rant on dietary

[qcnursingstudent]

I have been working at my LTC facility for about 2 months now. I have a resident who is on a pureed, honey thick liquids diet. The other day dietary brought his supper tray up. It was missing a soup and the pureed items on the plate did not match the meal slip. I called down to the kitchen and told them the issues and if they can bring up the items the resident wanted. The worker said OK and then a few minutes later I receive a call from the dietary director who said she didn't have any of the items. I told her that the plate she gave me didn't match the slip and I had no idea what was on the plate. She told me what they were and I told her that I wish she fixed the slip and told me exactly what was on the plate. She rudely told me that she didn't have the resident's items because she didn't want to puree something that one person wanted. And that she was shorthanded and was just trying to get the trays out for supper. I was annoyed and just said OK. I told the resident's wife this and the wife really wanted to speak with her so I called the kitchen to allow her to speak with her. They got into an argument. My coworker called the supervisor and she came up to speak with the wife. The dietary director ended up making the resident's original items and when she delivered it she was steaming!! And came up to me and said, "you shouldn't repeat what you heard!" And left.

I will admit, I could have handled this situation a lot better. I should have never allowed the wife to speak to the dietary director. I should have called my supervisor before and allowed her to handle it but I am a new nurse and I'm not good with confrontation and I just did not like how the dietary director was speaking to me.

My supervisor gave me a call and asked for my side of the story because the dietary director was telling her another. I had to write an employee statement. Basically it's a he said, she said situation. I just hope I won't get in trouble or written up for giving the phone to the wife....

Today I checked the resident's tray again and it was completely wrong! They gave him a regular meal instead of pureed. We called the supervisor immediately and I had her handle it due to the events of the night before.

I don't want to get the dietary director fired. I just want her to learn and supervise her workers better and make sure that each resident's tray is correct. Also residents deserve to get the meal that they chose not a meal that is convenient for the kitchen staff to put out.

[DierkyBrewster]

I understand the frustration, I also work in LTC. I have found that a pleasant attitude and a smile can go a LONG way when dealing with (sometimes difficult) staff members. Think back to when this situation totally began and think: Did I approach this worker with a pleasant smile and state my concerns in a pleasant way? Instead of a "Hey, you did this wrong can you fix it?" type Of way." I can almost guarantee that your attitude will rub off on others!

Imagine I come up to you friendly faced and energetic, "Hi! I noticed "Res"'s tray isn't what he ordered and he is wanting "insert what Res originally wanted here". Whenever you get a minute could you fix his tray?" (Notice this is sort of telling them to do it without actually TELLING them to fix it)

At this point if she says what you said she stated before (about not wanting to fix a special plate just for him), this is the point to get firm. And yes, she may be upset with you, but you have to advocate for your residents. I would say "This is the residents requests, and it's his right to eat what he wants. If you have an issue with this, I will gladly get my supervisor for you to talk with."

Most likely she would be huffy, but would fix the R's plate right then. (If she valued her job) and hopefully that would be he end of it. Remember to use the chain of command!

[qcnursingstudent]

Yes, I should have gotten the supervisor involved before the wife, I admit that. And now if a situation like this came up again, I would know how to better approach this. When I called initially, I was not rude to the worker. My exact words were, "hey sorry to bother you but, I received so and so's tray and the items isn't what he wanted. Do you mind sending up the pureed egg salad, baked beans and Cole slaw for him?" And she said OK. Things got messy when the dietary director called back and she already had an attitude and told me she didn't have the items and that she wasn't going to make it for one person and she was short staffed and trying to get trays out.

Next time, I would have just said OK and contacted my supervisor right away and have her deal with it. I was wrong in handing the phone to the wife. I take responsibility in that. But I was only trying to advocate for my resident. However, I took a wrong approach. The next day when I called down to the kitchen she was a lot more pleasant. She simply said, " my voice is blow today because I am trying to help you guys."

I think this situation shows my inexperience as a nurse. I've only been a nurse for 2 months and I'm still learning how to deal with other staff members and family members of residents. I'm always very pleasant to my staff members but when they give me an attitude, I don't know what to say back to them. Last night when the tray was wrong again, my other nurse called down to the kitchen and I listened to how well she spoke to her. She is a nurse with 8 years of experience who is very professional so I really respected how she handled he situation and pulled me aside to say what I did wrong in the situation.