Candyheart

I just take the time. I get in trouble with administration sometimes, but my residents love me. Its the most impotant thing I do at work, the minutes I take to rub a back or listen to some poor scared to death elder the first night in a facility. Its a crime not to have more time to do what you know as a nurse is your real job. Handing out 200 pills is not nursing.

One evening on the memory care unit, one of our aphasic residents, a very "good friend" of mine. walked up to me and offered me 2 perfectly formed "logs" in her hand. I quickly grabbed a tissue, took them from her, thanked her, and put them in the toilet. I figured I was lucky because (1) she handed insted of throwing, and (2) not squished at all. God, I love to hear this stuff!

I work as a nurse on the "memory care" unit. On the am shift there is 1 TMA, 1 nurse, and 4 aides. On the pm, 1 nurse, 1TMA, 3aides. Noc, 1nurse, 2 aides. There are 36 residents. The nurses are LPNs or RNs. I help the aides as much as I can, I feed residents at dinner (have to be in the dining room for safety reasons anyway). Seriously, I couldn't do the aide's job. It is hard physically, and the residents are hard to deal with. It takes a very special person to redirect over and over, sometimes agressive and combative people. It can be exhausting to care for these people and keep them safe. Still, we maintain a sense of humor and love on my unit. I love my job and consistent staffing is key to trust and routine on a dementia unit. Its not for everyone.

The common idea in this thread seems to me is that nursing is a lot of hard work, rife with libilty, highly regulated and filled with residents,coworkers, administration. Geeze, can't figure why a new nurse has stress. Also happens at the hospital, which some nurses seem to think is nirvana, the stress, too much to deal with etc. I like LTC because I personally like to develop a relationship with residents and try to make their lives better. When I started, I handed many meds in my dreams, cried on my way home from work, all that good stuff. Hang in there, it gets easier. As for some of the questions, borrowing -yes, not narcs.or the stuff you have in the narc box. Combing meds-realize that HS often means right after dinner. Trying to get meds down a sleeping 90yr old will convince you of that. As for supervisors 3-11 and 11-7, please! That's prime time for emergencies. That needs to change. Learning what works and what doesn't comes with experience. There is only one way to get it.

Of course the administration doesn't care, they don't have to count it or get in trouble if the count is off. If the drawer gets to difficult to count, people will quit counting it, it will be off and some poor new by the book nurse will count it find it off then there will be big trouble. I've seen expired narcs, narcs that belong to long dead residents, 2 stuffed full narc drawers. Just land mines waiting to explode on some float nurse about 0630, at the beginning of a 300 pill med pass. I hate this outdated system

I think one of the reasons there can be conflict between family and staff is that our perceptions are not colored by emotion. Their dying family member is not starving and do not need IV fluid. Bodies that are dying don't need those things. They need to know their life counted for something and your presence tells them that. Your wife's condition is getting worse, she has a progressive disease. I love my residents and I wish the family could see the many times I sit with their loved one, holding hands , talking about the life they lived and the family they love. Family members don't understand that nurses are advocates for the patient first always. That can cause conflict.

Its not only the narcs you are responsible for, you are also the only nurses for those units. How can you accomplish any work on your unit? And as was mentioned, how about report? These nurses need to deal with their time problems without you. It would be better if you told them no, but coming in on time will do the same thing. Good luck!

It sounds to me like another attempt to cut staffing costs by making everyone do everything. If an aide want to work in dietary, they need to be hired in dietary and put their time in the kitchen, not take time away from their resident care. This is a ridiculous idea to have aides do even more. Anything to maximize profits for the administration.

Thanks for the Depakote idea. Maybe it will work better than Serequel for some agitated behavior. One of the things I have noticed is that one day the resident gets their med and doesn't slow down a bit, just as wild as ever. The next day, same med knocks them out all evening. Of course, thats the day the family visits and is alarmed that "Mom is so sedated". If only they could see her on the other evenings!

She did this at work? I can't believe she would think this would be helpful in any way. If you found out he was a terrible person, would it help in his care? Your job as a nurse is to care for someone, not to judge them. I think if the family found out they would raise a riot with the management. In my facility, that would probably happen. What is the management thinking allowing this liability.

I agree with all the previous posts esp. the signing the receipt from the pharmacy. Also keep in mind that even though this is the first time you've been through this, the administration has been through this sort of thing many times. Just be sure you've documented every thing carefully and continue on with your work. I hope you find out what happened soon.

In our facility side rails have to be ordered, and signed by the resident or POA. We had a very restless and relentless resident that would not stay in bed, even though he said he was tired. He has two mats ,one on each side of his bed. The P.M. nurse let him lay on the mat, with a pillow. She said its not considered a fall because he wasn't on the floor. The resident was happy, and the nursing staff could get some work done. I don't know what the DON would think of it, but she wasn't there. I thought it was genius. This may be off subject but do you ever wonder just how the people who make up the rules about restraints etc. figure we can do our work. I have ended up taking a resident everywhere with me all shift, just to keep them safe. One on ones are not planned for at my job we don't have the time. With all restrictions, it's hard to insure safety. What are some of the tricks nurses have come up with to insure safety but still get work done?

Well, you've heard from alot of nurses and students. I think the bottom line is, will your attitude poison your patients. Can you put yourself in their place, scared ,or in pain ,maybe disfigured or in a body that doesn't function and is out of control? If you are going to make them think that they are disgusting and not worth your time, don't go near direct patient care. There are many other options such as phone triage etc. You need to figure out your passion and follow it. Don't inflict pain on vulnerable patients just because you have your licence and the nursing board says you're a nurse. A nurse is a patient advocate at all times. You sound as if you need to do some serious soul searching. Agrippa is right when he says it sounds as if you're not content with yourself. I hope you find that.

I've been a LPN in a LTC for about six months. The heaviest med pass is in the morning. Its not uncommon for a resident to have ten meds at 0800. You will have between 20-30 residents. Also many residents have DM so there is the BG monitoring and insulin. There maybe tube feedings. There will be neb treatments, wound treatments. The NP's order labs that have to be called in and orders taken and faxed to the pharmacy. There are often behaviors that have to be addressed. The facility that I work at is still all paper charting on the LTC units so that has to be done also. All in all, it's a full day. One other thing, people pass away on this unit and sometimes you've really developed a relationship with them and that can be tough to deal with. I love my job. I feel I make a difference in the residents lives every day.

I've been reading the other opinions and I have to tell you, those nurses that caused you all that trouble are the nurses you are going to be working with all the time. Lazy nurses, "territorial" nurses, etc. are going to be a pain every day in that facility. I work in a fairly big facility and we all interact a lot of different ways all the time. Charting is a huge deal. As you know as an ER nurse, it's the only way to know whats going on. Think about dealing with that staff every day.