Anglkses

I would have done the exact same things you did (except the incident report piece and I will get to that). You were diligent and put the patient first. You didn't make a big deal about it you simply sought answers to ensure you provided appropriate care to rectify the med error (and yes it is a med error since it was not given in a timely fashion, I mean last I checked right time is one of the 5 rights). Regarding the other nurse, she is embarrassed that happened and is striking out because that is how she is coping with the error. That said it doesn't excuse her behavior which appears to have been extremely unprofessional. Sounds like the ball got dropped on two different units/floors by multiple nurses. I am not sure of your policy but where I work if a med error occurs with no harm that is an internal QA process met by the filling out of a med error form. If harm occurs then we fill out an incident report. That said at the end of the day I bet that nurse who got all upity would have done the same thing if roles were reversed. We all want to do a good job but with too much work and not enough time we all are looking out for our licenses and a supportive environment is hard to maintain with that kind of pretext. Thank you for sharing your story and I hope that this blows over and the "lateral violence", as one poster stated, ends soon for that is never productive nor pleasant.

I would call after a week, I mean its not like you are calling each day. Another alternative is to get in touch with the nurse recruiter for the hsp. Send them an e-mail regarding your interest in the job, that you haven't heard anything in a week and wanted to just check in and reiterate your interest in the mission of the hsp, the job, how you can help blend the mission statement of the institution into your care, yadda yadda yadda. GOOD LUCK!!! I know un-nerving it is to wait for a response, seems like an eternity!

It depends on the size of the facility you are applying to. I have found that large health centers with internet based employment screening takes anywhere from a week to 3 months to let you know. I would say at this point with the number of applicants each job listing draws in typically its a 1-2 week wait to know. You can always call about the status of your application after a week to check in with them. If you are still under consideration this can communicate the sincerity you have about wanting to be employed by them not simply employed. Good luck to you on your job hunt!:)

I work in LTC/SNF nursing. I would say that the biggest obstacle I see to adequate nursing is overall resources set aside for LTC/SNF nursing (or any nursing subset I think would be safe to say). Multiple issues previously mentioned in this thread are born of a lack of resources. TOO many patients, overworked staff, lack of financial reimbursement for residents with significant behavioral issues (which administration will say is nurses fault because behavior monitors are not filled in- maybe thats because in an 8 hour window I am supposed to assess, pass pills, do IV's, assist with feeding, hydration, help my aid (yeah because I only have 1 a majority of the time), answer the phones, talk to doctors, process orders, inform families of issues, and provided psychosocial support for those with behaviors), etc. If change is going to happen then people need to start supporting nurses who are providing more and more care to patients rather than criticizing them when they are stretched too thin. It amazes me that the nurses I work with get as much done as they do and there are not more dire patient outcomes. I think it is safe to say there is a nursing shortage looming. At some point the nurses over 55 are going to either want to retire, be able to retire, or have to. After that you will have half a decade to a decades worth of new grads who never were trained. All healthcare subsets must be willing to invest in the future instead of putting out the fire immediately in front of their face.

Docusate Sodium, Omeprazole, multivitamin with minerals, zestril, metroprolol

I have a resident who is exactly like that but when she puts on her call light and the two aids and the nurse on the unit are in rooms doing patient care she CALLS THE FACILITY TO PAGE US TO HER ROOM!!!! She refuses mental health services, and in a 8 hour shift uses her call light on average 42 times... yeah! What I have to remind myself is that this resident has significant independence loss and thus the only control she can exert in her life is to ensure she is cared for. And in LTC you just have to grin and bear it because it is their home. Hang in there and just remind staff what factors contribute to her behaviors... care planning can be effective for big things but the intermediate needs (e.g. wants more fluids though the cup is full) is tough ground because if she becomes dehydrated and gets a UTI state can throw down and relate it to your refusal to care for her- wah wah wah.

Thank you all so very much!!! I had my first solo shift tonight complete with a hospice patient on the decline, a new admit, and someone with a blood pressure of 222/86. All in all though it went well and I got everything done. Thanks for the advice, you all gave me the courage to keep working at it! :redpinkhe

I am new to allnurses.com and this is my first post so I apologize if I do this wrong... here goes. I just started at a SNF (I have been there 3 days) and I am scheduled tomorrow as the only RN for the evening shift. I think the facility considers me oriented, even though the three days were not really the best orientations to how the facility works, what protocols are, etc. Is this typical? I received my RN through an entry level MSN program and so its been two years since I completed my prelicensure clinicals and as such am in need of new RN orientation. I am just worried that I am in the wrong place to start my career as an RN:eek:. Any advice would be appreciated, because I am so overwhelmed and feel just nauseated at the thought of doing total and complete RN care for 20 people I have met twice. Thanks to everyone in advance:D

I am facing a slightly similar situation myself. I just started on at a SNF and have received three days of orientation and am now scheduled tomorrow to work by myself. I am a recent RN grad who only has 6 months of experience in Public Health Nursing. Suffice to say it has been a while since I had anything to do clinically. My first three days have been filled with my orienting nurses calling out, a lack of protocol orientation, and some encouragement to bend nursing rules. I left after my first day an cried my entire hour drive home, and again the next morning. I am trying to decide whether I should quit due to the seeming lack of responsibility on the behalf of the SNF and its lacking reputation (which I of course discovered post hire). I mean as a new grad all we want is a safe and encouraging environment to establish our nursing careers and gain a solid and correct foundation to our nursing skills!!! I truly feel for you and hope what will follow will help you make the best decision... The harsh reality is that nurses tend to eat their young, it's complete bs and totally unprofessional. Alas, it is a reality we must all face. I have found that when someone is talking bad about me I confront them one on one and simply say "I would appreciate it if you have an issue that you please speak to me directly. I am new to this and am willing to listen and learn" blah blah blah. If these rumors start to affect the nursing process and care provided in your facility then I would make sure to mention it to your Human Resources staff, that is what they are there for. Regarding the errors, we are all human and that gut feeling that you feel when you realize you have made a mistake is a good thing because that is what we remember and keeps us vigilant. You learned that lesson and I bet you will never forget to get blood sugar levels before meals again. We all learn by making mistakes, even the doctor who tried to get you written up I am sure has made at least one mistake that he has never made again. Doctors and other health care workers with broader scopes of practice, some of them feel that they should not be bothered by the day to day events in their patients lives. Thats great for them, but you did the right thing by calling him and following your protocols. You should be proud of yourself that you had the courage to correct your mistake! That indicates to me that you will be an amazing nurse :) Regarding the admit situation, when you report on make sure that paperwork is done from the shift signing off. If it is not done, tell them that you do not know how to do it but that you would be willing to assist them with it. If you do not have time, then unfortunately thats the reality of the situation. Then go to your nursing supervisor and indicate that you were not trained on how to take an admit and that you want that training asap. If your professionalism and critical thinking are not appreciated at this facility after all this, then yes perhaps you should move on to bigger and better things. You deserve better than that... remember that you are a new nurse, there is a huge learning curve but you had a huge learning curve to get to this point too. Do not doubt yourself and your skills! Remember that you are working under your license, so you are in control of what you do and it should be listed in your state's code that as a nurse you have the obligation to pursue clarification and training on aspects of the nursing process you are unsure of, and if you do not get that then you should not participate in those activities until appropriate training is completed. I wish you the best and hope this helped a little... I know that my responding to you really helped me think my situation through, so I thank you for your post!