EmpathyInAction

II don't know about the "resort" part.... generally post acute care facilities you will facilities get 15 o 20 patients with most anything you might see on a Med surg unitunit, if that helps. Its very busy and patients are very needy because of their conditions.

I'm assuming that you would still start out working with a preceptor. Typically orientation is a lot of hours of facility policy and procedure, not really job training. If you are not starting with a preceptor then I wouldn't start. You need on the floor orientation. If you don't know the answer to that question, I would call the DON and clarify.

They may not be flammable, but at least one man has killed himself with his own farts, per the Darwin awards.

Although I didn't explicitly say so, I've still been working with a preceptor as Im very new to the facility. I guess I thought it was an obvious inference. My preceptor is one of the other nurses who treated this as normal. So as I said, I felt unsure how to handle the situation.

While I agree with this, it's not appropriate for the Dr to "yell" at the staff in the facility, assuming the OP literally meant yelling. If what was actually meant is "got my butt chewed out" that's a different story. It's well known that some doctors are just difficult and some are hard on new nurses. The best you can do is be careful and cover your charting as you go. Assuming that this Dr is just difficult on new nurses, you're going to have to grin and bear it to some extent. It will take time for things to get better.

I haven't read every reply but here are my thought: a well written resume, if completed properly and professionally (sparing the boasting and attitude of deserving better) should speak for itself. I had 2 interviews as an STNA based on my resume alone. My first nursing job, my employer found my resume and called me in for an interview without me ever having contacted them. My second and current nursing job I did submit my resume and was called in for an interview the same day. I have no super powers. Before I became an STNA, no previous healthcare experience. As a new RN, only healthcare experience as an STNA. I don the provide a cover letter or anything declaring my exceptional skills. My resume has a purpose statement that is about 7 lines long explaining my personal beliefs on nursing and why I feel I am a good addition to any facility. The rest is a normal professional resume. As I said, it should speak for itself.

There are tons of options with an nursing degree. Not everyone enjoys being a floor nurse. You have a lot of options though. I'd look into other job possibilities that might suit you better while still making use of your degree.

Started first job at a LTC facility at 22.74 with shift diff. Left after 3 mo. and just started a new job at an SNF at 24.50 with guaranteed raise over the next year if I stay I'll be at 25.75. Live in OH. This it pretty typical for my area.

I will make this short and sweet. Just because you do not wish to be brought back to life does not mean you wish to suffocate and die painfully at home. I did most of my clinical on telemetry floors as well as my role transition where we had several codes a day, some of which were DNA and some were Full Code. I cared for them all equally. If you do not wish to care for dying people who don't want heroic measures taken but do wish for comfort at the end, as we all do, then you shouldn't be working in acute care, let alone telemetry. Go to a doctors office if you can't be troubled with DNR patients and let someone who actually cares have your job.

The best advice I can give is to report these things to the charge nurse when they happen and document the interaction. I had a patient at my last job that was difficult and argumentative. She'd regularly insist I hadn't given meds, checked her BS lvl, ignored requests, etc. None were true. I was the charge nurse there as I was the only one on the unit, however I made it a point to always notify the supervisor and document. In my case, this patient had a pattern of this behavior with all staff, but I still made sure to cover my butt. We all have short comings and things out of our control, but there are also just patients and family who are just difficult and cause trouble.

That's exactly it! Something feels off. Either she has a complete lack of concern for procedure or she's intentionally not doing things properly. Either way, it's bad. I went ahead and spoke with the shif nurse manager last night. She apparently had been told that "someone" was leaving cups with "1 or 2 vitamins" in the cart. We had a quick but thorough chat and she said that they would be doing some random cart audits during her shift. She was also already aware that this person has a habit of not signing out narcotics. I am glad I spoke with her. I became a nurse because I feel I am meant to care for others. I also believe strongly in the service of others. I am not properly serving my patients by doing nothing about the situation. I have to protect my license as well. Thank you for all your replies.

Jadelpn I think you really summed up some of my thoughts better than I did. It really sounds like you understand my very real concerns. As for the narcotics count being off, it happens like this: When we do the narc count, she is reading the logs while I am counting. She gives a number and I say it's off by one and she goes "oh ya, I did give him/her one" and she'll sign it out right then, to my guess likely with the wrong time. Who knows if she did actually give the narc considering. Sometimes it's multiple narc for multiple patients during a count. The whole thing makes me very uneasy. I'm especially paranoid with narcotics and always double/triple check things before I punch them from the blister pack, then I make sure the patient takes it before I document it in the eMAR. Her lack of concern for proper dealing with narcs and laze fare attitude "oh, oops, he he" is distressing. That's all above and beyond my general concern for patient safety with unlabeled meds/ med cups/ meds not being administered. I understand the point made of talking with her directly, but am glad to see I'm not alone in seeing a serious issue with her practices.

I work in a SNF that takes acute care patients from hospitals, often fresh from surgery and/or with significant problems. On any given day I can have between 10 and 16 patients. It is tough, tiring and keeps me very busy. The patient population is constantly rotating: as patients are finishing thier convalescence, new more acute patients are arriving. I do not believe that this type of environment is for everyone. However, it takes time to adjust and you need strong organization skills and to learn how to prioritize tasks. This may or may not be the job for you, but if you are still orienting, you might want to give it more time.

I had not yet addressed the other RN. This is my first time encountering a situation like this, which is why I was seeking advice.

My first job was in a LTC facility. I was on the skilled unit but the patients didn't require the level of care that the people here do. I understand to an extent setting meds you have pulled and couldn't give right then in with that patients meds. The problem is they are randomly in drawers. I've not thought of checking the drawers before she leaves. That's a good idea. The narcotics really make me nervous. Her counts are always off and she has to fix them when we are counting... then I believe I find them in the drawer. I'm just worried for the patients and that this is going to come back on me negatively.