clownlove

So last year I was going through a real rough patch mentally. Unfortunately I thought I was going to be okay and kept going to work as we were short staffed. I was also being harassed by my supervisor and another EN on a daily basis but yet I still woke up went to work and did my job. What I didn't realize was that all the above was affecting my work to the point where I was reported to AHPRA. So at this stage they have asked that I complete 4 hrs of training related to knowledge and skills in documentation, taking patient observations and following directives. I have been trying for weeks to find courses related to this and have found nothing. One organization I spoke to stated that they could design something for me and that it would cost $2500. I don't have that kind of money just laying around. Can anyone help me? I did submit 5 different online courses that I found on Ausmed and they panel rejected my submission so now I'm back to the drawing board.

So things are going well and have overcome alot of obstacles and have been also learning heaps. I have recently been taking a vested intrest in ACFI's and want to learn more about it especially as the nursing home I work in has recently lost alot of funding due to insufficient ACFI documentation. Can anyone provide me with some good resources and even more so some good examples of how I can enhance what my carers document that would reflect the ACFI catagories. Some of out staff just write things like .... "Mrs Jones was toileted today x2 staff and voided x3" I'm looking to create a template that can be universal so that we can be more specific across all shifts so that the morning shift would write notes reflecting from the moment they get somebody up for a shower/breakfast and what steps were impacted and how they can word it properly. Hope this makes sense. Cheers

I have done my rough draft reply to this allegation however I have also replied addressed the other 6, I have included some comments from some of you who were kind enough to lend your insight. My next question is would anyone care to look it over for me and possibly assist with wording/content as this kind of thing isnt my forte. I basically want to articulate I think that at present there seems to be a double standard and that maybe one standard will be more suitable? Thanks in advance and I hope no one is offended that I may have used partial responses in my reply, if you would like me to remove same I'll be happy to. I can PM my reply.

Thanks Silverdragon102 Im not sure if there is going to be a meeting held or what as they have worded the letter " you will be given the opportunity following due process to respond fully to the allegations" This in itself creates a sickness in my stomach as I feel as though they may have already made decision but as they are required to follow the procedures regardless anything I say may not really affect the outcome. I'm hoping that it wont affect my employment but I have the sinking feeling. My response is going to have to be worded carefully, tactfully and factual.

No she isnt Aussie born, she is from England. She had also given the DON a list of things she feels that I dont do like contribute to daily paperwork, that I dont get RN's to sign off on new admission diet plans, that I dont complete new admission assessments and some of these things only just came up from the other day. I do feel a little scape goated and I'm not saying Im an angel but if I or another workmtre getting bullied I stand up and refuse to take it which she doesnt like, I suspect that she may be trying to use this as a way to pull me in to line so to say. I dont like to fight dirty but if someone is going to try to threaten my income/livlyhood then i will come out swinging, she might I add also on that same morning administered the other ladies ordine to her whilst she was on the toilet, so should I meboth this and the German comment to the DON. I dont want to be a whinger but is fighting fire with fire gonna be what it takes to get her to back off and leave me alone and stop looking for petty things. Im not the only person she does it to. Im getting all worked up, like I said I apologized to her and accepted what she said and why she was upset with me but yet she still felt the need to get it formally addressed which makes me think that I need to defend myself as well as indicate to the DON that she isnt exactly leading by example. Does that make sense or am I coming across as a whiner?

Very true ceridwyn I will refrain from thatterm as it can open to many unwanted doors, I have been replaying things in my head and while I agree that yes we should have a team leader on the floor to go to unfortunatly on that day the actual RN in charge was in a dementia training session. However yes I have researched Diaz and I agree that it may not have been the best choice but again I didnt ask the GP to order it, I was looking for an alternative and even though it was a small dose of 2.5mg it can still have a build up effect. In hindsight I do see where she was coming from but to go to the DON after her and I spoke and she conveyed her dis-agreeance in my ringing the GP and I did apologize and reassured her that I wasnt trying to backdoor her and that my intention was to try and help. I did however remember today that 2 days earlier whilst we outside this very same residents room she made a comment which didnt sit well with me. We were about to deliver some ordine to the lady next door and our lady who yells out could hear us at like 8am and as her door was half shut and the lights were still off she sang out and wanted to know who was there, now she is a dear little french lady. So this particular RN leans over to me and say " I dare you to go to her door and tell her the Germans are here" It might sound petty but I wonder as well how this could be perceived as personally I think it was uncalled for.

Thank you for that jadelpn I will be sure to add your insight to my reply. I'm not even mad anymore as I dont think it will go any further especially when I come at this from a different angle. One thing I pondered today is that since this particular RN has been filling in and has been on the ward for the last 2 weeks and has observed this womans behaviour, and then me speaking up the other day and then actually ringing the GP. At the end of the day am I wrong to question why she hadnt already contacted the GP and or the older persons mental health unit to try and do something for this lady already? Am I wrong here in thinking that perhaps it could be seen by some as neglect? I'm not saying it is but .....

Thank you ausrnurse, I can totally see what you re saying and I have spoken to this RN and I did state to her that I was in no way attempting to backdoor her or undermine her and she did explain the ramifications of diaz in the elderly which I took on board. We talked about this at approx 0800 hrs and the DON actually contacted me at 1445 prior to report to ask me to come see her. I did explain my side and she did ask that I submit a reply in writing and she assured me that this wasnt going to be put on my file, this particular RN tends to be very aggressive and she doesnt like it when she is challenged in any way. The RN that reported me also tried to implicate me for bullying another RN who is also the same one she constantly runs down and tells everyone how much she hates her so for some reason at the moment she has decided to be this RN's mate and focused on me. And honestly I have already been polite and showed respect to the RN that reported me the other day. I really need to ensure that I word my reply so that it reflects that I was really just trying to do the best for that resident under the circumstances. Sigh why do we as adults still have to deal with bullies!!!!

Thanks Mollytone that sums it up nicely as I wasnt trying to undermine the RN at all but I think she feels this way as she wasnt there, and I thought thats what we were supposed to do is show initiative as we all reap the benefits. thenightnurse456 Thank you as well for your reply and honestly I dont think we have such a policy as I have sent numerous faxes and countless phone calls prior to this most of which have resulted in a positive outcome of some sort even has been to demonstrate that I tried to do something in the eyes of he family, the eca staff but most importantly the resident. I see it as a form of customer service if you will. Both or your replies have given me some food for thought, so again I thank you so much.

Thanks Libby, I have drafted a reply so far and I beleive that I acted in the best intrest of this resident to try and acheive a positive outcome for her. And I think it would stand to reason that if the GP didn’t want to order a particular medication the she wouldn’t regardless of whether she was prompted or not and she is the residents GP after all. So this poses the question is it not within my role to relay to the GP changes within her patient so she can decide how we are to treat her? My intention was not to change her medication regime as suggested, I was acting out of my duty of care to try and achieve a better outcome for a lady who is suffering a lot of mental anguish. The afternoon shift nurse clearly documented on our system that she administered 2.5mg of diaz and that within a short time resident was settled and was even able to take a phone call from her sister and still maintain a conversation with her.

I have posted this on the Australia forum as well but thought perhaps there are more people reading the general forum. Sorry in advance for the double post if its considered a faux pas We have a lady in our nursing home who in the last few weeks has taken to yelling out literally all day and all afternoon. Its been distressing for other residents around her as well as staff and visitors. She had been reviewed by older persons mental health and they reported back to her normal GP that they didnt see anything wrong. Her regular GP did prescribe risperidone 2.5mg BD PRN This medication has been un-successful so the other day I was talking with the RN in charge and I stated to her that I thought that we needed to contact this resident's GP to seek alternatives, she very quickly replied that she didnt think we should and also stated that she didnt have confidence in this GP and that she had no buisness prescribing psychotic type medications and that it should be done through OPMH Yesterday I tried to contact OPMH to no avail and by 1430 aftet this poor lady had been yelling out all day and all afternoon I rang her GP and explained what was happening and simply asked her what she thought we could do as she was the one who prescribed the risp in the first place. Her suggestion was initially serapax but she quickly said no that it wasnt a good idea as we didnt want to knock this resident out so she gave an order of diaz 2.5 - 5mg TDS PRN Now bear in mind that the said RN was off shift when I called the GP and I didnt give the GP any suggestions as to what to prescribe, the said RN comes on shift this morning and in report hears that this resident had been given 2.5mg of diaz and that she had settled and had been easier to manage and the look I got wasnt nice. She then proceeded to go to the DON and reported me for acting outside my scope of practice for ringing the GP as she claims my intent was to change the medication regime and that I ignored her directive. I have been given a few days to respond in writing but I'm so ****** off that I dont even know how to reply to this, that being said this same RN also accused me of bullying another RN the other week and reported same to the DON, I was able to verbally meet the DON and explain the whole story so that was resolved and didnt go any further. If anyone has some good letter writing skills with this kind of thing any help would be appreciated. Do I not have a duty of care to this resident to try and acheive outcomes that benefit her and her quality of life. Regards and thanks for any help

Im an EN and at the care home I work at we have a lady who in the last few weeks has been yelling out literally all day and all night. She had previously been seen by OPMH and they deemed in their report to her GP that there wasnt anything wrong. She was however prescribed risperidone 0.25 mg BD PRN This medication has been un-successful so the other day I was tlaking with the RN in charge and I stated to her that I thought that we needed to contact this resident's GP to seek alternatives, she very quickly replied that she didnt think we should and also stated that she didnt have confidence in this GP and that she had no buisness prescribing psychotic type medications and that it should be done through OPMH Yesterday I tried to contact OPMH to no avail and by 1430 aftet this poor lady had been yelling out all day and all afternoon I rang her GP and explained what was happening and simply asked her what she thought we could do as she was the one who prescribed the risp in the first place. Her sggestion was initially serapax but she quickly said no that it wasnt a good idea as we didnt want to knock this resident out so she gave an order of diaz 2.5 - 5mg TDS PRN Now bear in mind that the aid RN was off shift when I called the GP and I didnt give her any suggestions as to what to prescribe, the said RN comes on shift this morning and in report hears that this resident had been given 2.5mg of diaz and that she had settled and had been easier to manage and the look I got wasnt nice. She then proceeded to go to the DON and reported me for acting outside my sope for ringing the GP as she claims my intent was to change the medication regime and that I ignored her directive. I have been given a few days to respond in writing but I'm so ****** off that I dont even know how to reply to this, that being said this same RN also accused me of bullying another RN the other week and reported same to the DON, I was able to verbally meet the DON and explain the whole story so that was resolved and didnt go any further. If anyone has some good letter writing skills with this kind of thing any help would be appreciated. Do I not have a duty of care to this resident to try and acheive outcomes that benefit her and her quality of life. Regards and thanks for any help