sweetsleep28

Sorry if this has been asked before, I looked around but could not find anything previously discussed on this situation. My Uncle was admitted to the LTCF that I work at. I had not seen him in 5+ years prior to him being admitted. Too make a long story short, there is some serious bad blood/family drama taking place within my family. My father and this Uncle have almost to come to blows at one point. I am very uncomfortable being assigned to his unit. In fact it makes very uncomfortable with him just being in the facility due to the fact that I am not in contact with family members that I have no seen/talked to in years. This may be a dumb question. But as a nurse am I required to take care of him because he is a resident there? I fear for my license honestly because another Uncle of mine who is his POA and my father as well as my self have had issues with each other. All of this drama stems from my grandmother passing and all of her children fighting over her estate. I'm afraid that if the Uncle who is the POA as some type of issue with his care that he will try to blame it on my in a sense. My faclity is fully aware that he is my uncle but continues to try and assign me to his unit. What should I do about this situation if there is anything I can do? Thank you for your time.

Holy Moley! I feel you on that one. I'm expected to do about 12 hours of work in 8. If I'm only an hour late getting done, it's been a good day! -Scheduled for 40, but usually closer to 52-54. P.s. Afternoon shift loves to call off and poo poo on days @ my building.

So, I've become a preceptor at my facility. The past week I have had a GPN with me. She's very emotional. It seems that every little thing makes her cry! She thinks that she should know everything already, and becomes terribly upset when an issue arises. I have tried to be nothing but supportive. I have not tried to push her to pick things up quicker. I've allowed her to work at her own pace and have always been right with while assessing,passing meds, etc. She is very green and has absolutely no healthcare experience. LTC is a hard first job to have. Sadly it is almost sink or swim. I don't want to see her sink. She has the foundation but just needs to build on it. She's numerous times a day that school didn't make it out to be this way. I am trying my best to pass the knowledge that I have onto her, but it is becoming more and more difficult to do so. I can handle the emotions of my patients, their families, etc. But I become terribly uncomfortable when she breaks down into a fit of hysterics over a dropped multivitamin and begins to cry uncomtrollably. I am at a loss of words as to what to say to her. Anyone ever been in a situation like this. Any input on how I should handle it? I meet with my DON and her on Monday to go over how her preceptorship is going. I want to be able to say good things about her, but I'm not sure if I am going to be able too.

I'm the 3-11 LPN on a highly acute skilled wing of the LTC that I work for. Yesterday I went to work and was told that I was to be a preceptor for a new graduate LPN who hasn't taken her boards. I know that we all had to start somewhere and being chosen to be a preceptor is not necessarily my issue. What bothers me is the fact that I was not asked or even told in advance that I was to be a preceptor. My unit is very demanding and it takes every minute of my 8 hours there to get my work done and to keep my resident well taken care of. So I guess what I'm asking, how can I be a good preceptor to this GN while still getting my own work done? What makes a good preceptor? I've never done this before and honestly I'm a little bit worried about my reputation at work. I don't want to be one of those nurses who "eat their young", but the high acuity of my unit makes it very difficult. Maybe I'm wrong in thinking that my facility should have given me a little bit of a heads up, so that I maybe could have formed a game plan. Any advice on how to be/give a good preceptorship, would be greatly appreciated. Thanks in advance.

I was offered a Restorative LPN job at a Genesis facility. Anyone have experience with this company? I've had mixed responses to this question.

It's by no means an every day occurrence and I am in no way asking someone to make an excuse for me. I thought I was doing the right thing by not leaving 3 nurses alone on a unit that they had never worked before.

It's not even so much the fact that she was snippy about me not taking a lunch, but that she was spoke to me in a not so professional way in front of the two orientees. I do have another job lined up in my haste and frustration last night I see I didnt mention that. I've be trying to stick around at this place long enough for my DON to hire and train some new staff, because she asked me really nicely almost begged me to do so. But the fact remains that I've putting my future on hold to help out this place that doesn't appreciate it. The working conditions are not safe and the nurse/cna to patient ratio is insane. I wanted to help out the DON and be a team player, but I cant keep being a team player if all I get is crap from one this one particular supervisior. Seems as tho she has vendetta out against me and takes every insignificant thing I due as an issue.

Tonight I worked my tail off. I had two people that I was suppose to orientating, plus I was helping out the agency LPN who graduated in September and thought taking a job with an agency would be a good idea for her FIRST job. So on top of trying to make sure that my two orientees didn't get thrown to the wolves, I was literally teaching this new nurse how to check G-tube placement, give PPDs, and insert foleys. Yes all of those things came up on my shift tonight. On top of also explaining to her that meds have two names when she said to me Pt. XYZ wants her dilaudid but the only thing I see for her is this stuff called hydromorphone. Things slow down for a few minutes. I send the two orientees to lunch, and continue helping the agency nurse. Because it's almost 7 pm and she is still passing 4 pm meds. At the end of the night I asked for a missed punch slip because I did not take a lunch. I didn't feel comfortable leaving any of them on the floor by themselves. She asks me why I need a missed punch form and I tell her. Her response to me is well I will sign it this time but next time you have to take a lunch. They are licensed so there is no reason why they couldn't have stayed on the floor by themselves. What?!?! What if something would have happened while I was gone, what if they had a questioned that needed answered and it couldn't wait till i came back from lunch. This supervisor is notorius for disappearing for extended periods of time and for not taking things that nurses report to her seriously. But she wants to get snippy with me over not taking a lunch! I bet if I would have taken a lunch and something would have gone wrong it would be a whole different story of why did you leave this trainees on the floor by themselves. This is not the first time this supervisor has given me crap. I dunno what her deal is. Being responsible gets you absolutely nothing and it's not fair. These people that run this building need to take a good look at themselves and realize there are more important things to get snippy over other than me not taking a lunch. They use and abuse their staff and then wonder why people don't last there more than a few months. I would have loved to have taken a lunch, but I'm willling to sacrifice what I want to make sure that these people who are my responsibility get taken care of the way they deserve. But apparently my priorities are out of order. Tomorrow they will be getting my two week notice. This was the icing on the cake tonight. I'm not putting license in jeporady any longer for this facility. I hope the people who run this building get their priorities in order. Because me not taking a lunch is by far the least of their problems.

You have just described every single shift I work at my current job. Tonight in a span of about 30 minutes I broke up a literal fist fight between a demented man and a LOL, managed to cover myself in Jevity tube feed because in my rush I opened the can then tried to shake it. All with everyone yelling for PRN pain meds and trying to help the CNAs pass dinner trays. I feel your pain!

At my new facility I am almost always on the Skilled Unit. With all the Alert and Oriented, walkie talkies, short term IV ATBs,Wound vacs, with a few demented LOLs and former marine who likes to beat up the CNAs thrown in for good measure. I don't stop from the moment I hit the floor. The majority of the time I have to finish what day shift didn't have time for before I can even start my first med pass. The computer won't allow my to accept the med cart untill everything from days as been "administered.' That unit has 9 4PM accuchecks, plus multiple residents who receieve neb txs with the first med pass. Everyone always wants the pain meds at the same time, I'm being paged to take a phone call a while trying to change a wound vac. It's 5:30 now, and I'm suppose to stop what I'm doing so I can go observe the dining room because there HAS to be a nurse there during all meals. Maybe 10 our of 30 take their pills whole. So I have to take more time to crush everything. It's 9:00 pm and now I have to look up my coumadin doses go downstairs and get them out of the pyxis that literally takes a minute between each screen. And waste 10 more minutes of my time. What's this? No one approved this order, let me stop what I'm doing and and go thru 10 more screens to be able to approve it. Oh yea Mr. Soandso has no oxycontin in the narc drawer, I'll have to go downstairs again, call the pharmacy and sign away my first born child so they will let me take a C2 out of the pyxis. Did I mention I still have about 12 skilled charts to chart in. Or that my failed hip replacemnt needs her 8cm tunnelling wound packed, JP drained and dressing redone. All while taking temps on everyone because you gave out flu vaccines. Plus 348 decided it would be a good idea to yank his foley out. And at the end of it all I still need to tape report, give report and do the never ending narc count. And at the very end you ask if me I want to work over. It varies on these lines every evening. And someone help me if there is an admission coming, because if one does I'm not getting done till at least 1 am. I haven't taken a lunch break but a handful of times in the almost 2 months that I have worked there. They are severly understaffed and in denial about it. On Friday I worked till 3 AM, there was one CNA for a whole floor of 50 residents. I feel like I can not give these people the care they deserve and get done everything that "they" want done in 8.5 hours. I feel like I am drowning from the moment I get there. Add in taking off orders and entering them into the computer and sometimes having to draw labs. There needs to be another of me to get things done completly. I'm begginning to think that this place and I are not to be even tho I do genuinely like the people who work there and the residents. I have to tell to the Supervisor when I need an issue addressed and hope they will take the time to call the dr. Sometimes they do,sometimes they don't. I have to throw other people under the bus when I chart,so that i can protect my own license so they can see that I had addressed the subject. That it wasn't me who didn't take care of it. They expect me to have come in early at least once a week for some type of inservice where the repeatdly tell us how "crappy" the care is that these people are receiving. The DON is condsceding and basically plainly offensive in some siutations. I worked 105 hours last pay period and they still wanted more. I feel myself getting burnt out already. There are too many things to get done and not enough hours in the shift to get them all accomplished to my standards. I consider myself a competent nurse and don't half do things. I don't know what to do.

Here's a good one. They have a contract with a local cab company to deliver STAT orders from a local pharmacy to the facility. I had cab driver show up reeking of booze and an illegal substance with a bag containing a bottle of Vicodin! The C2 script you faxed them can never seem to be located, even if you have the fax confirmation in your hand. It's Tuesday and your admit from Friday still doesn't have their meds. Apparently you never received the admission orders.

I'm almost a month in to this new job. Tonight I check the assignemnt paper and there XYZ RN in parenthesis next to my name? What?!? I have to be reading something wrong. How in the heck am I orientating someone, this has to be a mistake. The RN supervisor sees me lookly utteredly confused from the desk Supervisor: sweetsleep28 we hope you don't mind, you'll be orientating one of the new 3-11 RN Supervisors to the 3 North Med pass sweetsleep: No, I don't mind, but just so you know I'm fresh of orientation myself. Supervisor: We know. Only 2 of the 4 LPNs on tonight are not agency, and the staff member that is ours isn't competent enough to show her how to do things. By this point in time I'm trying to keep my jaw from hitting the ground. I was literally caught of gaurd by her reasoning. Now don't get me wrong it's not that I don't want to orient someone. At my old facility they frequently put new hires with me. But in this situation I'm still the NEW HIRE, I'm not even done with my probation period. I'm just getting comfortable with finding how who the residents are, with how they take their pills, etc. And now I'm suppose to show someone how when I don't even know how to handly everything perfectly yet myself. I don't doubt myself as a nurse, but this intimadated me. I dunno if was that I was new, that I was orientating someone who will eventually become my supervisor. I didn't want to not be a team player. I did my best, I showed her to do things to the best of my abilities. I'm still learning this myself, so hopefully if I showed or told her how to do something wrong, it doesn't come back to bite me in the butt. I think it went well. Am I wrong to be upset/angered by this.

The dr at my old facility loved to prescribe Rocephin 1gm IM for 3 days. The vials we had came with 1 gram of Rocephin to which the nurses at my old facility including myself reconstituted with 1.1 of lidocaine in a 3ml syringe. Any chance you are working in LTC facility OP? We did not place peripheral lines in my old LTC facility, if a resident needed to receive fluids, long term ATB therapy meaning more than 3 days of a med we always had Midlines placed. So that's my educated guess. So I personally understand why she may have been giving the Rocephin IM instead of IV. OR I could be totally off in left field somewhere

So I'm two weeks into my new job at LTC facility. I got about a solid 5 days of orientation, which is good considering most LTC orientations before I was thrown to the wolves. But alas that's how it goes most of time. Anyways: Tonight I was floated to the Alzheimers Unit, no biggie. BUT I never had any orientation at all on this unit. I had no idea who any of the residents were, and most of them wouldn't have been able to tell me if I had asked. I will wager a guess that at least 75% of them did not have an ID braclet on. The pictures in the e-mar were so distorted and fuzzy that I couldn't decipher who was who that way either. On top of that a resident came back from the hospital. I was never shown how to do re-admission paper work. I asked the RN supervisor multiple times just to give me at least a little direction. After about the 4th time of asking and being ignored I dove in head first and tried to figure it out myself. Today they started a new policy that everyone is to be open to air at night, and only resident who are care planned for it can wear any type of incontience product at night. My old facility did this so this wasn't a huge issue for me. There was one CNA assigned to this unit that had approx 25 residents, most of which were total care and incontient. She was literally drowning in complete bed changes by the end of the night because she was the only one on the unit. LPNs aren't allowed to leave at night untill they have rounded and checked each and everyone room for multiple things. I told the CNA that was working the hall that if she went and started her last round, I would come and help her and after I had given report to the oncoming shift. I did go help her after I had counted and have report, I figured I would have to make rounds at the end anyways so I why not kill two birds with one stone. We went around the unit changing everyone, cleaning off bedside tables and emptying trash cans. When I get back to the station the RN supervisor who had been MIA outside smoking all shift long, tells me that I'm not to do rounds for the CNAs! What?!?! And that if I'm found doing it again she will write me up? I tried explaining to her that I was not doing her rounds for her, but helping her so both she and I could get what needed to be done, finished so that maybe we might actually get out the building at a relatively decent time. I'm perplexed. I thought I was doing a good thing, by making sure both of work is done. Is that not what I am suppose to do? I always make my best attempt to be a team player. I will help anyone do anything. I'm not sure how I feel about working at a facility that doesn't promote a work environment where people help each other. And where I get threatend with write ups for helping out the CNA staff. It makes me sad because I do genuinely like the facility and the majority of people that I have met there. I do however fear for my license because of the horrible staff to patient ratios. Also that there are some supervisors who just don't want to be bothered with the new nurse who doesn't know how to do everything. There are ALOT of new grads working at this facility. I'm not a new grad but if I were I probably would be running for the hills if this were my first job. I've been around the nursing homeblock so I know what it's like, but this seems a little extreme to me. I'm sorry about the length and my ranting but it's all I could think of on my drive home. Any advice, words of wisdom would be greatly appreciated.

So I recently started a new job and I really like it. The only thing that is driving me bonkers is the way they do their narc counts. Instead of having blister packs that you just pop the med out of, they have boxes upon boxes of individually packaged narcs! For the past two nights it has taken me 30 minutes if not longer to count with the oncoming shift!! And then by the time I give report I am at the very least at least 40 minutes past quitting time. The narc log is atrocious!! I mean in the cart I worked tonight there were at approx 20 BOXES of meds with each box containing at least 10 pills. I have to unroll this giant roll of narcs count them and also make sure there is actually a pill in the pack, because of the way some people tear the previous pack off. This afternoon when I counted with day shift, there was a vicodin just chillin in the bottom of the drawer. It's super annoying. The girl I counted with tonight couldn't stop talking to one of the CNAs long enough to count, she started then stopped then started again with the same roll of pills. I'm new, and not wanting to ruffle any feathers didn't say anything. Also in the narc drawer tonight, there was a hospice emergency kit for one of the residents. that contained roxanol and 3 other meds that were just in bottles, not wanting to touch them I had to idividuallly try to tap them into the lid of the bottle to be able to count them. Seems to me there that there just has to be a better system, considering that this place uses computerized med pass and that you have to scan every other med other than the narcotics you give. It just doesn't make sense to me. Anyone else ever have to a crazy narc count like this? Guess I just needed to vent a little!! thanks!!