mander

I parked my fat behind here and I’m going for my adult geriatric np. It’s up to you whether you reach a dead end or not.

Can I ask how you are reimbursed for calls and texts? Or is it like on call hours for that?

I got a $2 raise... mind you I was already making below what other charge nurses were making at the time... and when we are short staffed I was always coming in and I work well with my DON. You should really be getting a raise if you have this on call responsibility. I personally could never take another job with my position, charge nurse or ADON. You could apply and let them know you expect a raise or negotiate on in 90 days or something. But if it's more of a headache and not worth it to get M-F then maybe it's not for you.

Do you have a ward clerk that fills out lab slips for blood draws and appointments etc? All of our units have a falls binder (where we pretty much just write the date of the resident's name and date of the fall as everything else is in the incident report or PCC), a coumadin binder (we missed those a loooooong time ago and got a deficiency on a survey probably more years ago than I've been alive), we used to have a wound binder but now most just keep a running list of current wounds, and the kardex is all on a kiosk so no papers around the unit. If a change is updated then it's there in the kiosk. Everyone has a separate gradual dose reduction binder for their units to track when changes are made. As for interventions, those just go along with the A & I process of ours which involves updating the care plan in PCC anyways so there's no need to track that. We do have someone responsible for tracking falls, date, times, injuries etc but we don't need to as unit managers. Much of this will depend on your facility policies.

Honestly, working 7 years n the ICU was probably the best thing you could have done.

That sounds asinine to me. I think we only report falls or incidents with injuries ONLY if there is a break in care plan or if it results in a death. Or if it's a burn. I don't think anyone wants to sit there and read all of that. What a waste of your time too! I wonder if your predecessor had some trust issues with someone and reported everything as no one could make a decision?

Yikes, we have at least 4 CNAs on days for 40ish residents, 3 on evenings, and 1 on nights. That's minimum before the DON and I are called in...

Smile... attempt to help... politely tell her she needs to calm down and tell her about discharging AMA. ?

Yikes. We have unit clerks that do that! I can’t imagine how stressful your place of work is. We are low on census as well so of course that’s all we hear. We’re still busy!!! We couldn’t get things done before and now we are just barely keeping up. What an ***. It doesn’t help anything trying to insult people. Go team!

They are nurses. I know they did more than study the art of medication passing in school. They need to practice to the fullest extent of their licenses. Yes, they need to report things to the charge nurse but they also need to do their best to take care of situations within the scope of their practice. The charge nurses need to empower their staff and hold them accountable. End of story. We are all busy but if they weren’t needed to practice as nurses we could just be using medication aides.

I hate the damn white pants. We all have color coded name tags already anyways. But our LPNs/med cart RNs have white pants, other RNs scrubs and white lab coats. Admin RNs can wear dress clothes but I've been wearing scrubs because it's easier. CNAs can wear anything but white pants. I think the white is bs because I always manage to get blood or treatment creams and ointments or dirt on my lab coat. The temps around the building are always messed up so wearing a long sleeve coat is annoying. It's not the worst but not the best...

We put up a Christmas tree in our lobby. Activities goes to every long term resident and asks them what they want for Christmas. If they can't speal for themselves we usually see if they need slippers or socks or some supply/clothes or a gift certificate to the beauty shop. We keep it around $10-20. We hang their lists on a tree and it's anonymous. Everyone is welcome to pick a tag. Leftovers go to a volunteer group to finish up what staff doesn't pick. Then each unit gets their gift at their unit Christmas parties.

We have a house supervisor at all times. We have a specific list of "When to notify DON and administrator". If you call for something dumb you better go find some lube for the ass reaming you're gonna get!

And their argument would be that they are paying you to be a nurse AND answer the phone. I would add that family members are unhappy you have to suddenly step out or you are being interrupted during assessments and this poses a risk to make an error. What if you were trying to start an IV and the phone rang? Does it ring overhead and bother the residents and interrupt their home-like setting?

ADON here. My DON and I area often coming in when staffing is critical. We've taken carts and done CNA shifts. Of course we're not going to be as fast and as organized but you gotta do what you gotta do. As long as it's not a weekly occurrence and you're not working 40+ as DON and shifts on top of that. Then I would have a discussion with your admin.