wiley6coyote

how do you handle complaints made to you regarding staff who have a reputation for bullying, harassment, silent treatment and who you have reported several times for witnessed abuse of a patient and still nothing is done by the upper management. Staff are afraid to speak up and seeing that this person appears "untouchable" in regards to disciplinary action the situation is worsening. How do I continue to show up for work, knowing that this is going on and all my efforts in protecting staff and patients have been futile.

I am appalled at the lack of knowledge surronding care of long term diabetics when admitted to hospital for conditions unrelated ie. heart attack. A friend of mine almost died this week because his BS was allowed to drop to 1.3( canadian ) !!!! not once but 4 times in the span of a week. Long standing insulin doses which these people/or their families have been using/adjusting all their lives are thrown out the window and the hospital staff change up everything including diets etc. CBS are not monitored properly - my friend's wife asked that staff check his CBS when she was there and was told " its not ordered to be checked until 4 hours later". I have also witnessed a hypoglycemic situation being treated with 2 PB &J sandwiches, 2 OJ's with 2 pkg sugar and a banana- so that the patients' BS was then over 27!! How scary is this? These are registered staff - who were supposedly educated or at the very least should have policies and procedures set. What to do??? Family have to almost stay in the hospital and take over this aspect of care.

I recently found a med error and followed through with a med error report ( I am the charge nurse for that shift). There was no harm done but the potential was there. The nurse who made the error was devastated even though I spoke to her about it in a non threatening way and told her about errors I had made in the past. I felt so bad after, seeing how hard she was taking it. Fellow charge nurses have since made it known that I "over reacted" and felt I should have just let it go seeing there was no harm done. Did I over react?? I don't care to have my license suspended for non-compliance.

A wonderful, delightful elderly resident for whom I had great affection and rapport was found gasping for breath, ashen and moaning early one morning . According to POA directives, he was sent to hospital. When the POA was called to let them know what had happened they said he wasn't supposed to go, they didn't want that. ???? I felt terrible- it is my biggest peeve in LTC that we are too aggressive and should allow more natural deaths. However, one must follow family wishes. I thought back to the aggressive treatments this family insisted on only several months ago, the bullying tactics of family members trying to get this resident to eat, drink. The overwhelming picky directives staff were to follow about when he was to be up, what he was to wear or not wear despite the protests of the resident, he was TOLD he must do this or that... the numerous " stomping down the hall to hunt up the charge nurse to tear a strip off her". I am disheartened with my nursing role right now. If I didn't need the money I would work somewhere else. Is it guilt, miscommunication, lack of knowledge that makes these families so obnoxious? When a family makes the decision to move their loved one to LTC, don't they see it is end of life care, not rehab. We have care conferences, set up nsg care plans but it doesn't matter, if Mary wants her mom dragged out of bed every morning for breakfast and put in a hot fleece track suit we have to follow her wishes -even though mom might be stripping in the hallway because she is so hot- if we change her and Mary finds out or God forbid comes in and sees her like that there is Hell to pay. I have families who ask every day why their loved one, who is in a locked alzheimers unit, is restless, confused, agitated? Or better yet, the ones who insist on the MD discontinuing all their meds and putting them on vitamins and then at night when the sundowning kicks in they get upset because their father/mother fell, or hit them or attacked a co-resident.

Wondering what the thought on admitting a resident to LTC without giving said resident any warning. Over and over we are having to deal with new admissions who have been "duped" by their families- they are told the craziest stories, lies etc by the family, so the family won't have to " deal" with the after math. But we are left with these poor souls who are frightened, confused, angry, resentful ( I could go on and on) and then they try to escape- and escape they do- we found one a mile away hiding in the woods! And then, to prevent any more escapades, there is an order for a heavy sedative so they can't think about escaping anymore. The staff is furious, the management??? who knows - we never hear anything. Doesn't this scenario sound familiar??? like a scene from " One flew over the Cuckoo's Nest" but it is truly playing out- I would like to know what other facilities do to manage or prevent this from happening???

Do you feel obligated to work extra shifts on your days off due to management not having the foresight to fill shifts due to vacations, LOA's etc. I work part-time of my own choice but get calls every day because of shortages. I feel for my co-workers- I have worked short too but the hours I choose are enough for myself and family- why must I feel like i have to explain myself - like I'm doing right now???

A very nice co worker admitted to me that she is resigning due to the stress of working with another registered staff member who is abrasive and domineering. This RN does her work well but is slower at some things - she takes her time, is meticulous and hard working but is not able to handle alot of extras. she works only part time. When we started working together she was so afraid of doing some skills and was constantly asking for help. Now, I see a huge improvement in her confidence- however, since this other person began on the floor she is a wreck. This other person writes people up, reports them, plows around the unit with a loud, intimidating voice. I saw this coming -that my co- worker would resign and I have been thinking that maybe I should, as a senior staff member go to our DOC and have a talk about how we failed this girl by not mentoring her and encouraging her rather than letting the other girl bully her ( management loves a snitch). We are always being told to respect each other, help each other out and yet that certainly didn't happen here. Should I stay out of this?? What do you think??

I hate MDS with a passion.

Good for you!! I stayed out of nursing for 13 years raising my family and never missed it - later, much to my surprise, I re-certified and found a part time nursing job. I really enjoy my time at work now and of course the extra pay helps. The only thing I would have done different -looking back - is that I would have tried a little harder to find something that fit my family's schedule rather that quit outright- because we really could have used the extra money. We managed but it was a big load on my husband.

Well this is EXACTLY the problem in our facility at the moment and the employee morale is zero. It is a well known fact that if someone is in from head office, the upper management is throwing their arms around the employees and being BFF!! but when corporate leaves it is a whole different scenario. We are losing great staff at an alarming rate.

Why are we so quick to judge others? Lately I've seen so much backstabbing, accusations, negativity at work that I'm in total shock that fellow registered staff members could be so cruel. I am not talking about one or two people here. I have seen staff get an idea in their head that someone is " out to get them" and by the end of the shift and into the next the poor person, who was going about their business and oblivious to the gossip, is almost tarred and feathered and hung out to dry. Then, in the next moment the accusations are proven false and no one - not one person- apologizes!! I have been left notes and had insinuations made that I am sitting around on my shift when in fact, I almost never get a break and spend a lot of time " housekeeping" because others leave charts, old notices, etc laying around and I like my work area to be tidy. I have stocked med carts, emptied trash, washed and dried bottles that were coated in old drippings ie. colace bottles and still .... I hear " what are you nurses doing??" As for common courtesy.. what happened to that???? I was out the other day shopping and I had one person after another walk in front of me in an aisle where I was trying to find something, and not one person, young or old said excuse me. I'm sure we could debate this one forever but I just needed to vent. We need some civility brought back to our lives, thats for sure.

Thanks for all the wonderful suggestions. I hope we can implement many of them and make our unit something to be proud of. The staff that works there really love the residents and we do try to be flexible - in some ways it is my favorite place ( I work in several units) to be.

The residents are not able to comprehend/ give an opinion which is probably why it is the most neglected area- no one complains except the staff.

Any suggestions for redecorating an Alzheimers/locked unit?? Ours is painted the most depressing shade of green with dirty flooring to boot.It always smells and does not feel uplifting in any way, shape or form. The staff would like to make it more welcoming and homey but feel overwhelmed as to where to start.

I took a break from nursing and swore I would never go back- the best feeling in the world was getting on the elevator and walking out of the hospital for the last time. Now. years later I returned and I love it. I work in LTC and would never go back to hospital nursing. LTC definitely has it's issues but my attitude is I try to be the very best that I can be when I'm working- I put 110% into it and if that is not good enough well I can hold my head up anyway. I find in general, the public is ruder, more demanding and narcisstic than ever before. I don't have any real advice for you except maybe it's time to look at a different area of nursing - something that will ignite the passion again for you. All the best.

I like night shift because it is quiet and less staff. Generally I find I have no issues with staff because it is a small, close knit group. I have heard plenty about the dramas of day staff. I also don't deal with management ( a huge plus). I can comfort the residents one to one ( it's LTC) because I usually have more time ( but not always) It can be pretty crazy sometimes esp. if we are in outbreak or have had multiple medical emergencies but on the whole I like it. My biggest health concern though is my weight. I'm packing it on- I recently tried to start flipping my meals upside down so I would be eating breakfast before I go to work at night etc and trying to eat a sandwich in the middle of the night and staying away from the nibbles and goodies that night shift is famous for.

I need some info regarding RAI therapy for Graves disease. Is it safe? Are there any studies showing a risk of contracting cancer? As for the Graves itself, does it go away after treatment? If not, what should one be aware of regarding their health for their lifetime. This disease has manifested itself in our family and is taking a huge toll on the individual. I am at a loss as to what to tell them.

Wow- guess this is a touchy subject!!! I don't expect people to stay past their shift - I will even tell them to leave things for me to do so they can go- and if they ask to leave a few min. early to catch their bus I have no problem. It just struck me the wrong way to have someone refuse to show paramedics to a room because it might cause her to leave 5 min.( tops) late. What were they supposed to do- find the room themselves?? I think a little give and take is in order. I'd like to see what would happen if the fire alarm went off 20 min before the end of the shift. lol- that would be something!!!!!

Well call me old fashioned..... but I wasn't asking for this person to stay every shift and work overtime, I only asked that she show the paramedics to the room until I got back from dealing with the other issues which didn't take long- two nights later I saw her running out the door 5 min. early - she had no qualms about doing that but on the flip side she couldnt stay five min. later to help me out? We are all taken advantage of by administration - the bottom line is money/profit but I try to remember that it might help to lead by example???

Would it really kill staff to hang around perhaps 5- 10 min after their shift to assist with an emergency?? A few weeks ago, a resident went sour approx. 40 min before the end of the shift- I assembled all the paper work, called family etc etc including calling the ambulance and then was getting calls from other floors which I needed to deal with. The resident was stable enough so I asked the nurse in that area ( I am the charge nurse for 4 areas) to please show the paramedics to the resident's room and she says to me - I can't stay I have a friend waiting for me in the parking lot- and that was it- she didn't stay and I had to run around like a nut watching all unionized staff leave right on the dot of 12 and ended up sending the poor soul out myself and leaving late- I don't care about myself leaving late- I hate coming on a shift and being handed a mess like that and even though the night staff was there by then they hadn't had report- Back when I first started nursing ( 20 years ago) if something came up you helped out, now staff watch the clock like they are in a marathon and start putting their coats on as the hands inch up to the final hour. If someone wants a tylenol at 1150 too bad they don't have time to stop and give it - it might take them past quitting time. I have even seen staff get up and walk away from charting ( I'll finish tomorrow) because their shift was over. They tell me they are not getting overtime so why should they stay?? I guess work ethics are not a good enough reason.

Good advice .....also stay away from Facebook and adding co-workers to it- big mistake. Be friendly, help out as much as you can but make it known you won't allow them to cross the line with you.

This sounds very familiar- certain people work better than others. The gossip in our place is unbelievable- and people lie in wait for others to make an error and then report them asap- others are afraid and intimidated by staff and some staff are so insubordinate it boggles the mind. It absolutely starts at the top and our top gossips too!!! I am curious to see what others say- I have no problem with my staff because it is the graveyard shift and we work well together - everyone helps everyone but I have heard stories about day/evening shift that would curl your hair. It is mostly put on the managers back to resolve issues otherwise we are accused of not doing our work properly and a bulletin goes up with our job description and a warning.

I hope I don't get hate mail over this but I've thought about this alot in my many years in LTC. If you make the most difficult decision to put a loved one in a nursing home- I am talking the truly elderly with advanced dementia etc, why would you insist on making them a full code. I think it should not even be allowed to be a choice.Send them to hospital if you must but to throw an elderly, fragile demented person to the floor, strip them of their clothes, pound on their fragile bones, take away all dignity etc to bring them back for what?? Their quality of life? When a person enters LTC haven't you pretty much accepted that this is the last residence they will ever be in?? We have residents whose families never, ever visit but at the yearly conference they continue to insist that we resusciate Dad even though he is beyond functioning at any level. They can't bring themselves to make that decision even though it would be the kindest one in the world. Just let nature take it's course and allow their loved one to die peacefully when their time comes. We just recently got a crash board and some assemblance of a crash cart but on nights?? There is only one RN and they are the only one with the key to open the room to get it. How on earth can they possibly do CPR with skeleton staff who cannot leave their areas to help? I think the public needs to be educated on the realities of aging, death and dying with dignity.

:nurse:This is pretty much how our home works except that blood is drawn only twice per week-no stat orders. If it is that serious then they are off to the hospital.

I am just curious why you would have to draw blood if BS was too high or low? In LTC this is not an option and also, I have a child with type 1 D and highs and lows happen alot - I think it would be less time consuming to have the med nurse do the check and give the insulin , it takes very little time to check a CBS and if you have the med cart with you, you can give the insulin right away rather than going back after someone else has checked the blood.