barbarake21

I've been fired once already because of office politics. Caught me totally by surprise, had no inkling anything was wrong. It took me two months to find another job. A second, part-time job is now my 'backup'.

As a night nurse, I have to agree with the 2PM meetings. And, no, 10AM is not *better*. Another hint - don't put up a notice on Monday for a mandatory meeting on Thursday and expect your weekend staff to show up. Just saying... In fact, this whole 'putting up notices' to inform people of meetings is ludicrous. If you want monthly meetings, schedule them for the second Tuesday or third Monday or whatever - something consistent so people can make plans.

If I'm reading this correctly, you think two nurses for day shift is overstaffed (for 37 residents)? (Depending on the type residents,) I might agree that it's a bit light but 1 nurse to 37 residents is too heavy.

There's two questions here. One, can she refuse to have her meds crushed and two, can she refuse her medications, period. (The assumption here is that we're talking about oral meds.) Answering the second question first - of course she can refuse her meds. Whether competent or not, no one can force her to take them. The first question is trickier. When our doctors order medications to be crushed, it's generally because of swallowing difficulties. Then the order is phrased as nurses 'can crush'. But if the order is phrased as medications 'must be crushed' (because the doctor suspects the patient of pocketing narcotics or something like that), it needs to be documented. Personally I'd go by the order. If it says 'can be crushed', it's up to the patient. If it says 'must be crushed', than that's the only way you can offer/give it and if the resident has problems with it, she needs to work it out with the doctor.

I can answer that (at least for myself). I've had my share of shots through the years and I'm not against vaccines in any way. I've had them all. But the one and only time I had a flu shot (4 years ago) left a sore spot in my arm that still remains. To this day, I can unhesitatingly find the spot where it was given. No, it's not 'in my head' and yes, I realize that it's not necessarily the vaccine itself which caused the spot. But - in my head - flu shot equals sore arm. Of course it helps that I've never had the flu. Actually, I haven't been to a doctor because of sickness in 45 years.

BostonFNP - I am in no way disagreeing with you but when I read statistics like that, I wonder as to how valid they are. It is my understanding (please correct me if I'm wrong) but they only way fly can be conclusively confirmed is via a culture. When my son had 'the flu' a couple of years ago, he was 'diagnosed' at the college clinic and told to rest, fluids, etc. (He was fine after a week or so.) Anyway, they *did not* do a throat swab/culture. I'm thinking that maybe now - with all the concern about pandemics, etc. - maybe doctors are simply doing more cultures and getting their diagnosis 'confirmed'. In other words, maybe the same number of people are getting sick but the number of cultures (and 'confirmed diagnoses') has increased. (I've taken way too many statistics courses and am convinced you can make statistics say almost anything if you want to. Look at advertising.)

I'm 52 years old and have never had the flu. In fact, other than two pregnancies and an ankle injury, I haven't had to go to a doctor in over forty years. I have no philosophical objection to a flu vaccine but I am not convinced of its effectiveness. My other problem with it is that I got my first - and only - flu shot two years ago. Felt fine and had no side effects other than a sore spot on my upper arm from the shot itsef. Well, after two years, that sore spot is still there. I don't understand why since I've had plenty of other shots and never had that reaction but I did with the flu shot.

I think there's still some prejudice against male nurses. (I'm a female.) The nursing home I worked at hired a male nurse just out of nursing school. He was the nicest guy you ever met, hard-working, always cheerful. And our manager treated him like absolute garbage, practically followed him around looking for stuff to write up. Hey - new nurse - straight out of school - that's not the way to treat people. (And - no - she didn't treat brand-new female nurses the same way.) At the same time, a significant percentage of our elderly residents (or their family) don't want a male nurse treating them. One of his first shifts (night), he was walking down the hall when he heard one of his patients calling for help. He goes in and finds the elderly lady, stark-naked, crumpled on the bathroom floor. He immediately called for one of the CNAs to come get me. I was just at the end of the hall so I was there within 30 seconds. He was kneeling next to her, asking if she had any pain, etc. etc. - normal questions. As it turns out, no injury, everything was fine. Next day, the resident's family complained that he had seen their mother naked. The manager formally wrote him up and told him he should have put a towel over her before doing anything else.

I worked weekend nights in a LTC. Two units were LTC and one was medicare/rehab. and each unit had 40+ people. The LTC units had 1 nurse/night, the medicare/rehab. unit had 2. Management then decided that the rehab. unit could get by with one nurse at night. Several of the nurses immediately quit. So now they're scrambling to find coverage. One morning (after a long night), I was just leaving when the staffing coordinator stopped me to ask if I would be picking up a shift. After I confirmed that it was the medicare/rehab unit and that I would be the only nurse, I said something like "I don't care what management says, that's way too much for one person so, no, I'm not interested". To make matters even better, this happened in a public hallway with people around. (What can I say - I was tired and obviously not thinking. I should have just said I had plans and let it go.) Oddly enough, after having NO write-ups in the previous year-and-a-half, I got three in the three weeks. I can take a hint - started looking for another job, found one (quickly, thank god) and gave my notice.

Best of luck in your new home and position.

Most of my family lives in Europe/Germany. All I know is that they pay signifantly less (per capita) for health care than we do here in America and - more importantly - they have an longer average life span. I wish more Americans would realize we do not have the best health care system.

1. Short staffing 2. Overwhelming amounts of paperwork

First of all, best of luck with your daughter. Yes, work is important but family is more important. I hope everything turns out all right for you. Second, when you're hired for PRN work, that does not mean you are always available to work. It's not like they're paying you to be available. If they need someone, they call you to see if you're interested in working. It does not mean you *have* to work.

CapeCodMermaid - Can I come work for you??

I don't know any LTC nurses that follow *all* the rules. It's impossible to do everything we're supposed to do in the time allotted (at least at my former facility). (Each nurse had 30 residents, mostly medicare.)

I was thinking this same thing. I would guess that making a copy of the incident form would be against HIPAA regulations. It truly is a 'no-win' situation.

Thanks to everyone for their words of encouragement. This whole situation really blind-sided me. I don't think I can get away with simply not mentioning that I was fired. Yet I don't want to get into the 'other nurse' and 'narcotics missing' and 'DEA investigation' either. So I'm not sure what to do. Oh well, I'm sure things will work out eventually.

I worked at a LTC facility for 21 months until I was fired last week. For the first 19 months, everything was all right - wonderful evaluations, no write-ups, etc. Then two months ago, happened (more on that in a minute). Since then I've been written up 3 times and fired. The ? I work nights and I sent a nurse home (with my supervisor's approval). Needless to say, narcotics turned up missing and - somehow - the DEA has become involved. (When I first heard this, it struck me as strange. Does the DEA normally investigate something like this?) Anyway, I heard recently (within the past two weeks) that the investigation has expanded and the DEA is now investigating (more people/the facility itself). I'm not exactly sure what's going on but rumors are running wild. I suspect that this investigation is the real reason I was fired. Of course I have no proof. How do I handle this topic in an interview?? Any suggestions would be appreciated. PS - I'd like to reiterate that *I* did not have the missing narcotics, it was the nurse I sent home. PPS - Regarding the three write-ups - I have documentation and/or witnesses supporting my version of events for each one. And I added that information to the write-ups. But evidently that doesn't matter. PPPS - My unit supervisor only found out I had been fired two days after it happened. She knew nothing about it. PPPPS - I find the whole situation so depressing and frustrating. I'm not perfect but I really did try to do my best. Four nurses from the facility have called me and offered to give me references. I never thought something like this would happen to me. Again, thanks in advance for any suggestions.

I feel for you, I really do. And I wish I had some good advice but I don't. I've seen similar things happen at my LTC facility - it happened to me once and I've seen it happen to others. Just wanted to let you know I'm wishing you the best.

First of all, I'd like to thank everyone who's contributed to this post. I'm in the same boat so it's good to see that I'm not alone. I've been a LPN in LTC about three weeks by now. I am also the slowest person giving meds and everyone keeps telling me I'll find my own 'rhythm and shortcuts'. But that advice is simply not very helpful since any 'shortcut' would threaten my license. It's a shame because I like LTC. I like getting to know the patients and I like having some sort of routine. But I can see that it's going to be impossible to do it 'right' and 'in a timely manner'. I get along really well with the people (both patients and fellow employees) and everyone has been very kind and helpful. Even the one notoriously crusty charge nurse likes me because "she's a worker". I do try hard - I'm not goofing off or taking breaks - but it's impossible to get everything done in the amount of time given. And I agree that management closes its eyes to the shortcuts they know the 'good' (i.e. 'fast') nurses are taking until they're forced to do something about it because something happens. I feel discouraged at this point because I like 'nursing' but I don't like the environment. (And my particular environment right now is better than most, I don't know how some of you handle it.)

I live in Upstate SC. I'm a brand-new LPN (took the NCLEX-PN on Saturday, license issued Tuesday, applied on Wednesday, interviewed and accepted position at LTC facility today (Thursday)). I'll be working 7A-7P Saturday and Sunday alternate weeks. (This is perfect for me since I'm going on for my RN.) Starting pay for new LPNs is $16.50/hr. Add $1.00/hr for weekends. Another $1.00/hr for '2nd shift' (from 3P-11P) and $1.50 for '3rd shift' (11P-7A). And any hours over 8 in a 24-hr period is time-and-a-half. So I'll make $17.50/hr from 7A-3P, then 18.50/hr from 3P-4P, then roughly $27.00/hr from 3P-7P.

Thank you for your quick response. I can't remember the times either, I'd have to make them up. What I'm worried about right now is that one of the other techs called me this morning and said that she had heard out paychecks would be held back until we 'fixed our errors'. (Everyone else went through the MARs and added in the time but evidently at least some missed a couple.) The administration is in a panic because DHEC is all over them and coming in for an audit this week sometime. Evidently the more errors, the bigger the fine. (At least that's what someone told me.) They only started the course/test thing about four months ago. Would you believe they found that one of the med techs could barely read?!?!!? But she'd been there a long time and 'knew' what patients got what. They stopped her passing out meds for several months but are so short-handed they now have her doing it again!!!!

Hi everyone: I am a nursing student and will be taking the NCLEX-LN on 6/28. Hopefully I'll be finishing school and taking the NCLEX-RN in January. But I currently work (part-time) as a 'Medical Technician' in an Assisted Living Facility. This is not a licensed position, I merely had to take an 8 hr. course and pass a simple 10 question test (both done through the facility itself). I've been working there 8 months. I took the month of April off from work because of school. When I came back on May 10th, I noticed that some of the other techs were now filling in a column on the back of the MAR that we had never used before. I asked one of the other techs about it and she said that, when giving a medicine PRN, we were now supposed to check on them within two hours to see if it had been effective. Fine, no problem. I'd been taught to do that in school and had been doing it anyway, albeit unofficially. So I started documenting it. On May 17th, I noticed that some techs were also putting down the time they checked the patient (even though there's not a column for that information). I started doing it too. In the beginning of June, the administration had a meeting and told us we (the techs) all had to go back and add in the time we checked from the first of the month through the 17th. I have a problem with this. It just seems wrong to me. None of the other techs have a problem with it, I seem to be the only one resisting. Am I wrong? Should I just go ahead and do as they request?