jackiemc08

Yes. I told her that we could not do what she was asking. She was adamant that it was perfectly legal and appropriate. "We did it [at the last place] all the time." The directive was for me to tell my nurses to hold the resident down and give her the Haldol. I called the corporate nurse to make sure I was correct. Of course, she told me that I was right and that we should not do what the admin said to do.

Thanks everyone. I left that job and have another one at a much, much nicer facility.

We have 118 beds. I have applied for every job I can find locally. I have an MSN with an emphasis in administration. My husband had a severe traumatic brain injury 4-1/2 years ago and after that I had this feeling that I needed to do something other than occupational medicine. I was certified in case management as well at the time and had to use all of my knowledge to help him. I ended up doing most of his therapy myself because no one else seemed to be helping him. I knew that if we had the struggles then others with no advocates must be just drowning. So, I started working as a weekend RN supervisor at a nursing home right around the corner from my house. I loved it and wanted to make a difference for others, so I applied for this job as DON and got it. I had so many high hopes and have grown to love the residents. It will be so hard to change, but I know I must if I value my license. Thanks for the advice about the nurse consultant. I just have an open and trusting nature and am learning the hard way that I can't be like that. I welcome all the advice I can get from those that have been doing this a long time.

I am a fairly new DON at a 118 bed facility in East Texas. We have a new administrator who I thought I liked, but things are not so wonderful right now. A couple of weeks ago, we had a new resident with psychiatric issues in her history. She had been living alone, but was sent to a hospital and subsequently placed in our facility by Adult Protective Services. One evening, she had an episode and got very angry. During this time, she began yelling, felt that she was being held against her will and began calling the police every few minutes. There were no medications ordered, so I called the physician on call for the nurse since I was still in the building. She refused the injection and I called the administrator. She told me to tell the nurses to hold her down and forcibly give her the medication. We did not feel that was a prudent plan of action and I called my regional nurse consultant. She was not available, so I called the lead nurse consultant for our corporation, who told me not to do what the administrator instructed. My beliefs that this was battery and chemical restraint were confirmed by her. Yesterday, I was reprimanded by the administrator for calling the corporate nurse. She said that I should not question her directives and should have done what she told me to do. Also, when I was hired, I was told that I was on call 24 hrs a day. The ADONs (I have 3) are on a call schedule. This administrator told me in a meeting that I would be in the call rotation from that point forward. I asked if that meant that I would not be on 24 hour call and she said "No, you are on call all the time, you will just take a call rotation, too." Last week, she announced to the ADON on call that I would be taking 2 shifts that Friday (16 hours) as charge nurse. I have not worked a floor in 13 years. I have an MSN with an emphasis in nursing administration and have been an occupational health nurse for the last 13 years doing case management and managing a clinic for a healthcare system. I feel I should look elsewhere and now. Suggestions? I really do want to stay in long term care. Am I crazy - is this normal behavior in LTC?

I was an EMT in the emergency room before I became a nurse. It helped me to get my first job in OH, 12 years ago. If working in industry, they want someone who can handle an emergency and a variety of situations. I now have an MSN and manage an occupational health clinic at a hospital. I would hire someone with EMT experience.

My husband had a Vail bed when he was in the rehab hospital. I ASKED for it. It kept him safe without frightening a person who couldn't understand. The nurse there wanted to restrain him and I told her she would NOT do it. She asked if I had ever cared for a head injured patient and I replied, "Yes, I most certainly have." She was a lot nicer to me for the remainder of the stay. Why would you want to restrain a person who just doesn't understand? There are many other ways and I was more than willing to stay with him. His speech centers were severely damaged (yes, they think he has two- left handed) and he did not understand speech or any other kind of communication. He did understand kisses and hugs and he recognized people. Sometimes I am ashamed to be a nurse when people associate the ones like that with the profession.

My husband had a bicycle accident on 8/11/04, which resulted in a severe brain injury. He was in ICU for almost 3 weeks. I had been with him the entire time. When he was transferred to the floor awaiting discharge to a rehab facility, he required constant monitoring. I asked for a sitter for the 11-7 shift so I could sleep. He had undergone bilateral craniectomies for the brain swelling, leaving 2 LARGE cranial defects on the sides of his head. He was unable to understand what was going on. Because of this, he would swing his legs over the bedrails in an attempt to get up. He also tried to remove the oxygen tubing connected to his tracheostomy. I had to replace the tubing over and over again during the day. He hugged me and pulled my hand to his lips. The next morning, I returned about 20 minutes earlier than anyone anticipated. When I got to the room, I found my husband with a VERY frightened look on his face and the sitter and RN standing at his bedside. His left hand was tied to the bedframe with a roll of kerlix! If you know anything about a head injury, you know that when coming out of the coma, the patient is confused. You would also know that agitation should be avoided because swelling, BP, and pulse increase dangerously. There was NO order for a restraint, the restraint was not an approved one- it was a dang roll of Kerlix! I felt TERRIBLE for leaving him to sleep. I still can't forget the look on his face. It was heart wrenching. Please don't EVER do this to a patient or a family member!!! Jackie McDonald, RN, BSN, COHN-S, CCM