Emma123

Thank you for the excellent advice here. I thought about documenting the comments/behaviors. I will from now on. To be truthful, the "management" isn't the problem. It's only one particular one. But she has the power to terminate us. What's the use in following the chain of command to report the abuse she is giving us, when her superior is an old friend from nursing school? And that would be the DON. And the other ADON is the DON's daughter. Yep....we're pretty much in a rock and a hard place. It's just sad to see REALLY GOOD NURSES leave this facility due to their constant patronizing and put-downs, which were not done privately, either. I thought about placing a small piece of duct tape on my pen to serve as a reminder to "shut up and keep it to myself" any time I thought about speaking up for myself. I guess I'm just really sad it has to be this way. Because I SO TOTALLY LOVE my coworkers. We help each other out, no questions asked. A great group of people. Even the administrator is a nice person. But I fear going to the administrator would be "breaking the chain of command" and then if I truly DO make an error...they will jump right on that...to get me out of there. Sad. Because I love the patients. Love my work....Wish it didn't have to be this way. How one person could make good nurses leave like that.... Seems like the only way to survive is to be the "tattletale" the "martyr" the "narc" the "kiss-ass".....you know the type....I think that's the only way to survive there...

No. Just myself. They said it was "my voice" they heard. But all we were talking about is the way we've been picked apart lately. Especially when we've been picking up TONS of hours to help out. This manager also put me down in front of a physician a day after the write-up. It's getting worse, unfortunately...

So, I was in the med room at work, talking with two other co-workers (also nurses) about the struggles we're having lately. The door was cracked. Our voices were low. We were simply venting. Apparently they stated they heard my voice...they...being the "management". I got called into the office and was confronted about "making negative comments about management" in front of coworkers, thereby it is "insuboordination". Write-up stated "making negative comments about "management"." Has anyone else been written up for this? Is there truly a regulation I broke? Or is this about power and control? I ask because this particular member of management is the reason three nurses have quit in the four months I have been at this facility. I feel it's cumbersome to refute the matter, as the "higher up" from this person is....her friend. And the other member of management is.....the manager's: daughter. Our voices were low. There was nothing derrogatory stated. No foul language. Just generalized feeling like nothing we do is good enough, and it's hard to be constantly criticized. May as well shut up and take it. I decided to wrap a piece of duct tape around my mouth before going to work daily. (Kidding). I just feel I'd be better off, in say....Communist China?

LMAO!!!

I feel your pain, and here is what I did about it: I had a patient arguing with a family member at the nurse's station. I tried to put it out of my head, but I had a new admit and was confirming orders. I picked my head up, looked at them and said, firmly but politely, "Would you please take your conversation to the day room? The work that I do at the nurse's station needs to be accurate for this patient. Med errors can kill people." I know it was gruff, and to the point.....but the family DID move elsewhere, and they.....yes, they did....APOLOGIZE later. I have found that telling people "why" I am doing a particular task leads to understanding and better cooperation. I am firm when possible. I even set time limits (when possible) when I initiate care...ex: "Mrs. Smith, I thought I would take care of you right now while I actually have 10 minutes just for you." You are letting them know you only have such and such amount of time, but you are also "attempting" to make them feel "special." This doesn't work all of the time, but most of the time. Like I said, I feel your pain.... Emma

I am so sorry to hear about this situation in your community. I'm an LPN wishing to become a SANE but don't know if I need to be an RN to qualify. I'd like to see one here in my community in Michigan. Here's to wishing you well in your very important, and much needed, endeavor! Emma

Thank you for the extremely useful information. I could probably find another job....but in all honesty, the facilities are run pretty much the same that are in my area. This is the worst (management wise) that I've come across though. ALL of the employees are opressed, not just nurses. They treat the housekeeping dept this way, as well as the central supply director. They add more and more duties to them, cut their hours, and expect these things to get done. So what do you see? You see them running nonstop, winced faces, angry, short-tempered, and tearful. So another question I have....the union would be only for the nurses, correct? What about the CNA's? Another question: What about LPN's? I looked up the state association online last noc and it said for "Registered Nurses". Bummer!!! I'm an LPN currently. As you know, SNF's are pretty much staffed by LPN's. I truly do want to make a difference. I want to help. I want security not just for me, but for all of those involved here. Sure I could move on, but being an LPN makes it even harder to find work since hospitals in my area don't employ them, and the ones that do, pay very poorly and the ability to use my nursing skills is limited in that setting. So for now it's :bowingpur "yes maam, please beat me down...:bowingpur ...yes I'll kiss your butt....:bowingpur. Oh, sorry. Did I miss a spot?":bowingpur Thanks for all the helpful advice. I, too, am learning a LOT from this. Emma

I can't even begin to thank you for the information you shared. I will definitely look into it and see who may be interested in this. When you say it comes down to a vote, I am assuming that a for profit organization such as mine, that administration could over-rule the nurses. There are way more chiefs than Indians, as they say. We're short staffed and the same nurses pick up tons of extra shifts. (TPTB probably know this; that makes our vote even less, if it is democracy-based). As I said, the morale is really bad where I am at. My coworkers and the CNA's are exemplary in my opinion. We pretty much support each other. I recently read an article on this board about morale and loss of hope (I can't remember the name of it; I'll look it up) within the medical profession, and essentially being bullied into submission and being fearful of standing up or speaking out d/t consequences up to termination. I was told this morning that in two years, my facility has fired 40 nurses. YES, 40. I realize it works to the facility's advantage to pay the "nominal" fee of a physical/background check. The orientation was "watch what this nurse does" for three shifts for me. Not much went into training me, money-wise or even time. They didn't have someone off the floor go through admissions forms, etc. They made the poor preceptor work the hall PLUS try to train me. One of my former patients was a director of nursing in a prison and told me it is more cost effective to a company to have turnover than to retain and pay out long term benefits and retirement funds. Since I work for (my opinion here) and unethical company, the picture this pt painted for me makes sense. The long and short of it, when it comes down to voting, believe me, there are way more mgmt, marketing, and corporate fools than nurses. We are way outnumbered. So another question (sorry) is, if the facility and TPTB decided against it (as they, with 100% certainty, would), even if the nurses all decided "YES", it's still THEIR company, right? They can still have the final say? Or bully us to the point of being fearful to even vote in the first place. ? I just wanted to investigate into this some more and I really appreciate your posts and help. Thanks again, Emma

Thank you for your post. We think the same thing about the administrator. We just lost 5 people, including the ONLY full time physical therapist who was very good. So now my "rehab" unit is with fill in therapists, not those that know the facility and have 10 years vested in the company. This administrator has ruined a lot here, unfortunately.

Thank you for your response. So....how do I get a union involved in my company? (Or is that not an option....please excuse me if that is an "uber" dumb question).:sofahider

You will only know what has been described above once you are a nurse. There is no way anyone could explain it; it is very personal to nurses. I would not want my own daughter to be a nurse; I've adamantly told her to not even consider this profession. That being said, working for an agency is nice because you can avoid much of the politics. Provided you have a spouse with steady income for those in between times you don't have an assignment, and for the better insurance benefits. The happiest I was as a nurse was when I could go to work, do a good job, take care of patients, do my charting, and then drive home. WITHOUT all the politics.

1. I don't understand that, sorry? 2. No way in hell. Emma

I wanted to post this question under the thread which contained the objection form (taking an assignment and filling out a form, aka Safe Harbor), but did not want to hijack their thread. I want to know more about unions. Where I work, it is an "at will employer", meaning they may fire you with or without reason. Do unions protect you from this? If anyone has any feedback, another question I have is this: Does anyone know if union based facilities have better retention of nurses? Right now at work, there is a huge drop in morale, as administration stated to the nurses when corporate people were in , "When corporate is here, they are right. You are wrong. Shut your mouth." This came about after a condescending woman in a suit was watching me do my med pass and juggle an admit, then have one brought to my floor (without my knowledge). I simply stated to this woman, "Communication could be better here; If I'd known I had this other admit coming, this could be prevented." (referring to her negative comments and raising her voice about our attending being unprofessional and in a hurry and just 'horrid' to the patient caregiver). Anyway, the long and short of it, I was given a final written warning, stating that if I break any company policy I am immediately terminated. Because, "You are NOT to talk to other people about our problems. You do NOT talk to corporate. You refer them to ME." ("me" is the administrator who cornered me in the kitchen). I still have refused to sign the write-up. She says that what I did was unprofessional. (Umm...I didn't yell. I didn't REFUSE the assignment; I simply stated that advance notification would have been helpful). Imagine a woman and a man coming to you; man with huge wound on face standing in front of you. Woman starts asking you about how to treat it. (And you are in the middle of giving meds, and a new admit, and you wonder who these people are and why they are asking you medical advice). And this condescending corporate individual (who I didn't know was corporate) informs you that this is a new admit to your hall, and stated in a loud voice, "Don't you tell me you didn't know about this admit. The person sitting right here in this chair---as she's tapping gruffly on the chair with her ink pen---took this message!" Bottom line: I did NOT doing anything wrong. Well, I guess I did. I wasn't a good Stepford Nurse and cheerfully say, "Oh, so glad you are here. How may I help you?" I didn't have a right to feel under pressure? They get angry with us for overtime, but two admits plus medicare charting on 17 people, and all the other redundant forms they need us to fill out before we leave....isn't that enough already? I witnessed the administrator call our unit, get the social worker on the phone and, in front of all of us, instruct the maintenance man to "Shut up and quit complaining and just move these people" when we made several room changes and maintenance man was overwhelmed. I'm not kidding here..."Shut up." "Shut your mouth." These are ver batim words we are told. So the point of my vent is this: Would a union shelter/protect its employees from these bogus write-ups and mistreatment? Any thoughts? Thanks for your time Emma

ROFLMAO

....wondering....am i the only one reading these responses and actually saying OUT LOUD....yes! Oh yes, that too!! (Thankful to not be alone. Insane and in good company, much better)...

Isn't THAT the truth!!!! Regarding the (Go into marketing....lie real good) post.

I couldn't refuse to accept report. As for the timing of new admissions (I've already tried to inquire about timing), they tell me that we have to take them when the hospital discharges them to us. We have no choice. I guess my biggest problem with this scenario is what was described by the earlier poster, in the bonus check for the powers that be. I cannot tell you how many UTI's our patients have developed...duh...when they have to urinate and they put their call light on and it's on for 15 minutes if not more (then a family member comes to hunt me down as I am getting an I.V. flushed), I am embarrassed. I care about patients. You'd think that as many patient surveys that have been done and the overwhelming response is that they need quicker response to call lights....they would see. But...unfortunately here in Michigan (maybe all states; I'm not sure), there is not a mandated nurse:patient ratio in long term/subacute rehab care. Seriously, 28 patients???? All who have legitimate needs that should be met in a timely fashion. One nurse, struggling to meet their expectations. It's sad. All they say (TPTB) is that they "have a budget to adhere to". Again, so why the bonus checks for the marketing deparment???????? To add insult to injury, this same marketing individual says to me, "Make sure the bed in room 350 is made." The new admit's room. Why do they delegate that to nursing staff? We're busy trying to do patient care. She walks slowly away and chit chats....someone should teach her how to make a bed. Thanks for listening. I appreciate the advice on meeting with the higher ups....but trust me when I say they are patronizing, stubborn, refuse to listen, are always right, and it's all about the dollar. Emma

I work in a LTC/Subacute Rehab Unit. Typically I'd have 19 patients or so. Now I have 28. One nurse. Manager is in meetings all day for the most part, so she can't help too often. I have to say: I am getting really stressed. I'm feeling frustrated. There's so much charting, PRN's, etc. I send out a patient to the hospital on almost a weekly basis, so it's not like these patients are stable, long term care people with naturally occurring ailments. So I approach my unit mgr and tell her about the stress I'm feeling. She says it happens all the time when the census is high; the nurse on the floor gets stressed, and then there's a lot of call-ins. Yes, I can see that. Burnout City. If they know this happens, why don't they do something about it? I told her I get nearly nauseated when the marketing girl comes strolling down the hall with her pleasant radio-d.j. sounding voice, heels click-click-clicking down the hall with flower in a vase in hand, ready to hand over a new admission (during med pass with roughly 10 diabetics who are unstable). I nearly want to each time I see her coming. They have a BUDGET (for profit organization) they have to adhere to. SOOOOOOOOOOOOOOO....When I learned that the Marketing girl.....gets a BONUS CHECK....thus the smile on her lovely face.......for increasing the census....thereby bringing more money into the facility..... Can you imagine my disgust? Is this typical? Is this the norm? Throw your front line troops (nurses and Cena's) under the bus, burn 'em out, fire 'em, re-hire (this is the norm where I work; the turnover is HIGH).......and.... GIVE BONUS CHECKS to the non-clinical staff who have no clue how hard we work????? I've been written up for overtime. How do I manage to cover my butt (chart), get all of my work done (believe me, my pace is beyond fast; I race down the halls), and not have overtime? I get told, "We are a 24 hour facility...pass it to the next nurse." (Yah, and have the next nurse pass on to the next....then when there is a care conference they pick up on the fact that some of the admission paperwork is incomplete, and "Why wasn't this done? Why wasn't that done?" Sorry. I just had to get this off my chest. The only thing that keeps me going there is the learning experience, I like most of the girls I work with, the commute is not bad at all, and it's a job in this hard economy. So, I probably should just bite my tongue and be thankful. I know. But seriously...bonus checks? Where's OURS? Thank you for listening, Emma

I'd like to thank all of you who replied. What I don't want to do, unfortunately, is quit. I was hoping there was another solution. It appears as though my gut (and yours, too) suggests leaving the only solution. It's actually cheaper to have the high turnover. The orientation they provide is one day (with doing nothing but paperwork and procedure). Then you hit the floor running following a nurse for about a week. There's not much cost involved (other than the required physical). But when the employee hits their 90 day mark, they have to fork over the benefits. I work for a "for profit" company. Maybe that's the problem. I guess it doesn't matter what the "problem" is. I'm just bent on finding a solution. I don't want to quit. I like my coworkers. They're all just as frustrated as I am. Our DON was on vacation this past week. I don't know if my unit mgr has had a chance to talk to her or not. My guess is, it doesn't matter. The changes they were going to make were to change the shift hours so that third shift was responsible for the morning diabetics. And yet, that doesn't solve lunch or dinner. That still doesn't solve the lack of nurses to the amount of patients. Oh well. Back to the drawing board? Thanks for listening.

I'm currently working in a LTC facility in the Subacute/Rehab unit. I've been there 4 months. When I hired on, they said when the census hit 24, there would be 2 nurses on. Well, we're at 29. We have 30 beds. I have 21 diabetics, almost all with sliding scale insulins to treat. And...I have to be in the dining room when the trays arrive (requirement by state). I am finding it IMPOSSIBLE, as are my coworkers, to get there on time. I have dementia patients (apparently they just want to fill beds and don't care if it's a subacute unit), and they wander...so finding half of them to get their fingerstick done is also a chore. I'm running to the point of sweat pouring off my body. I don't mind being busy; in fact I love the challenge and love running. But...I don't like being overwhelmed. I don't like running so hard and still not managing to get the tasks done on time. And it's not just me, the other nurses have expressed this to our unit manager, who is going to bat for us at some point this week. The bottom line is: money. They have a marketing liason who gets these people recruited from discharge planners at the hospital with NO medical background. She waltzes in and states "You have 2 new admissions coming this shift." and smiles, heels clicking, walking down the hallway. She has no idea how difficult it is to get our work done, plus do quick head to toe assessments, get orders verified, get meds ordered, on top of the workload we already have. The nursing home administrator has a background in business. She apparently "went to nursing school but didn't do clinicals." She has NEVER taken the time to assess what happens on our unit. She says, "Halls A and B have 30 patients and they have only one nurse." But....these people are long term care patients. I've worked those units, and the staff anticipate their needs (as they are demented and don't use their call lights). So, even though there are 30, there are only 2 diabetics, and they are not alert and oriented. They also only have about one or two patients that request PRN drugs. My unit is diabetic and PRN hell. I can offer a PRN drug to a patient while I give them their scheduled meds, and they'll say "No. I don't need it now." (Which is fine). But then in the middle of getting 21 fingersticks, I'll have a patient ask for a suppository. Then an enema. Then 1/2 a vicodin. Then ask for me to come in and "remove my impaction". Then the phone ringing nonstop. Families of all of these patients calling asking how their aunt is. Families who are there who are demanding a cup of ice ...NOW. I love what I do. And none of the nurses are willing to stick their heads out and make a stand. Corporate walks through and grabs the Vanco I.V. off my med cart as I am getting ready to walk into that patient's room. He has it in his hands and says, "Why is this here? Should I take it?" I reply, "If you have an infection and think you need it." He says, "Perhaps I'll report it to your D.O.N.". ****This is frustrating beyond all frustrating***** These Corporate Carls (I call them), come in, intimidate (or try to), and don't listen to the real issues. Don't understand that I'm going to put the I.V. Vanco on my cart as opposed to walk all the way back to the med room, if I'm getting ready to walk into the patient's room. There's no where to put it in my med cart. The last Corporate Carl that walked in asked, "why isn't there a sign that says 'Med Room' on this door?". I about died. How about we advertise, in neon lights, "Narcs Found Here!!". I politely looked at him, ignoring his (what I felt to be ridiculous question), and said, "While you are here, would it be possible to assess the need for additional nursing staff?" He said, "You can ask me anything. It doesn't mean it will be honored." (while laughing). It is a "for profit" organization. Is this the problem? Or is it the same everywhere, for all of us nurses? Have I seriously got a chance at getting someone somewhere to listen to our plea for help? Can I call the state? Is there a staff/patient ratio requirement on a LTC subacute unit? How do I find out? I don't want to quit this job. I love what I do, but it has to be made POSSIBLE to get the work done safely for patients, and safely for our licenses. Nurses are literally clocking out and going back to do their charting (No overtime allowed) to cover their butts. It seems that they will open up amongst each other, but have fear to make a stand. Maybe they know it will do no good. I'm told by one of the attendings who comes in, "Nurses last about 3 months and then fly." I'm also aware that it's cheaper to have high turnover in staff than to retain staff and pay out benefits. I'm feeling very unappreciated. Errors are unavoidable with the high demand on this unit. A missed med here, a missed treatment there....I see it everyday. None of us want to quit....we just want to be able to work safely. Any suggestions? I'm running out of hope.... Thank you. Emma

Is that the patient's personal medication record (MAR)? Because putting another patient's name on the original pt's chart is a HIPAA violation. Just wondering.

I just wanted to say my thoughts and prayers are with you. You've gotten some great advice here, and we are all here for support too. Many hugs Emma

a potential employer (post interview) WHY they didn't select you as a candidate? I was told that they went with "another candidate" yesterday. (Still sort of fishing the waters for a job closer to home). My main reason for asking is that I wondered if it was r/t negative references. (Mind you, on the fax for reference check it asks if employee is eligible for rehire....that would pretty much say it all, wouldn't it? You all might remember my post about my former boss telling me my blonde hair looked trashy.... Thanks for any input. I just wondered how to professionally "word" the question to them. My former boss still hasn't gotten my W2 to me to file my income taxes yet. I keep thinking, "haven't I taken ENOUGH abuse from her already?" P.S. I touched up my roots last night. hehe Emma

Thank you all for the reassurance and help. I guess I'd rather have a nurse or two roll their eyes at me than have a patient on the other end roll off the face of the earth because I made a mistake by not knowing what I was giving...any day. Thanks again for the tips!!!!!!!!! Emma

How do you go about "looking up" a med you aren't familiar with at work? Do you bring along a med book? Use a PDA? The reason I'm asking is because I'm returning to doing inpatient care from working in an office (don't give meds there other than vaccines, really). How do I keep on time with passing meds? I've had other nurses roll their eyes at me when I went to look up a med. But they didn't know what it was for, either. I don't want to be "untimely" but I also want to be prepared in case the patient has questions about their meds, OR a med where I'd need to watch for particular s/e's. Thanks for any advice!! Emma