Rehab Woes

[txnurse2014]

I work at a rehab facility that also has LTC pts.I work three suppose to be 12 hr shifts weekly that half the time run 14 hours long.Two of my three shifts I work LTC hall with 22 pts. and a med.aide and am able to handle the hall fine.But on my other shift I work the Rehab hall with 12 very demanding and time consuming pts. and no med aide.Yesterday I had two admission within 30 min. of each other and ended up staying till almost 10:00pm and had been there since 6am.Patients arent put in the computer till they arrive and it took an hour for it to be done.I am told just to do what you can and leave the admission for the next nurse yet also told to send med list to pharmacy and input meds,admit assessments into the computer which doesnt leave much work to leave.When I asked for help with the two admissions I was told it doesn't take long to do admissions.I am so frustrated with my facility.Only have been a nurse six months all six at this job.Management isnt helpful and DON isnt either and already gave notice and is on her way out.I was not trained in how to do admissions and theres no info written on what needs to be done which I feel is part of my problem.Should I look for another job or try to work out some of my concerns.Any ideas on how to make my admissions go smoother?

[anewsns]

I don't know the profess at your facility but at mine the admissions do take a long time ! The nurse manager usually does the order entering and faxing to pharmacy etc and usually they try to spread admissions out amongst nurses , so by 3 to 11 I only have one admission and I just have to do the assessments. Even then there's a lot of paperwork that can be done within 24 hours .. Usually if I'm straight out I just do consents and the admission assessment and note . Braden , falls,TB, careplan etc can be left but I try not to leave anything most days. I've heard of rehabs who are in a similar situation though.. Sounds awful ! But i would stick it out a bit longer , see if you can get a routine down , make a game of it .. Try to eat even if it's only a 20 min break! Eating and using the bathroom makes you more efficient even if they feel like time wasters in the moment. Just stay calm . I can affirm that sounds nuts though and sounds like youre going as fast as you can .. Some nurses skimp on assessments or cut a lot of corners. I don't recommend that personally, over time you'll just do better assessments faster

edit: also , it took me a long time to learn this but sometimes no matter how much of a big deal the CNAs or patients are making about something , eye drops, guaiacs, missing walker , whatever, take care of the most important things and you'll get to it when you get to it . Make sure you're really on top of your high acuity patients and admissions first. In the same breath , patient care usually comes before paperwork. (With the exception of some things like getting new admit meds ordered >answering a call from a daughter wanting to know why her mom changed from miralax to colace, you can call her back) Paperwork just looms in the background and causes dread until it's done , and once your report and keys are handed over, you can go hide and snack and finish it. I find with these boundaries I'm a lot happier and my care is a lot better . Sorry if I over formed but hope it helped in some way

[txnurse2014]

yes it did.Nothing at my facility runs well!I have two gtubes that have run out of feedings and then run out of the replacement feedings so i had to get yet another order.supplies run out often.No help is given on admission or nursing period and no adon at my facility.the facility is only a year old and is beautiful but is not run well.my coworker had three admission one night and asked for help but no one helped so she left crying in her car.all the seasoned nurses are leaving cause they are tired of waiting for the issues to get worked out because its a new facility.there is no where except at the nurses station for me to chart so yes thats part of the problem with constant interuptions which i dont answer call lights after my shifts is over and new nurse has taken over.Is the pace at all facilities so fast paced?thanks for letting me vent!

[thevez]

It's a new facility, but I feel like you're in hell. Get out of that place. I work in rehab as well and we do our admissions and patient care like the first response has said. Your place is not a good place. Tell your nurse managers your concerns.