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LeahSunshine

LeahSunshine

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  1. Hello, I recently had a small kind of altercation with another nurse I work with. She's more of a pet iem worker than a regular but I see her pretty often. We had worked together a few months and things seemed fine, but apparently they weren't. Sometimes she's worked my shift but usually I report off to her for the next shift. One night I handed her some forms for a patient and jokingly asked if she knew what to do with them (because I had never seen them before, I had already talked to coworkers about them but didn't get a great explanation so I would've taken any advice on how to document/fill them out). She didn't take it jokingly and thought I was insulting her intelligence by asking her. She started asking how long I'd been a nurse and said she's been a nurse for so long, etc, getting louder and louder. I apologized and said that I was sorry if it came across that way, but that's not how I meant it. She then yelled some more and said I've made her mad in the past and I better watch what I say to her because this is the last straw. So I left at that point it came across really aggressive and threatening and I talked to my administrator and said that I thought if she was spoken to it would just make her angrier, but asked if it was possible to not schedule me around her because I was uncomfortable working with her. I also don't know what I've done in the past to make her mad, because things were seemingly fine and I was scared anything I say would set her off again. He said they'd try not to schedule us together but then basically it couldn't happen that way because she works my unit most frequently. The next day I saw her at the time clock first and thought maybe things had cooled down so I smiled and said hello like usual. She glared, rolled her eyes, and walked away. I figured okay, so we're just not going to do the pleasantries thing...that's fine. I can deal with that as long as she's not as hostile as the other night. But then I had to count off with her later that night and things got rough again. I had gotten really busy and sent a resident to the hospital at 9:30pm. I basically just finished the paperwork at 10:45 and my shift was over at 11 so I didn't even have time for a dinner break. My coworker knew of the altercation from before so she let me give report first but said to have everything ready so I could go right away and wouldn't be alone with this other nurse. So at 10:45 I was pulling out the next shift report paper and still trying to make sure I didn't miss any paperwork for the hospital and checking that my faxes went through. I knew I was forgetting something, but I was so worried about how I would word everything in report so it wouldn't come across wrong and cause an argument so I just went through the assignment list and practiced it in my head. What I forgot was to take the med cart trash out (a second time actually, because I had taken it out but it got full again during the hospital transfer) and wipe down the cart-normally something I do every night and when it starts getting late my coworker and I usually help each other out with that so it almost always gets done but it didn't tonight (this happens to me frequently from the previous shift and I don't flip a lid about it, because I know that it can get busy). So I gave a very brief report, basically saying everyone was "fine" and only mentioned fingersticks, PRN's, and the hospitalized resident. We counted off and she immediately saw the trash and went off on me. She pulled it out and threw the bag on the floor saying that I always leave a mess for her and she has to deal with my trash every night-which is completely untrue so I said I'd take care of it before I leave but that I rarely ever leave my cart a mess. She kept going and getting louder like she does and sp I responded again saying "I almost never leave my trash for you, and I already emptied it tonight but it got full again I'M SO FREAKING SORRY!" I'm not proud of raising my voice back but I've had it. While I was still there she started telling the other nurse and CNA's the same thing (I never take out my trash, I always leave a mess for her, etc) and she didn't sign the narc book before I left either. I'm worried that if she'll lie about that she'd lie about serious/important things. I know this is just a stupid argument but after the first night I'm already uncomfortable even seeing her in the parking lot, much less working with her or handling narcs with her. She's scrutinizing everything now and after telling me I've made her mad before I wonder if she always has. I don't know how to work with her and I feel threatened by her. I think she has anger problems and I don't know the extent of them but I don't know what she meant when she said I better watch what I say to her and it's the last straw. Now that I raised my voice back I especially am concerned.
  2. LeahSunshine

    Whose responsibility is the incident report in this case

    Yes and I left that facility. I'm still in LTC and it still gets crazy sometimes but not nearly as bad/unorganized as this place.
  3. LeahSunshine

    Whose responsibility is the incident report in this case

    We are supposed to have a secretary but she's leaving so we've all been expected to answer phones. Since I was signed off on the cart, I haven't been paired with anyone but I am technically still orienting to the facility and will be for another several weeks. Today I'm supposed to be orienting on the desk but my preceptor is equally as busy and hasn't had much time to explain anything. It's so frustrating! I really don't have anyone that is precepting me.
  4. LeahSunshine

    Whose responsibility is the incident report in this case

    That's a good idea, if I can at least get that done during the day then I can go down the list of all the other tasks as soon as I hand off the med cart and I won't be stuck at the computer right in the middle of the nurses station. Thank you for the encouragement, I really needed that.
  5. LeahSunshine

    Whose responsibility is the incident report in this case

    That's the problem! Until I hand off the cart I can't even begin my charting at all! There's way too much to do. Meds are the primary focus and those never even get done on time, then there are orders and miscellaneous requests throughout the day. I just have to write it all down in a to do list and work on that when I hand off the med cart. Then you have treatments to do, which never get finished. I'm honest about it and I don't sign off if I didn't do it but some nurses just sign to be able to get done. I'm going and going right up to 3:00 or later when I catch up on the tasks I couldn't complete earlier then I try to focus on banging out the chart notes. I'm really discouraged. I don't know if it's just this place or if every place is like this but it's overwhelming and there's not enough time in the day for everything that has to be done.
  6. LeahSunshine

    Whose responsibility is the incident report in this case

    Yes I am. It's the rehab floor in a Ltc facility. I don't think I can handle it. I might be leaving but I'm afraid most facilities will be the same.
  7. Hello, As a new nurse, I am a little slow at getting things done. I also work on a really busy floor with constant interruptions, so my med passes are always late. I have 18 patients right now and sometimes up to 22. I am really sick of getting held 3 hours trying to catch up on filling in certain documentation in the MAR, writing my discharge and Medicare notes in the computer at the end of the day, etc. I'm 7-3 shift. Usually by the time I get to my notes I've had it. I'm tired and worn out and frustrated and some days I want to completely give up way before the end of the day. If I still get questions from family or residents, I would try to help. I'd also answer phones since I would document on the computer near the phones, but the longer you stay the more things that come up and it really keeps you much longer than your shift. So I stopped answering phones once I pass off the cart and if anyone asks for anything while I'm documenting, I started referring them to the nurse that took over or an aide on second shift if they can help. It's the only way I get out at a reasonable time (1-2 hours finishing up my daytime tasks, instead of 3 hours extra). Keep in mind, I'm still on orientation and shouldn't even be getting overtime right now. Anyway, today, around 4pm-after giving report and handing off the med cart-a CNA wheeled a resident out who had blood on his arm. I was finishing up my charting for the day and the nurse said that it was a previous shift incident, but that was the first moment it was brought to anyone's attention so I said, "We're on the second shift now and I'm off the cart so I'm no longer in charge of this patient, you'll have to do the report." She argued with me and ultimately gave in because I said that if I had time during the day to do my notes and they had been done already, I would have been punched out and left the building already right after handing over the cart and reporting off. Was I in the wrong here? I think it was an old skin tear anyway, but why wouldn't it be her duty to assess and write the report if it was first mentioned on the 3-11 shift?
  8. LeahSunshine

    Holding BP Meds and contacting MD

    Hello, I'm a new grad at my first nursing job. I'm technically still on orientation but am allowed to pass meds. I have a patient that goes to dialysis and tends to have low BP. I got in morning report that the on-call was contacted for low BP and and order obtained to hold all BP meds for the night and overnight shift and re-evaluate in the morning. He has an order for Metoprolol in the morning, hold if BP is lower than 100/60, and then in the afternoon he gets Midodrine and Cardizem. In the morning his BP was 108/78 so I gave his Metoprolol, but when I checked his BP in the afternoon and it was 80/40. I couldn't remember what Midodrine was, but the previous shift held that so I checked with a more experienced nurse to ask if it's for BP and she said yes, but I didn't know that it increases BP and she didn't mention that either. So I held both afternoon meds, but then I got home and looked it up and I think I should've given the Midodrine for that. I also consulted with another nurse and the unit manager to let them know what the patient's BP was and what meds were held and asked if I should call the on call PA and they said that he has a history of low BP and it's normal because of his dialysis so that was fine and there was no need to contact the on call. When I handed off report, the next nurse said I should have callled the on-call to report that his BP was low again and that I held the meds. The communication here is terrible and I get different ways of doing things from everyone I ask and all the different people I've oriented with. It also doesn't help that everyone walks on eggshells when the PA is here and they only want to call him if it's a dire situation because he's really snappy and rude. But anyway should I have given the midodrine and should I have talked to the PA, either about the previous night's order or the afternoon meds being held? I just need some guidance on this (and probably many other things, because I don't get that guidance where I work). Thank you!