tinytrexarms

I will keep this in mind next time, I like that. Thank you :)

I have said "you are being hateful, I'm trying to help, tell me how to help you" many times, in a calm tone. And the other day when my WBAT c hip precautions insisted she was walking out, I calmly said "ok, let's do it" and stood next to her to help her stand. (She can stand, but not walk and quickly realized this, as I knew she would) You can be kinda tough, while still understanding they are afraid and hurting. "Cut the crap" is rarely productive, but telling them they are being ugly sometimes works. Then again, sometimes doesn't because they don't effing care. Lol

I have a med aide who is absolutely invaluable to me as a new LPN, and a seasoned 30 yr vet LPN as my evening med aide. (She just got tired of the stress of the floor and now does meds) they are my backbone for the moment. It's my CNAs that are testing me.

I have zero down time. Lol. And yes, in LTC setting I'm the low end of the totem pole as a charge. I'm basically a secretary, babysitter to my aides, and responsible for all treatments and monitoring ADLS. I did score a great position on the skilled/rehab unit in our facility. Its a bit overwhelming, because I am so new, I'm learning on the fly. It's high pressure as this unit has a much higher acute pt volume. Our small town kind of uses us as a step down unit. A particular aide I have will kind of look at me, and say ok. Then continue to sit on her butt until she feels adequate time has passed and do it. She gets it done eventually, but it's like she's testing me, seeing how far to push.

I'm new to my position, and I am a new nurse. I worked as an aide on the floor through nursing school. Now, I am charge nurse over the aides I worked with. Some of my aides appreciate that and go the extra mile for me because I put in my time. Some others though, ignore the crap out of my direction and do whatever they want. I'm not a babysitter, I'm not a micro-manager. Tips on managing difficult employees? I'm not, and never will be a yeller. Our staff situation is so tight right now that the higher ups aren't going to fire anyone, if only to maintain PPE.

He has had two full work ups. Sent him out twice, only to have the same results. He has been on my unit for 3-4 months. We have racked our brains trying to figure out how his deterioration was so quick with no apparent reason. I had him in a recliner right outside my station, and he still managed to roll out of the chair. He is not sliding out, he is rolling himself sideways or reaching over the side. I can't try a gerichair without an order. He had no med changes, no contraindications with any of his meds, and blood levels were WNL. They added Zyprexa which as of this hour, has him sleeping, but we will see what the day brings. Honestly it's breaking my heart as this is a pt I've grown quite attached to, and I just really wanna minimize incidents until we get the dx figured out.

Geriatric pt on a LTC unit, a week and a half ago was friendly, talkative, semi independent AAO×3. Presents now with severely altered LOC, dyskensia, hallucinations, everything in the book. Clean UA cleanest damn UA I've seen in LTC) , all blood screens negative, (every-freaking-thing) clear neuro, there's nothing. This pt was in perfect health for 88yo. The advice I need, is about this: 6 FALLS IN 24 HOURS. I am having to do 1 on 1 with him, and I simply don't have the staff! I tried an activity board, it worked for a bit, Ativan takes the edge off, but isn't lasting, I have tried every distraction method I can think of. Me, PCP, family and other staff are out of ideas and I can't keep having my poor aides sit with him and get behind on their work, while I do my TX and everything else for the 30 other residents on the unit.

admittedly I have resorted to bribery on many occasions. (Take your bath for me, there may be a soda in it for you) LTC is a different ball game though. I know which residents are fine with a 2X weekly bath, and who needs it 3X, and how to approach them, since I have them every day.

Agreed. Mutual respect is a must.

I have full sleeves and I love my tattoos. But I wear shirt sleeves at work and keep them covered. It's part of being professional.

How many times a day do I hear "god is good!" Or "gods miracle" etc. In my very cynical head I think to myself, "yeah, those antibiotics had nothing to do with it" Out loud I nod and smile. Whatever gets them through the day. It's the horrible broken cries of "why is god doing this to me" that hurt me to hear, I want to comfort them, and tell them gods not doing it it's just a horrible twist of life, that we all die some day. I mean, it must be a horrible feeling of betrayal that your ultimate loving God/best friend and personal wish granter is leaving you in dismal pain.

Treating the UAP'S like crap and expecting miraculous displays of super human feats from them. A nurse I worked with in LTC use to gripe her aides out for taking lunches and breaks on their 13 hour shifts. I always scheduled my aides lunches and breaks and made sure they took time to have some water here and there. Needless to say, my unit ran smoother, I had 75% less call ins, and my aides felt appreciated so they were willing to work harder and go the extra mile for me in reciprocation. She ended up quiting because hers made her life miserable.