you up and take you home.

NO cell phone allowed in the bnuilding....period! Nursenan

We have used a variety of different topical meds on many different types of wounds. Depending on the resident, nutritional problems, causes....... Recently our facility contracted a wound specialist. The docs nurse practioner visits our facility once a week and prn to assess and recommend treatments. She has also cut our treatment time in half, making the nurses oh so happy. Nursenan

The corporate nurse I work under is a consultant nurse for the company...her specialty is the MDS...just wondering what it would take to start my own business with the MDS part of nursing in mind...any thoughts or suggestions? Nursenan

The corporate nurse I work under is a consultant nurse for the company...her specialty is the MDS...just wondering what it would take to start my own business with the MDS part of nursing in mind...any thoughts or suggestions? Nursenan

A pill.......the easy way????

Yes most are on way to many meds....our medical director is very good about letting us cut them down if we can....and have you ever noticed the ones who take barely anything are the healthiest??? :stone Nursenan

I have aides I would trust to do it and aides I wouldnt...but I also have nurses I wouldnt want to do things like that for me...I think its situational...our facility doesnt even allow the aides to do vitals Whats with that? Nursenan

Will add your son and you to my prayers Deb. Nursenan

Deb, If it had been any family but her they would have hauled her out...they only let her get away with this behavior. The worst part is...We believe she is setting up the "things she complains about" herself, then blaming the staff.

Yes, I would! I have been riding my own for 3 years. I love it. Is it dangerous? Yes, but I feel lots of other things r also. Its just a choice. You do or you dont. Just like helmet laws (which I dont want to go there) it should be a choice. Nursenan0

Rude doesnt even describe my yesterday! This whole situation has gotten out of hand...the short version.......... One of our LPN's young daughter lives in our facility. The mother has filed a lawsuit against the facility...ongoing for a year now, and legitimate in my opinion. This woman is the terror of all terrors when it comes to family. The facility turns their head and she does what ever she wants. On the clock or off. Yesterday topped them all. She came in, transferred her "hoyer lift only" daughter into bed herself....then came screaming out into the hall wanting me to "come look" well she screamed, yelled, cursed in my face for about 5 minutes...at the top of her lungs, until I put my hands up told her I didnt have the authority she was looking for. I went to get the unit manager of that hall. As I was in the hall discussing the complaint with the UM and the medical director she comes rushing down the hall f-ing this and that while she was screaming she was calling the state. The unit manager tried to get her to calm down and discuss what was wrong and she called her f-ing this and that....then she rushed out of the facility. She returned a few minutes later and reported many lies about the scene to the administrator. We are all devastated by what has happened...not to mention the many alert and oriented residents on that hall who were witness to the scene. Then we are told...coporate will have to handle this and decide what to do! AAAAAAAAAAAGGGGGGGGHHHHHHHHHHH what is there to decide????? I dont get it. Can you spell M-O-R-A-L-S ???? The unit manager found another job today.... My conscience says I should go to, but I love my job...just not the way things are being run.

Just like most of the other replies...been there done that. I hope your back feels better soon but I'm guessing that wont be the case. The other posts are right, keep track of all the information about the injury, it may come in real handy with workmans comp. We had the same problem in our building, Now our facility policy says NO cell phone in the building at any time. Write ups arent used in your facility? or maybe its one of the cases where they dont matter even if you write them?

Well I calmed down a little by the time I got into work today.....and part of my problem solved itself.....I decided I would go ahead and finish the assessments I had started...I completed the SS part without a snag....but surprise! When I went to complete the activities section.....I found no documented proof of activities, so snooping further, I found no activity progress notes for the past 2 quarters on the majority of residents...oops. Sooooo I went to a meeting I had asked for with the administrator, DON, and coorporate nurse. I told them how I felt about covering up problems and passing them on instead of fixing them ( I put a bug in the corporates ear about auditing for progress notes), and by the end of today, I was back to my own assessments only. What will happen to the others....not sure. I tried to talk to the administrator about the attitudes, when asked to complete their work on time...her reply was...."well they are always mad at you anyway, some people just cant work on a time schedule like you can" (I'm trying really hard to pretend that time schedules isnt what MDS jobs mean )

At first I overlooked it...but after 2 years of this....I'm steaming mad, psychotic is how my close co-workers describe it but either way... I'm the MDS Coordinator for our facility. I do NOT understand this building. Everytime someone slacks off on their job, it ends up being my job to do. Every time someone "doesnt have time", it ends up being my job. Examples: A resident is admitted to the facility. The nurses on the floor dont acknowledge she has a skin issue going on. They dont chart it, start a treatment, or pass it in report. Needless to say it was horrible by the time whoever found it and reported it. This had happened over and over. So the answer to fix it is.........ding ding...you guessed it, the MDS nurses will now do skin rounds with the floor nurse every monday, initiate treatments, and perform measurments. Also on that line....MDS nurse will look thru all new admission charts the morning after admission to check and see if the nurse who did the admit, followed thru with skin protocol. If not MDS will initiate it themselves. That happened months ago, this week. I was personally invited to the administrators office, where she and the DON asked if I could do the sections on the MDS that social services and activities normally do. Well of course I can! Do I want to? Do I have time? NNOOOOOOOOOOOOOOOO!!!!! But then...they dont have time and they cant keep up. Now I find out, I'm also to do their careplans, and give them my notes to write their progress notes by. I have held my temper until today.............the activities director comes to me, with a smirk on her face I might add, and gives me some detailed worksheet she says she has to fill out with every assessment....and whats more, she says i have to use the activities I "see" the resident have.I dont see most of this. She doesnt have it all logged she says, she just uses what staff sees plus the activities on her calendar. Needless to say, my assessments and hers look nothing alike! She thinks we can adjust that if she "helps me out a little" OK, now that I have that off my chest......Does anyone else have things like this happen? or am I the lucky one? I'm taking it to the coorporate nurse and administrator tomorrow. Arent staff members to be held accountable for their own work any more? Will I have a job when I do? Not sure I even care at this point. Interdisciplinary...what does that mean? Nursenan

I agree with the family involvement. We have an alzhiemers resident who would not take a bath or change clothes. We had tried everything from going back later to trying a different person to approach her. After getting the family involved we tried several different approaches with them. After identifying that the woman had always been modest and had had problems with having her clothes off we ended up doing a blanket bath with her....it doesnt always work but does a majority of the time. Family involvement might provide insight into the residnts reactions. Nursenan

Just from moving from IN to OH I have noticed the different feelings toward RN/LPN job positions. In the facility I left our ADON was an LPN. No one thought anything about the LPN part, it was the fact that when she was on call and you had to call her out of a bar to get help...and you werent at all comfortable with the advise given. Other facilities in In I worked under an LPN and was very happy and learned many things from them that I didnt learn as an RN in school. Then I moved to OH............I only have 2 facilities to compare from this area but I think the ending is the same. The first facility we had an even mixture of LPN/RN positions. I was evening charge nurse but...I really needed and appreciated the experience and help from the LPNs who were floor nurses. On my days off anLPN filled in my position. When I left the facility....she applied for the position and was given it. She was/and is an excellent nurse ! Now to the downside....my current facility.... When I started there they had RN's in the building, one who I was replacing. RN's were not tolerated well outside of the DON position. Everytime was hired...she was given such a hard time, she left. The LPN's always blamed it on RN-itis. That Rn's were to good to carry a floor position. The end result is that our local hospital stopped sending us patients. We didnt have the skills to care for the patients coming out. Our LPN's refused IV training classes. They did want thqat kind of responsibility. Needless to say working on call 24/7 and working every weekend didnt last long with the few RN's we did have. A few of the LPN's went to take the IV classes but whether its a law or a company requirement we still needed RN's to run certain antibiotics, which we were getting quite a few of. Care was going downhill and no one watched over the STNA's. The company has made a drastic change and is now filling positions with RN's. They have gone as far to layoff an LPN this week and replace her with an RN. Anywho......I think the whole point of my story is.....It isnt the RN/LPN title that makes the difference. Its the nurse herself. If you can do the job, and do it well you deserve the job, regardless of title. If you cant do the job...move over, your being replaced. Nursenan

We had a similar incident at our facility. Actually ended up with the spouse being banned from the facility unless he was accompanied by a family member to visit his wife. Was an ugly situation but turned out well. The man eventually got the medical attention he needed also. Our social workers took care of the situation as it was brought to their attention. Nursenan

State Tested Nurses Aides....thats what they call them here in Ohio...in Indiana we called them CNA's... Nursenan