AnnaleaRN

I just wanted to take a moment and tell you folks how much I love my new job in LTC. I worked LTC as a new grad and it didn't work out. I accidentally ended up in corrections. While I loved my position, I was becoming institutionalized. I thought it was time to make a change. SO I took a position in LTC on night shift (mostly r/t proximity to home and the sign on bonus). I absolutely love it. It has the same problems with understaffing, etc. as most facilities. However, the entire staff cares about these folks. The unit manager is even involved. I have seen her stay late just to hold a resident's hand because they were upset. Look, it's not perfect. Not everyone follows "best practice" guidelines. But at the end of the day, they love these residents as people. For me, that is the most important part:)

I accepted a part time position in a state prison. It starts on Monday. Do any of you veterans have any advice for a newby?

Thanks so much for the feedback, everyone. I want to clarify a few things and ask a couple more questions. Please humor me:-) GrnTea- I am certainly willing to put the effort into making a change for the better of the patient's and the unit staff! I really love my job. I'm also not a quitter:-) I agree with you that not taking meds exactly on time can be perfectly safe and happens all the time at home. However, the unit I am referring to is relatively acute. We are a "sub-acute" rehab. PICC lines, trachs, etc. We hang IV meds, blood, as well as the patient's regular meds. These folks certainly don't need acute care. However, they are still quite sick. My biggest concern is the fact that it isn't charted accurately. I may very well be being a silly new grad about this. However, if you can't get it in on-time, and it's not unsafe to do so, why put false information on the medical record?(Again, not being flip. I just want to understand.) I'm not sure how to change my attitude about the situation. Do you mean to be less rigid about charting administration times? The Commuter I have no doubt that timely med administration is difficult in any healthcare setting at least some of the time. For everyone, I guess the question is: Do experienced nurses, as a whole, feel comfortable charting late med administrations as on time under circumstances that are not going to cause any immediate harm to the patient?

The all-mighty dollar is clearly king in the field. How does an individual resolve themselves to being a part of something that is so clearly bad for the patient? Is it something like "this is the way it is, but at least my presence may make a difference occasionally?" I am truly NOT trying to be flip. I'm just not sure how to approach the situation realistically. A job change? A career change?

I absolutely agree. It is, indeed, impossible to pass the meds in time. I certainly don't hold any ill will towards this "hypothetical" nurse for doing what she feels she must to survive. Here is the issue that has kept me up tonight. This action of falsifying the time of med administration is not without consequence for the patient. It could be unsafe. Also, I feel like it is a serious violation of a patient's rights. On the other hand, I don't want to get this person in trouble. As you said, she is just a player in the game.

What would YOU do? Say, hypothetically, that you are a new graduate RN at your first job. During morning med pass at a SNF, you witness another RN entering incorrect times for med administration on multiple patients in order to seem like everyone received their medication within the designated time frame. When you asked this nurse about the times, she states that she "guesses every nurse has to make a judgement call on how to chart." Would you take it further? Would you ignore it?