LASLPN

mmmmmmm, this post brings back bad memories! I had 3 cna's on my shift that would act unprofessional on a daily basis. using cell phones while actually doing patient care, eating while walking down the hall, leaving the unit w/out telling me, taking extended lunches, using ebonics and inappropriate topics of discussion on the floor in front of residents and their families,hanging out and being loud at the nurses station.....I was new to this facility so I sat back for a second, observed and finally I started to try and get a handle on my crew.... at first I spoke off the record to each in a casual atmosphere about my expectations and theirs. I had thought this would change things.......it did not. I had to resort to the written/verbal paperwork. I then was labeled as a unfair pill pusher! I was accussed of being unfair and just out to get them.. I never tried to make it personal at all. I went to my unit manager and expressed the difficulties I was having. I found that it was making my shifts uncomfortable. I told her that I would have to refrain from being the one to discipline these young women and have my sup do the grunt work for awhile. 1 month passed and unfortuanately I had a complaint of rough care from 2 residents sharing a room along with a family member present. well, guess which ones were involved? YUP! I follwed procedure...supervisor involved...unit mamnager called ect... when I went to them to ask them to write a statement on the events that occured i was told by one that she had arthritis in her hand! ok, so be it ... your an adult..you get paid just like me to do a job I thought ...its your choice if you do not want to protect yourself from such allegations. well, all heck broke loose... I was talked down to, i was starred at ,, laughed at as i walked by...follwed to the time clock ...one even called her mom at the station to tell her i was harrassing her! its was immature and way unprofessional. OH and so freaking hard to stay silent cause i wanted to tear em a new one! but! i thought of my license and stayed professional and just shook my head and laughed silently. that was until 11:20 p when i went to leave and found a tire on my slightly used but new to me Jeep Liberty slashed and flat! now, I only make 17 bucks an hour.........sounds good but you know how far that goes these days!!!!! well, of course no one can prove anything and the only thing that was done is... im sorry this happened........I asked for another shift and was told none were avail. after 3 days of trying to get there early and leave late in my daughters car I couldnt take it anymore and quit.....so, now it looks bad on me cause i didnt/couldnt give 2 weeks notice(i offerred but only on a diff shift) and yet another job change on my resume....im not so sure us nurses can win this battle, esp. when people wanna fight dirty! just so ya'll know i was a cna for 3 years....i do get down and dirty and i am a smoker so i understand the meaning of grabbing a puff ..........im so not a hard butt, i do believe in doing your job to the best ya can though and i do expect that the cna's on my shift strive for that as well. is that too much?

breathe............and congrats on passing the board:)......... #1. clock in, count narcs, and get report--insist on a walk through....lay hands and eyes on all of your patients with the nurse you are relieving..warning, some may balk at this stick to your guns its important. while you are in the room...check out the patient...color,breathing,pain level, mood, ect. check out machines....tube-feeders,wound vacs,IV,O2,foley's(esp. the bags!)....any wounds,ect. #2. set your cart up ..........anything that you may need for your shift.... #3. get your blood sugars before dinner....if you have alot do them all sep. then you can start meds....alot of patients dont like their meds w/dinner or before ..they like them right after, lolol... #4. write down everything! so that you can refer to it later when charting. #5. verify your narcs before the on-coming nurse arrives...it is easier to find mistakes in deduction when you do dont have someone freaking out next to you. #6.when charting write a brief note on what you observed, did and what occurred during your shift,,,, in your head see it from the beginning...EX: alert, verbal, pleasant mood, foley intact...urine yellow, % of dinner consumed, fluids, ect........chart any as needed meds and why and their effect, just a note: if it is not effective CALL THE MD! NEVER CHART THAT THE MED DID NOT WORK W/OUT CALLING HIM! When charting on skilled patients remember to write about what they are skilled for....... you will do fine..........make sure you stay on orientation until YOU are comfortable and never do anything unless you are 150% sure ....COMMON SENSE is a good nurse! it may be easier for you too if you are on a slower paced shift....day shift goes by quick and is caotic. night shift is way slower just more paperwork. I prefer evening shift cause its still busy enough for the time to go by and the carpet runners leave by 6p, lololol good luck!!! you will do fine!

LOL.......I can relate so much to what you are saying. Unfortunately, there are going to be so many days/nights/evenings like that!.............nursing in general is mental and physically draining. I am type A so I have to have EVERYTHING in order which drives me crazy, lol... in a perferct world the cna's would go the extra mile and the nurses would all do everything that was written on the MARs and TARs plus...........Admin. would get OFF the carpet every now and again w/out STATE behind their heels! Supplies would be plentiful and WHERE they belong,hence everything would be in place to help all of us help the patient.... who should be the ONLY unpredictable part of our job. BUT!........but, I fear it will never be this way.I can tell you it is exhausting to strive to be the best but what choice do we have? PLEASE, do not cut corners. Take a look at your MARs, ask your UM if you can get any orders changed by the MD to group some of the meds together.....EX: vitamins,,,,HS meds on patients that are in bed at 7pm...ect. I try to have all my PO meds out and in before they fall asleep because it is too hard to get them to wake up to take them. I try to only have to go back at 9p for BS and those things that have to be given 12 hours apart and so on. In our head we know that giving a remron at 6-7p is not harmful and this may be where you see nurses cut corners... I say to get the order changed to protect your orifice. EX: if it is scheduled for 9p get it changed to 8p and give it at 7p............:) Help the MD's remove anything that is not needed, I once had a patient (tube feeder) on a appetite stimulate! I ask you... NOT NEEDED, lol! FSBS 4x's a day on a patient that is never over 150 is not needed....ect. The DOCs are not going to change this stuff on their own we have to ask them firmly...wink-wink. as far as the paperwork.....that is something you never want to minimize it is way too important, trust me.....nurses are mean and w/ a lil power they are worse(not all). I was talked down to by several nurses because I called the doc to change a PRN to routine on a patient that has been asking for pain med every 6 hours every day for months....obviously she is dependent on this stuff ( vicodine 7.5/500) the reason I did it was for 1 it looks bad on us if we are giving an as needed med ....routinely and she may need something else... anyway- the doc weaned her off.ya know by now that the patient had a cow! well the other so called bosses(fellow nurses) expressed i was starting trouble.............um, im confused! work smarter/not harder is what I thought I was doing....and looking out for the best interest of my patient...ah well... stick to your guns...:) Thanks for letting me vent too!:wink2: