croppyRN

If anyone has some tips for this new MDS nurse I'd be so grateful. How do you keep organized? I only have 8 Med A residents, but lots if part B and the extra work involved w them. I work in small 50 bed facility, usually 46+ census. No help from DON, who is too busy. Rcvd very little training. Regional Coordinator very helpful but has large area to oversee. This is my 5th week solo. The constant meetings are such a disruption. I know I need to work on time management, too. So if you feel my pain, is love to hear from you!

Joanna73 - thanks for your input. I start next week so I guess I will find out soon enough how much they expect of me. I agree with you that it is important to know the residents well. It will be interesting to see how this all plays out... But for now, back for some more RAI MDS 3.0 reading!

Thank you everyone for your replies. I really appreciate that you took the time to give me your advice. I did decide to accept the job and start training in two weeks. I've been trying to find info on MDS Coordinator terminology online, as well as getting a "snapshot" of what a typical day looks like as an MDS nurse. I have downloaded the MDS 3.0 and RAI manual to read, but would love to hear what the job really looks like. Thanks in advance for any help. As for now I'm clueless!!

Ruas61 - thanks for your reply. My MDS friend told me about this job. She is corporate level now and manages many MDS nurses at their different facilities. The MDS nurse that is there now would be the one training me. I have been working in LTC for almost 2 years. As far as my job duties, it sounds as if the DON was thorough in her descriptions. She pointed out that some aspects of job would be more difficult than others, and was specific about details. So I hope I was given all the info. PS I love your profile picture! I'm hooked on that show!

Advice please! I have been offered a position as an MDS Coordinator for 50 bed LTC facility. Perfect size for me since I have no experience. Will receive at least 2 weeks training + opportunity to shadow MDS nurse in another facility. I am a new but older nurse and wonder if this change would be a good idea for me. As for my current job, a combo SNF rehab and LTC facility, I do love caring for the elderly. My patient load is ridiculously small in comparison to other places. It is a beautiful place, while the other is very old. I know the final decision is mine, but veteran MDSers, what do you think? Am I getting enough time for training? I've been assured that DON and other staff will be available for help. And I will also have ability to phone others for help. Yikes! Didn't mean for this to be so long.

Hi joanna73. Thanks for replying. Your advice is very good, but my problem seems to be taking the knowledge from the textbooks/classrooms and applying them on the floor. Especially when I have more difficult decisions to make. It really upsets me that I am still having a problem with this a year later

Thanks for your advice joanna73. I think those are good ideas, but my problem seems to be taking the textbook/classroom knowledge and applying it on the floor. It scares me that one year later I am still having trouble with that

I hope someone reading this can give me some good advice. After over one year working as an RN at a short term rehab/LTC facility, I am beginning to have doubts. I love taking care my patients, and find the older population to be very satisfying to work with. The problem is, I still don't feel confident in my nursing skills. Of course, I am doing so much better now than when I started, but I still feel lost, doubting myself, not really remembering what to do in certain situations. I look at the seasoned nurses and long to have that experience. But I also look at some of the nurses that started around the same time as me, and they appear to be much more knowledgable, confident and quicker with their work. I know time management is part of the issue with me. I also don't like the stress that sometimes comes up, either with patients deteriorating condition, or dealing with difficult aides. I guess I just don't know if this is where I should be. But I love medicine and don't want to walk away from all of my work at nursing school and just waste my RN license. Does anyone have advise on where I could go from here? I considered MDS, but again, this involves patient assessments. I worry that I haven't the right skill sets for that job. Plus, I'd have to go back to the classroom for more education. I'm not really thrilled about that. Are there other options for me that I haven't considered? I apologize for my lengthy new thread. I just wanted to give as much info as I thought would be helpful. I suppose this could be different definition for TMI!! :)

As a new nurse I guess I should have warned you. When a patient says they think they're going to throw up, grab the basin first, ask questions later.

Thank you all for your suggestions. I really appreciate you taking the time to reply! I have to admit, I don't drink enough water, because I know where that will go, and most shifts I don't have time for more than one or two bathroom breaks! Will have to figure that one out. After all, this is what I'm always telling my patients, stay hydrated. Guess I should practice what I preach (well, try to, anyway)

I am looking for ideas on healthy foods and snacks that I can eat on the run that are known to help with concentration, memory, etc. Also any vitamins that help with this as well. If anyone has some helpful hints to share I would be so grateful. I often find it hard to focus during my shift, and really have to work at concentrating. I try to eat healthy, but this is not always convenient or even practical. Does anyone get where I am going with this? I hope so, because it was a lot of work just to post this!

Good for you! Sounds like you made the best decision. Good luck with your new position.

I think the above advice is very good. I needed it too, because I find myself in the same situation when dealing with my patients and residents. A lot of the time I have to interrupt them and apologize, explaining that I have to complete "X, Y & Z" before a certain time. This usually makes them all apologetic, which isn't my intention, but it is necessary. Otherwise I would be in their room forever. But this is still a work in progress for me. It's not that I want to be chatty and kill time, but sometimes I know they are lonely and just need someone to talk to. So, I give in, which causes me to fall behind, just like you. I am sure if you work at this, things will go more smoothly with time. My goodness, you've only been at this for a week! Give yourself time, and don't be hard on yourself. Easier said then done, I know. Good luck, and keep at it!

Very well said! I think you are on the right track. You aren't perfect, and this person (for whatever reason) has selected you as her punching bag. Just remember, these type of people are very insecure. They can only feel good about themselves if they're tearing someone else down. Unfortunately, that someone else is you. It sounds as though you are in a losing situation, given the tight relationship between your evil manager and the DON. Unless you have the stomach to continue working under these conditions, I would consider looking for another job. You said you've been there a year, which is plenty of time as far as any future employers are concerned. Just don't give your notice at this job until you have everything in place at a new position. Good luck to you!

I have only been at a short term rehab/LTC facility for about four months on my own, but I won't sugar coat it for you. It is very overwhelming at first. You will be intimidated by the other nurses who just soar through the shift, knowing all (or most) of the residents, knowing the routine, etc. Please try to keep things in perspective. You are brand new. It is going to take some time. It will be hard at the beginning. I don't know if you will experience this, but I felt as though the clock was my enemy. But above all remember that safety has to be foremost in your mind. Be sure to focus on giving the right meds to the right patient, the right dose...you know what you learned in school. If you have questions, don't feel stupid about asking. You will probably have to ask the same question more than once, too. That's okay. Some nurses are willing to help, some not. Don't plan on finishing your shift on time, either. The oncoming nurse should understand, because they were in your shoes once, too. Some will be nicer about this than others, but try not to let it get to you. As others have suggested, use all the orientation time they offer and don't let them intimidate you into going on the floor early. (For so many of these LTC places, they want a paid worker on the floor ASAP). Also, if you feel you're still not ready after orientation time is up, ask your supervisor or DON if they will give you any extra time. If they tell you no, you will have at least tried. It never ceases to amaze me how willing LTC places are to put new grads on the floor with barely any orientation/training. Then they end up having to deal with the paper work and problems associated with the inevitable mistakes new nurses will make. It doesn't take a genius to figure out that a better trained nurse will perform much better than a poorly trained one. I hope that I haven't frightened you to death. You will find so many aspects of your job rewarding. For many of these residents, you are their only family. Once you begin to feel more comfortable with your routine, you will find yourself getting attached to these people. Of course, some more than others

I agree with the other posters, you did the right thing. You used your assessment skills by immediately taking her vitals. Even though it was difficult to obtain her BP, you were aware that her pulse was dangerously high and warranted a call to the doctor. I, too would be nervous about this type of emergency because I'm a new nurse as well. Just remember that you went with your instincts and ended up doing the right thing! We've all been taught to listen to our patients: If they tell you they "don't feel right" pay attention and assess them carefully. That's what you did. Don't be hard on yourself. It is going to take us new nurses time to pick all of this up. (Something I have to remind myself a lot!) Good luck with your job and your nursing career! :)

brandy1017 - you've really captured the perfect description of this nurse: bully!! she is also on some kind of power trip, and it seems to be her drug of choice, to use people and walk all over them. as someone else said, she does these things because she has no self-confidence in herself. my best action is to avoid her and if i need to interact, to keep my head and stand up to myself without stepping all over her huge ego. thanks for your a great words of wisdom, and for taking the time to help me out. i appreciate it! :)

onyx77 - thanks for taking time to reply to my cries for help! it is good to know i am not alone. i have heard that time management does get better, and i feel i've made some progress, but it doesn't seem to be enough yet. as far as your comments about nurses getting their shifts done on time, at our place, we don't see too many people leaving stuff for the next shift. what i sometimes suspect is happening is that the 'fast' nurses are cutting corners with their med passes (maybe not giving the stock meds, etc.) just speculation, but i wonder... also, about proving ourselves, i think a lot of people make split decisions about others without even bothering to get to know them. this is a shame. i feel that once they get to know me, they will find that i show up for work to work, not to cause trouble and slack off. i try to do what's best for my patients, but in an atmosphere such as mine, that is easier said than done.

capecodmermaid - thanks for your reply. i am so surprised and pleased by all of the responses i've received. this forum is such a great source of information and comfort. i know that we're not going to agree with all of the responses we receive, but so far, i've been to take something useful from each of the members. as for yours, believe me, i need to hear your reminder that i am new and just because some of the staff pretty much roll their eyes :icon_roll at my questions i will get this eventually. i am still hung up on the speed thing, i hate to see everyone else leaving on time at the end of their shift while i'm still charting, etc. makes me so frustrated. i actually think i may be spending too much time with the patients. i need to be able to better assess when they truly need me or not. thanks for your wise advice. i am so glad you took the time to give me your . (i think i go overboard with these smiley symbols, etc. need an intervention!)

christopherh - i laughed when i read your sentence "worthy of a sound slap upside the head." that's exactly the way i think, (and privately wish sometimes) that i could actually do! you have given really good, practical advice, and i will try and remember it. my husband has told me that he has become much better at handling conflicts and disagreements at work, but it has taken time and practice. as for finding someone to talk to, there are two nurses that i think i'd be able to talk to, but unfortunately, they are both out right now for health reasons...sigh.

crunchrn - thanks! i am trying, but i think i'm barely hanging by just my fingertips some days lol! but you have summed up this whole mess with your second sentence. :cheers: when i posted my problem the other day, i was having quite the pity party. i know everyone has these from time to time. i feel a bit stronger today, and i will go into work and just do my best and hope the rest will fall into place....eventually!

itsmejuli - i see in your wise response more mention of the "culture" of the workplace. as you said, it takes more than one person for a conflict to arise, and i have to remember that. my knee-jerk reaction is to place all the blame on the bully nurse, which i guess is human. but i have a lot to learn about how to handle conflicts in a more diplomatic, calm manner. :argue: i am glad that for you things have finally worked out. i hope i can say the same as well. thanks so much for your response!

mindlor - your advice about taking this nurse aside to talk privately, it seems like a good idea, but if you ever consider doing it, i just want to pass along a story and some advice to you. our orientation nurse told us the story of just such a conflict she had with another nurse. she felt the same way you did; she would talk privately with this nurse and try and smooth things over. they went in another room to talk. at one point my orientation nurse placed her hand on the others shoulder in what she thought was a well-meaning gesture of reconciliation. the other nurse went ballistic, telling her to take her hands off her, etc. needless to say, it didn't go well. a few days later, our orientation nurse found out she was being sued by this nurse! bad nurse claimed that she'd been bullied and attacked by the nice nurse, shoved and injured, etc. our nurse was absolutely devastated. her reputation was almost ruined because of this incident. so the advice is: always, always have a witness present when confronting someone at work, and never have this talk in a private room. as for your other advice, i will put at least a year in at this place before i look anywhere else. but be assured, this woman is not respected. you are right, she is feared. and she is trouble.

ransom - such a great quote! wouldn't it wonderful if more people considered this and actually acted on it? :heartbeat

esme - you know what? that lesson about people who attack others, or tease others (as i used to teach my kids when they were young) really does mean that they are very insecure about themselves; well it is so true, and i sometimes forget what i have tried to pass on to my kids! i'm glad you reminded me. thanks! that quote by eleanor roosevelt is awesome! i think i am going to copy it and tape it to my bathroom mirror. then i can see it every day. maybe one day i will be able to reach that point. thanks for responding. :)