AtheistRN

Report to your supervisor and go up if necessary. No excuse for missed BG and insulin, twice! No excuse for not infusing nourishment as ordered. That nurse is a danger to your patients and should not touch them again until they are straightened out. It would be different if they documented everything and reported to you accurately. But they didn't. It's like they were never there, except to run an infusion without proper equipment. Sorry you are dealing with this. Protect your patients.

Hi, OP. I came from a family with a lot of dysfunction and substance abuse. In fact, my adult some is a homeless heroin addict. Heroin, fentanyl, crack, speed, anything. He always has reasons to justify his usage and everyone else is in the wrong. When any plan that is suggested which doesn't involve some kind of drug use, he balks and disappears. He loves Xanax. I have had my own issues which I won't go into here. Suffice to say I'm not stranger to severe ptsd and subsequent SA. That being said, your comments are all aimed at protecting your substance use and excuses for it. Your focus should be your children. Please see a therapist regularly, have them get therapy, too, and go into outpatient rehab so you can be home with the kids. NA and AA are free resources. Lastly, I would not be comfortable working with a fellow nurse that has taken something " to take the edge off". I know addiction is a disease and it's really, terribly hard and unfair. But you need to be crystal clear when you are responsible for the lives of others. Good luck.

My test was done in less than an hour. I was stunned and thought I must have failed. It took 2 weeks for the results to post. 2 weeks! But the "good pop-up" showed and I did pass.

Thank you for your response. The issue here is no eschar whatsoever, just large open wounds with slough.

Hi all, I'm an RN working in a skilled facility and have a question for the experts about heel ulcers. My understanding is that when stable eschar is present, this is usually "left alone". What about when heels have 2-3 degree ulcers with slough, drainage, and odor? I suggested sharp debridement by MD, but other nurses have said that heels don't fare well, being distal, etc, and should be "left alone." This does not make sense to me, especially if the pt is not diabetic. Your input is appreciated.

I work my butt off. 80 residents, 4 CNAs, one nurse. Can't clock-out for lunch, wouldn't stop working if I could. Usually don't spend time off the floor except to pee.

Of course it needs to be reported, that's not even in question. And if protocol leaves room for cover-up by the powers that be, what then? A simple in-house med error report isn't an option.

If a terminal, DNR resident dies and a med/transcription error is discovered, how and to whom does one report this to avoid potential cover-ups? I cannot elaborate, but imagine what Rx is ordered.

I am a new nurse to the facility, but have been an RN for 2 years. I have very high expectations of myself and other people. If a CNA is improperly providing care, totally slacking, or faking VS, I will talk to them about it. I have not written anyone up or insinuated I would do so. I also recognize great work and tell people frequently when they are doing a good job. The other day I was pulled aside by a nurse that has been there many years and told I need to watch my back. I am ruffling feathers by insisting things get done right. I was told to ask the other nurses first and be more careful. I was so offended and hurt. The biggest deal about it is that I believe it is gender bias. I am a female with a strong personality so I need to be more careful? The male Nocs nurse yells at the CNAs but that's ok. I was told people have worked there a long time and I need to slow down or my job could be at risk. My boss has said nothing about this to me. I work very hard because I am a good nurse, I was taught to do things right, and (bottom line) the residents are paying me to ensure their care is excellent. Now I have to worry that my bar is too high? Excuse me, but Forget that.

Nocs with 70+ residents, 4 carts, on my own.

I've seen anywhere from 8 to 20 dollars more an hour for acute care RNs. I have never heard of a nursing home RN getting paid more unless DON, DSD, etc. In No. CA, at least.

I am smart. That's how I got to be an RN:thankya: Terrible at venipuncture, though

Some things that bug me (RANT): 30-60 residents with less than 5 minutes to see each resident. Staff that should never be in charge of care for people. Staff that are completely uneducated. Staff with educations that still do things like reuse blood contaminated, single-use products. Nurses that lie about passing meds because there are too many residents and not enough time. Nurses that lie about whether they gave a suppository or not (I counted---you lied!) Lack of oral care for residents. All of the therapeutic conversation and dignity stuff learned in school is looked upon as a waste of time when put in practise. Ambiguous orders from a doc that oversees 3 LTC facilities of 60-99 residents each and has private clinic time. PAPERWORK PAPERWORK PAPERWORK. Lower pay than hospital counterparts.Noise levels that are grating on the nerves constantly. DONs and administrators that could care less about the actual humans being cared for. DONs that don't back up their nurses when it comes to giving CNAs direction. CNAs that smoke pot in the parking lot. Nurses that steal drugs. Call-offs. ETC ad nauseum. These are not particular only to LTC. But these are problems I have faced.

Great news: the situation has been resolved in a positive manner. Phew! I lost some slep on this. Thanks for the input

I have found that some nurses are reusing vacutainer hubs, tourniquets, and bringing a visibly blood-soiled trolley into resident's rooms for draws. DON was notified. She said to talk to the TX nurse- the one responsible. DON was angry that I even called her to ask if it's our policy to reuse. The Vacutainer hub has blood on it. I'm SO bothered by this.