CloverPark

This issue will NEVER improve and will likely continue getting worse as long as (most) nursing homes continue to run as for-profit organizations that are owned by people who know very little about healthcare...

So there's probably going to be a lot of people who say that your decision was dramatic, that you should just get a job elsewhere, that you've only been a nurse for 5 years, etc... Well, I've been a nurse for 10, and I'm seriously ready to give up too!! From what I know/hear, it's bad EVERYWHERE! Sure, I bet some jobs aren't TOO bad, perhaps even "nice," but at the end of the day, I'm still working in a field where profits are valued over people, and nurses get thrown under the bus and even end up in jail over a mistake... I went into nursing because I genuinely enjoy helping people, but the environment has become so toxic, stressful, and overly demanding that it is often impossible to truly give patients the care they need and deserve. Plus, it's just not worth it to have the soul (and sanity!) drained out of me to the point where there is NOTHING left when I come home to my family... That being said, I recently quit a toxic job and I am about to start a new one. If this one doesn't work out for me, I'm honestly going to consider a career change.

I'm glad there was a happy ending for you! At the time, for whatever reason, I thought going through the EEOC was going to be a lost cause so I hired a lawyer. That lawyer ended up screwing me over with a communication error (told employer I would accept a job as a tech, which I did NOT agree to). So I dumped the lawyer and decided to go the EEOC route. However, due to that miscommunication/"inconvenience," I ended up receiving a much lower settlement than I was originally entitled to. So lesson learned. Anyways, I am just NOW about to finally start working in a hospital again after being seriously traumatized over this ordeal (definitely not the same hospital). Honestly, I'm pretty nervous, but at least I won't make that same mistake again!

I would only disclose this if I absolutely had to. For example, my ADHD medication showed up on a urine screen once when I started a new job. The person who ran the test (not associated with the organization) called me and asked me to email them a picture of my prescription bottle, which I did, and that was it. There was no reason to let anyone else know. Also, it's not just the fact that you take that medication, it's the diagnosis associated with it. You never know how people will react, especially if you have not been employed there long. Based on my own experience, I will never again disclose the fact that I have ADHD to anyone in the workplace unless it's someone I trust 100% completely. During orientation at my very first nursing job, I randomly told the nurse educator that I had ADHD while we were discussing what I can work on so that I could get out on time (I tended to stay late charting, but again, I was a new grad). She seemed very understanding; however, I got a call from the director the very next day and long story short, I ended up being fired. No, I did not make any medication errors or do anything unsafe or inappropriate on the job or call out/come in late, etc... It was literally JUST the ADHD disclosure. This was almost 10 years ago, but it still affects and haunts me to this day. That was my "dream" job, and I had worked SOO hard and was SOO lucky to have landed it as a new grad. I STILL wonder what could have been if I had just kept my mouth shut.

I live in NJ and I have NEVER seen anyone NOT wearing a mask. I honestly think I might get shot if I didn't wear one out in public...

Are you kidding me??? Girls your age LOVE "dangerous" guys!

I think we work at the same facility! ? In all seriousness though, I totally relate to how you are feeling, because I am dealing with these same issues... Unfortunately, I can't even offer any good advice. I have been working as a subacute nurse and/or supervisor in the nursing home setting for almost 7 years now, and I just can't take it anymore. There have been times when I was hopeful that maybe I could help make some positive changes, and I did make some... But there are just too many problems, too many issues, and too much drama in these facilities, and hence, it is just TOO FAR GONE! I have recently started my RN to BSN online and plan to start working in a hospital soon. It will be sad leaving a place that once felt like home, but we have to take care of ourselves, because no one else will!! Walking away might be the best and only thing we can do to preserve whatever's left of our health and our sanity!

My input: I work at a subacute/LTC facility in NJ and things have been rough to say the least. I do want to point out that this facility has had a good reputation and has done very well during state inspections. That being said though, COVID-19 hit us hard, and it often appeared as though no one knew what they were doing, which is stressful and frightening. Administration states that regulations keep changing from day to day, even hour to hour, and I'm sure that's true, but there is such a lack of communication, and it's scary going in to work not knowing what you will be facing. One day it's "No one is allowed to wear masks" and the next day it's "Everyone MUST wear masks!" That of course, was very early on in the game before we had our first positive case. That seems like forever ago, but it's only been about a month. So much has happened and so much has changed... I can't keep track of the number of positive cases we have, but I remember the "official" number from last week was 56. No one knows the real numbers though, because 2-3 weeks ago (I can't keep track of time anymore), the local hospital, who does all our labs, refused to give us any more tests. During that time, residents kept getting sick... and kept dying. I believe the death count is at least 20 now, but I've honestly lost count. Early on, they emptied out our 2 subacute units, one of which was my regular unit, so I was initially bounced around and then worked regularly on the dementia unit after the nurse there became sick. Employees were dropping like flies, and others just didn't come to work, so we were working dangerously short on a daily basis. This of course, put us remaining few even more at risk, because being stressed and overworked made us more susceptible to getting sick from this virus. A little over a week ago, I began working on my unit again, because it was reopened and turned into the "COVID Unit." This unit was set up because the DOH stated that COVID+ residents must be separated from the residents that are "well." To me, that's a joke, because no one knows who is "sick" and who is "well" anymore! Not without testing!! Our facility did manage to contract a different lab that has supplied us with more tests. I believe the vast majority, if not all, of the new tests we have sent out have come back positive. The dementia unit had actually managed to stay "clean" for so long, even while the other 2 LTC units were in their peaks. However, this virus is completely taking over that unit right now. I have no doubt in my mind that literally every resident there is infected. Unfortunately, we cannot test everyone, so many residents will remain "presumed COVID-positive." COVID-19 has taken a toll on staff as well. Honestly, it feels like there are more who are/were sick than those who are not. This includes employees of ALL ages, young and old. I work 11-7, and three of the nurses, several CNAs, and most recently the supervisor on my shift have all gotten sick, with one ending up in the ICU. Fortunately, she is recovering at home now. There are many more employees on other shifts who have also become sick. One has been in the hospital for at least 3 weeks now with no end in sight... And sadly, another has passed away... That being said, I am grateful for the fact that I've managed to dodge this virus so far, and I'm not even sure how. I do believe in "mind over matter," which is why I go into work every day telling myself, "You are fine... You are healthy... You are F-ING IMMUNE to this S***!!" (I apologize if you were expecting rainbows and butterflies, but I'm just keeping it real here!). Don't get me wrong, I wear my PPE and wash my hands like a champ, but so has everyone else here who has gotten sick. I strongly believe that in addition to taking proper care of yourself and following the necessary precautions, you have to put yourself in a positive mindset and remain focused in order to stay healthy. There are definitely times when this is easier said than done, but I do my best not to allow myself to be consumed by fear and negativity.

Wow, I feel like I'm reading my own post... I too have ADHD and anxiety so I feel your pain! I definitely believe that the more experience you get, the better you will feel regardless of whatever position/specialty you are working. I have been working in subacute rehab for almost 6 years now, and I am FAR beyond the anxious scatterbrained new nurse I used to be... But honestly, I learned the most during times of chaos, code blues, and patients circling the drain... It may be horrible to have to go through, but that is what makes us stronger and wiser, because we will NEVER forget those times, and we come back to them often when new situations arise. At some point in time, you will just know what to expect and what to do, or at the very least, have a very good idea.... Nowadays, I can take vitals and see a BP of 82/40, HR 127, SpO2 76%, etc. and still play it cool like "You're doing fine, take a deep breath," "Don't forget to drink your water, you need to stay hydrated," and "I'm going to give you some oxygen, just as a precaution," with a smile and the most calmest demeanor ever as I assess, analyze, and consider my next course of action.... And I am telling you, that calmness you project makes ALL the difference in patient outcomes... even when you literally have NO CLUE as to what you should do, that calm approach will prevent a patient from freaking out, which prevents YOU from freaking out, and buys you a bit of extra time to think about what your next step will be.... And you will definitely need that calmness when you have a basically dead yet full code patient that the MD refuses to send to the hospital... I also dread phone calls. Always be sure to have the most recent vitals, labs, and any pertinent info readily at hand when you make calls to the doctor.... And be prepared for questions out of nowhere.... You may call a doctor for a respiratory issue, but then he/she will ask you when the last BM was.... Make sure you have ALL the info right there in front of you when you call.

I don't know which is worse... The nurse who rattles off useless information or the nurse who literally just reads off the report they got from the shift before them.

I have another "just for fun." The aides where I work don't write notes unless they are filling out an incident report. That being said, this was by far my favorite incident note I have read: "Patient was found on the floor on her hands and knees, in doggy style position..."

I just had to share this... So I work night shift, and early this morning I had a patient fall (ugh). It was really hectic this morning, so I didn't get a chance to read what she wrote in her incident report until after she had left. I couldn't believe she actually wrote what she did, and I had a good laugh, but wished I had seen it earlier to have her rewrite it. Anyways, here is what it said: "...Patient was on the floor on her hands and knees, in doggie style position, when I found her..." I don't know what she was thinking!

YES! This! I had the same problem as OP... Mind you, I was the BEST at my facility at blood draws, but sucked horribly at IVs.... Finally, I decided to observe one of the best IV starters and saw her do that little upward motion. I took a mental note and then tried that technique once I had the chance... And I got it!!! Been using this method ever since, and now I'm up there with the best of them at my facility.

Any nurse must ALWAYS carry a pen! And it also wouldn't hurt to have a member nearby as well.... Seriously though, I was once told that a pen is part of our uniform as a nurse.

Just this morning actually I was caring for a woman in her 80s who recently had a THR. Since she was on total hip precautions, she had a wedge pillow between her legs. She complained about being uncomfortable because the wedge pillow was so big (It actually was bigger than the ones we normally use. I had never seen one like this at our facility before). She said, "I don't mean to be a pain... I don't ALWAYS complain about big things being between my legs."

Thanks for sharing! I am a smoker, however I was able to quit cold turkey once I found out I was pregnant, because it wasn't just about me then, it was about my baby... then shortly after she was born, I started up again, though I definitely smoked much less than I used to. Once I was pregnant with my second child, I again quit cold turkey, and even stayed off the smokes for 5 years... It wasn't until I started nursing school that I felt triggered... I picked the habit back up due to the stress and I still smoke now, because nursing=stress. I plan on quitting again someday... when I am no longer a nurse... because honestly, I don't think I can do this job without smoking....

Ugh.... this reminds me of a time back when I was a CNA in a small hospital and they were expecting a Hep C positive patient and the charge nurse was scrambling to figure out where to put her... because she didn't think she should be sharing a bathroom with a non-hep C patient.... and on another shift, I was assigned to do a 1:1 with her for safety reasons, because she was going through hepatic encephalopathy and was very dioriented... The nurse came in the room and said, "If I were you, I'd wear gloves at all times while I was in here... She has Hep C and there's probably Hep C all over this room." Mind you, she had no open wounds and was sleeping almost the entire time...

And yes, I do feel a bit ranty this morning...

In my facility it's God forbid you question the MD... however, after being scolded, I did slip in a little "Well, the way the order was written..."

Hi everyone, this is more of a vent than anything... I currently work 11-7 shift as a floor nurse on a subacute unit (Subacute/LTC facility). MD wrote an order to D/C foley at 11pm, which the 3-11 nurse did prior to the end of her shift. The order then stated, "Monitor for voiding/do PVR: if 350mL or more, leave Foley in, OR if no voiding after 8 hours, reinsert Foley." So Foley was removed at 10:45pm. I monitored for voiding, and the patient was assisted to the toilet on my shift, but did not void at all. So at 6:45am (8 hours after removal of Foley), I put a new Foley in him. The output was 350mL immediately after insertion. Usually, in my facility, MDs tend to write the order to D/C foley at 6am (or so) then monitor for voiding during 7-3 shift, when the patient is awake, more active, drinking more, etc., which makes more sense to me. However, this order was very clear in specifying that the foley be removed at 11pm and if no voiding after 8 hours, to reinsert foley. So that is what I did. However, when the MD came in that morning, she basically scolded me for putting the foley in, and stated that she "intended" for it to be done on 7-3 shift, "some time after breakfast," when the patient was more awake/drinking more, etc. So pretty much, she wanted to wait until around 9-10am or so to put the foley back in if needed. First of all, I am NOT a mind reader, and I will not ASSUME what you "intended," when the order CLEARLY states to remove foley at 11pm and if no voiding after 8 hours reinsert foley. If I had NOT put in a new foley, wouldn't that have been an error on my part? According to the order?

I too have ADHD and was the 3-11 supervisor for about a year and a half at my current job at a sub-acute/LTC facility. I am currently on Adderall, but it is definitely not enough for my ADHD, and most of the time, I actually feel like there is no difference as to whether I take it or not. Strangely enough, I found that supervising was actually a good fit for me as someone with ADHD... Personally, I tend to get bored/forgetful when I am stuck in one place, especially if there's not much going on. As evening supervisor, I was constantly on the move, which my "hyperactivity" was well suited for... going from unit to unit assisting with multiple admissions, emergencies, acute discharges to hospital, etc. I also enjoyed helping to teach/train new nurses. As far as my "attention-deficit" part goes, I relied heavily on taking notes/creating reminders for myself. I also made check off boxes on my notes for things that need to be done/followed up on, and everything was always color-coded. Made life way easier for me. However, working 3-11 is rough, and I could no longer handle the hours (I'm married with 2 kids and was missing out on so much). I switched to being a floor nurse on our busiest unit on 11-7, which I really enjoy. On my unit, we have a nursing assignment Word document that we constantly update and print out at the start of the shift. I make sure to add all the necessary notes and make my check-off boxes. If I can't chart on something right away, I make a note and a check off box so I can do it later. Honestly, check off boxes are my LIFE!!! As end of shift approaches, I always make sure that every box is checked off. I have also casually disclosed my ADHD to my coworkers after working there for a while and gaining their trust. For me personally, I feel like this takes a big load off my shoulders and I have felt way more comfortable since doing so. I have not been judged or discriminated, and we can even joke around about it, which I don't mind at all. If worse comes to worse, I just jokingly play the "disability" card then ask them what THEIR excuse is... We all crack on each other, that's how we survive... But all jokes aside, all of the nurses and CNAs to this day still call me the best supervisor ever, and I lasted much longer than any of the other 3-11 supervisors before and after me (we actually currently have no FT supervisor on 3-11, because NO ONE wants that job!). I have always loved wound care, and decided to get my wound care certification. Ideally, I would love a job focused in this specialty, but I have had a hard time findng one, but I still have hope, and I'm still looking... If there is a specialty you really enjoy, my advice would be to get certification/look for a job in that area. We ADHD-ers tend to do best in areas we truly enjoy.

I didn't have time to read all the other comments, but I appreciate you posting this. I was "blessed" with large breasts and cursed with flat nipples (sorry if that is TMI). There was NO way any baby would ever latch on! I tried EVERYTHING! I went to the lactation consultant... Those plastic rings only made things worse... but I was determined to breastfeed, even if it was breastmilk via bottle... 3 months later I was exhausted. The time it takes to pump plus feed via bottle left me constantly busy with no time for much else. I lost all the baby weight and then some within the first 2 months, which may sound nice, but was definitely unsafe if I had kept on going the way I was. It was actually my PCP, who was also my OBGYN/the one who delivered my baby, who urged me to consider formula, as she was concerned for my health... Not all women are physically capable of breastfeeding. And they should never be shamed for it! I definitely believe I was a better mother after switching to formula, as I had more time for both the baby and myself. And even though breastmilk is the "holy grail" of healthy nutrition and wellness, oddly enough, my daughter who received breastmilk for the first 3 months of her life was sick much more often than my son who was formula-fed from the start...

I'm going to go all out right now and expose myself in hopes that it can help you (and perhaps others) feel better.... I was Hep C positive (cured with Harvoni!). I've been "intimate" with my husband and gave birth to 2 children before I knew I had it. During the birth of my son, his and my blood actually came into contact with one another, as evidenced by an ABO incompatibility reaction he had, since we had different blood types.... After being diagnosed, one year after the birth of my son (second child), I was certain as to the time frame in which I contracted it, which was before I met my husband, and I completely panicked at the thought of passing it to him and/or my children. After grueling bloodwork was done, it was confirmed that both children and my husband never contracted it. After extensive research, I came to find that this was not us being "lucky," but was actually quite the norm... Hep C is MUCH harder to spread to others than most would think. So I am 99.99999999% (honestly, I'm sure I can say 100%) sure you are safe. However, it is always best to be safe and get confirmation.

I have never come across a questionnaire that asks if I have ADD/ADHD when applying for a job... In all honesty. after going through what I have been through, I would have left it blank. My story: I was working as a float tech at a hospital and I gained a lot of respect because I worked hard, was always eager to help and learn, and patients loved me. There was one unit where I worked often and I really loved... After I became an RN, they hired me for a FT position... I was doing fairly well, but like any new grad, I was struggling a bit with my time management... often staying late to finish charting. We had a meeting (me, the DON, nurse educator, and my preceptor) and all in all they said I just had to work on getting out on time, but that it wasn't a serious issue that couldn't be fixed/improved. Yet, me being the perfectionist that I am freaked out and later disclosed to the fact that I have ADHD to the nurse educator, who I trusted and felt comfortable with. She was very understanding and gave me reassurance. I never told her not to tell the DON, but then again, I never could have imagined what the DON ended up doing. I got a call from her the next day saying that she couldn't put me on the schedule until we had a meeting. Mind you, we JUST HAD a meeting! When I showed up to said meeting, she informed me it would be at HR... Then out of nowhere she spewed out all these false allegations about things I screwed up, and even though I shot down every single one, I ultimately ended up being let go. I was still on orientation at the time, so there wasn't a whole lot I could do. I did go to a lawyer and could have potentially gotten a decent amount of money for being discriminated, however the lawyer miscommunicated with the hospital and they got mad. I then went to the EEOC and got a settlement, but trust me, it wasn't much. And the pain and suffering can never be cured with money... It took me a long time to gain the courage to look for another job... but eventually I did, and I'm happy now for the most part. I work as a subacute nurse because I am still scarred for life from that experience in the hospital. I am VERY careful about who I disclose my ADHD to and I NEVER leave it anywhere in writing.