dotter

My daughter used to go with me in the summers when school was out. We did have permission from the administration tho. She helped the activities director some and just enjoyed visiting with the residents. They enjoyed her too. I still have some papers that she wrote and had one of the residents sign where she adopted them. I can't remember how old she was, probably pre teens. At the time she said she was going to be an activities director but in reality she became an RN and is administrator in a home aide facility. At the time I worried about her "bothering" people but I think it was actually good for her and for them too. I know this isn't exactly what ya'll are talking about but it's another side to the story.

There is a patient like this in every home I've worked in. You can't please them, they are demanding of everyone's time and they just want to keep someone in the room with them all the time. I think it's just the kind of person they are. I have a patient just like this now. She calls you to come do one thing then she remembers all these other things that she wants and keeps you trotting back and forth. She does the same thing with the cna's. She's a "me" person. Probably has been that way all her life. This probably sounds harsh to some of you but I think it's the truth.

Some things are just plain hard to handle. I've been working in a facility for about 4 yrs. It's very close to where I live and I'm just trying to ride it out for 3 more yrs until I can retire. We have certain vital signs that are to be taken every shift, such as medicare pts, falls, pts on ABTs, new admits, etc. There are hardly ever more than 10 pts on the list. When I started at this facility the LPN who was orientating me said "well sometimes we have to lie a little" and she'd make up vital signs. Mostly it was because the cnas were just too sorry to get them. ( please don't anyone take that personally). I make sure they get them on my shift and I make sure I chart them. If for some reason I don't have the vital signs I just chart on the patient without them. I've noticed on weekends that most of the nurses don't even chart them half the time. Why have the cna's get them if they are not going to chart them? I don't know how this facility gets away with some of the stuff I've seen. gripe, gripe gripe. :chuckle

TBLPN, I'm glad that you understand the problem. I really don't think some people understand. For one, when a patient is admitted they choose to use either the main pharmacy or one of their own chosing. If they choose their own pharmacy their family usually picks up their meds. We have patients who use different pharmacies that deliver. We can't just call any pharmacy like Eckerds and order the med. My question is how can I cover myself since I can't get the med? I'm wondering if nurseduck can answer my question?

nurseduck, I don't know where you are but in the areas I've lived in 2 different states all the nursing homes use the big pharmacies and they only deliver once a day and if you get a new order on saturday you don't usually get the med until monday. That's just the way it is. I can fax the order or leave a message on the pharmacy voice mail to order it but it's not going to get to the home until monday. and usually it's the fault of the nurses at the home for not ordering it in time. I only work weekends and I don't want to cause a riot I just want to cover myself. I like julielpn's answer and I wonder if it's acceptable.

Nursepenny, things are very different in hospitals than in nursing homes. A 62 bed home is not going to have a stocked pharmacy like in a hospital. Earle, I think you might have misunderstood the situation. I'm there from 7pm til 7 am only on sat and sun nites. Yes I can order the med and I do when it's not there but I'm not going to get it until the pharmacy delivers again and that will be on monday evening. My main concern is that I was charting "med not available" to call attention to the fact that there was a problem because this has been going on for the almost 4 yrs that I've worked in this home. If was brought up in a meeting that we should not do that. I imagine the pharmacy consulant caught that when they did their review. I've noticed that the rest of the nurses just go ahead and initial the med like they have given it even tho they haven't. I just can't do that.

I work in a nursing home and yes we do have a back up pharmacy, emergency box, etc. As far as I know no one in this home uses the back up pharmacy. I don't know why. This is a small home 62 beds and seldom full. Ladies you just don't know the half of it. I'll be posting about other issues as I'm able. I borrow the med when I can. Most of the time it's the day nurses fault because she didn't make sure the med was ordered. We have stock colace etc. so that would be no problem. We have our main pharmacy but it's not in our town and the med is delivered once a day and that's it. After hearing some of your opinions I think the thing for me to do is leave the Administrator a note even tho it will be "tattling" on my part and probably make someone mad. I've always been taught that if the med is not there it's my responsibility to get it. Well it's just about impossible considering the hours I work. Also the med is not sent sometimes because it's not time for it to be refilled. Now I don't know what happens to it but the pharmacy is very strict about that because of billing. Thanks for all your opinions. I definately won't be signing for it again if I don't have it.

I work 7p to 7a every weekend. Almost every week there is some patient whose med is not on the med cart. Possibly because the med was not ordered or the pharmacy didn't send it for some reason. We are told not to chart "med out of stock" or "temp unavailable". There is no way I can get the med in on a weekend so what can I do to cover myself? I don't feel right charting that I gave the med when I didn't.