EmeraldCoastRX

TGIF.... So this week I had to terminate a nurse for the first time at my current facility. I've held management positions in the past, so this was not my first rodeo. I did however, find this one to be tough. It wasn't because I felt that this nurse didn't deserve to be terminated or because I had any personal attachment to the individual. In fact, it is the total opposite. This person had a long list of infractions and some that were very serious. I also barely know the individual. I feel that the company as a whole is much better without this individual onboard. What's the problem right? Well, people talk and from what I understand, this person is at a very low point in life outside of work. Single parent, several children, financial issues and this list goes on. The thing that bothers me is that I feel as though I'm kicking this person while they are down. The leader in me says that every opportunity was afforded to this nurse professionaly and one must be held responsible for their own actions. The nurse in me says I should feel compassion. Not just for the individual, but for the people in this persons life. Not to mention we are a week from Thanksgiving and a month from Christmas. Isn't this how our minds as nurses are geared to work? To be compassionate? Thoughts? Anyone else ever have this struggle?

Welcome to LTC. Technically no, there is not enough time, but you find it. Once you get a routine down, it won't be that overwhelming. Yes there will be days where the inevitable happens and your shift is thrown into a tail spin, but you adapt and continue on. Hopefully your new facility isn't a stickler about clocking out as soon as your shift ends. Soon you will have a PHD in time management. :)

Lol!! We ARE experts at being creative in LTC. I can't speak for all, but personally I have my hands full of it every shift. Ever tried to convince a demented patient that they are not the governor? Perhaps one who calls 911, weekly, to report that they have been kidnapped? Calling on the cell phone that the RP insists the 90+ yr old patient MUST have in the event of an emergency. And that's on a slow night....3-11.

Agreed. I understand that some facilities require business casual for nurses. Khaki pants and polo shirts. Yuck!

State and Feds together is tough. The feds are watching the state, so the state goes the extra mile. :/

I would assume the alternative. I think there are many residents, currently in LTC, that would benefit from this type of facility. Obviously not folks who require skilled care, but the ones who only require minimal assistance with ADL's. There are residents who decline because they could be in an ALF, but they end up in a LTC for lack of money. Most ALF's that I have seen are an apartment type community. Big bucks! In LTC they're not really pushed to be independent and they become more dependent on the staff day after day. That, in turn, shortens their life span. I see people who are

Leadership is the process of influencing others to accomplish a task/goal/mission by providing purpose, motivation and a sense of direction. I've found that keeping my team informed, helps them see the purpose and importance of their role. You'd be surprised by the number of aids who know to reposition a pt q 2 hrs, but do not know why. I always take time to explain the "why" or the purpose. Yes! There is always time to do this! "Let's walk and talk." I'm infamous for saying that at work. The motivation part can be tricky because it can differ from person to person, person to team and personality to personality. I give the veteran aids the respect that they deserve. I'm respectful, but also very assertive when I need to be. I believe that by respecting them, they will respect me and this motivates them to work hard for me. That respect and motivation trickles down the chain. When I have a lesser experienced aid or even a "lazy" aid, I don't let things slide. I address things immediately. Sometimes this goes back to providing purpose. Understanding the "why" motivates them to be better or CARE for that matter. The sense of direction is a combination of the first two and also setting the standard. Let them know what is expected of them and make everyone accountable for their own actions. Acknowledge what's good and address what is not. I'm a hard ass, but I'm approachable. When a correction is needed, I try to start out with a positive, followed by the negative and finish with another positive. It works wonders. You may find that the negatives continue. In that case, don't be afraid to make an example out of someone. I've had to walk a few aids down to the DON's office, but the problem is generally solved after that. I let the aid explain why they are there, which goes back to making them accountable for their actions. Not everyone will like you as a person, but most will respect you as a charge nurse. Leadership doesn't require making everyone happy, but does require getting the job done. In our case, the job is providing excellent patient care.

Be eager to learn. Find out quick who the vets are and ask to do your orientation with them; RN or LPN. Learn the CNA's and what sort of leadership they respond to the best. They can make or break your shift. Take notes and keep them with you. You're always up against the clock! Knock out all of the "additional" tasks every chance you get and don't put anything off for "later" if you have the time to do it now. Things have a funny way of stacking up quickly. Never say the "Q" word (Quiet). Treat your patients as if they were your own family and they will become your family. No matter how stressful a shift has been for me, I always leave with something that has made it worthwhile. Most important is to enjoy it and remember, no matter how bad it seems, it can always get worse. :-D