Seeking advice...HELP

[scott1305]

Hi All, I recently started a new position at an Independent Living Center and I work the NOC shift (2200-0630). Since I have been here I have noticed so many things wrong with this place. The health and wellness director never returns call, she has 2 jobs so she consistently leaves work early. There are a group of caregivers that are usually on their phones or refuse to help a resident if they are close to getting off work even though they still have 20-30 mins left in their schedule. They tend to leave things for the NOC shift to finish, even though there are only 2 of us at night. One LVN (myself) and one caregiver. I am responsible for the 2300 medications as well as any PRN medications. We have multiple residents who should be in a different type of residence altogether. The facility is quite large. We have approximately 100+ residents. All are under my care and that makes me nervous. I have experience with large facilities, I come from a Clinical Research facility that housed 200+ volunteers, but I had staff. My experience from that facility was as a Nursing Supervisor so when I started at this facility I knew that I could handle it, however what I was told at my interview and what is happening is completely different. I was oriented in the facility for 3 weeks, each week working a different shift. During the NOC shift not only do you have med pass you are also responsible for cleaning incontinent residents periodically throughout the night, resident laundry, call bells, wandering residents, medication orders, Q2 checks (including repositioning), assisting residents to the bathroom, incident forms, and anything else that the previous shift couldn't finish. During my training most the staff was quite nice, but constantly complained about the Health and Wellness Director. I took it in stride and just figured people complained because people complain. Well, now I know why they complain. She doesn't do her job. Most of the time her work is divided between the nurses and the Patient Coordinator even though we have work to do as well. Complaints have been made up the chain of command, but nothing has been done. I had a training with our Facility Director and during that time I realized most of what was supposed to be done wasn't being done. I mentioned a few things that were happening on the floor and he seemed surprised by most of it. Which tells me things aren't being directed towards the right people. Since I have started I have been told by multiple staff (including some management members) that I should take over as the health and wellness director. My question is this, should I voice my concerns to the current HWD or directly to the Facility Director?

[TheCommuter, BSN, RN]

My question is this, should I voice my concerns to the current HWD or directly to the Facility Director?

I am an advocate of not skipping the chain of command because it tends to upset people when you go over their heads to to report issues to their superordinate.

So, my suggestion is to first report your concerns to the current HWD. Give this person time to address your concerns. If nothing improves in a month or so, you will have a leg on which to stand when you report above the HWD's head.

However, expect to end up with a bulls-eye on your back. In general, people dislike those who report their concerns.