Stuck up RN?

Here.I.Stand, BSN, RN · Dec 2, 2016

I don't know your mom, nor each situation. Those are some pretty significant time management troubles, though. Employers probably don't want to pay for several hours of post-shift charting, but they can't have her working off the clock either.

JustBeachyNurse, LPN · Dec 2, 2016

Mom needs to figure out why she is staying 2-4 hrs post shift. Paid-budget issues. Upaid--liability & labor board issues. Common theme--not "stuck up" or "close knit" but documentation. Is she inefficient? Not using appropriate abbreviations? Double documenting? Overcharting?

If after all this time she continues to require 2-4 hours over time past shift to complete documentation there is a big problem. She needs to consult the nursing educator or documentation specialist or management to observe and audit how she's document to find the issue. Employers don't take kindly to 2-4 hours of overtime to complete what should be completed on shift.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Dec 2, 2016

I don't know how to tap dance around the questions I'm about to ask, so I'll be direct with no offense intended. Is your mom overweight? Does she have joint problems? Is she asthmatic or have any kind of heart problems? Is she easily stressed? Is age a factor? Weight in itself may not be an issue unless it's excessive. But combined with one or more physical and/or emotional issues, it can be a problem. I'm no spring chick myself, and just purchased a treadmill 30 minutes ago. But I have no other physical issues to go with my few extra.....ounces.

The one nurse I recall who never left work at a reasonable time had very bad joint pain which caused her to move very slowly. Plus, she was getting on up there in years...not adapting well to a constantly-changing environment. Any kind of issue that would contribute to decreased cardiac output can lead to decreased production. Slow motion is a deal breaker in acute care. Multi-tasking on the fly is a must.

One last thing that I presented to an OP on another thread is that perhaps she's still performing on an LPN/LVN level even though she's an RN. Lots of LPNs-LVNs believe the job duties are the same. But there are added duties that were once left to the RN. Now, with her being the RN, it all falls on her.

These are my thoughts (I could be way off the marker, though).

caliotter3 · Dec 2, 2016

Along with the very informative previous information: Maybe at this point, these facility jobs, with so much multi-tasking, are too much for your mom. If she can not, with the help of others, pinpoint and work on her time management skills, she could consider going to extended care home health. She would be working with, and charting for, only one patient in the home. Minimal contact with other caregivers or supervisors. Unfortunately, since most of these cases are at the LPN level, many agencies pay an RN working these cases at the LPN level. This kind of work is still better than not working as a nurse at all. On an overall basis, the decrease in stress and charting responsibilities, could make the difference for your mom.

Pepper The Cat, BSN, RN · Dec 2, 2016

Staying 2 to 4 hours is problematic to complete documentation is problematic. Yes, I would be annoyed if the person on the shift before me does not have everything completed when I start. It means info I need to do my care is not available. I may not know what she did do and didn't do causing gaps in care.

I don't care how pleasant someone is, if every time I follow them I have extra work to do, yeah I am going to be annoyed.

Dafabb, LPN · Dec 2, 2016

It sound like a big time management problem yes but it also sounds like she lost her motivation...Did she have this problem before she became an RN and worked in NICU. Was she on time then and finished at shift change. I am going to say something and I hope your feelings will not be hurt. This is no disparage to your MOM. If she coming from Med/Surg to NICU that is probably the biggest jump you can make in a hospital. It is the one thing I would have never done without extensive training. I am and LVN in Texas and keep in mind we did everything any RN up until the 11/12 where they were changing to all RN. There is no where in a hospital I have not worked and done a good job in all except NICU. I even did that but it was called the white room where the babies were fine getting ready to go home. It was not difficult at all. I think out of anywhere in any hospital NICU is the MOST specialty. They have to know and read minds of what is happening and they have to have that special knowledge and sixth sense.. I applaud all of these nurses and Doctors. All of our other patients can tell us what is wrong in some way. I can see where you had trouble there.... Letting this experience set the rest of your career should not have been a life changing experience but a learning one. It sounds like it was the opposite.....Your time management is also learned. It took me about 7 yrs to perfect it.....I love home health. There are no time rules. You are one on one with clients. You can have as many as you want and are available. And you learn to love everyone of them if you have them long enough. You visit and go to the next and so on then go home at your pace. You could do that as an RN. admission assess. etc. This is my 1st love and I wish I was where there were a barage of clients or maybe will do that after I retire:)

Mr. Nightingale · Dec 20, 2016

Thanks for your response. Her first job as an RN was in the NICU. She was an LVN doing M/S for about 5-6 years.

Her first job as an RN in NICU as she recalls was very traumatic in which she was basically forced to quit. ( manager asking her math questions, ration and proportion, telling her not to touch anything unless being told) fyi: she was not written up, or did any mistake that put her patients on the line.

I see my mom as super detail oriented, its as if every patients in the ICU. Charting in detail. Whats just so bizarre is in these past 2 years of me setting her up with new RN jobs. The same outcome is happening where shes not effective.

I keep telling her to introspect since she worked as an LVN for many years keeping the same job. What baffles me is after that first Job in NICU it vasically destroyed her.

i tell her to focus on the routine and jus make sure her patients are ok.

Mr. Nightingale · Dec 20, 2016

After her traumatic First RN job in NICU she actually pursued what you suggested. Worked with 1 pediatric patient with c/p etc. I motivated her to try something different because she wanted also to prove that she can be an RN. Sadly that hasnt been effective. Btw mom is healthy, no communication barrier and is beautiful. Lol. At home she is definition of a nurse at how she does things. Shes not on any psych meds lol.

I think her work experience is a little complicated.

1980-2000 = LVN in m/s ( no problem, no delays in work etc)

2001-6mos = traumatized first rn NICU

2001= still did Little rn work in LTC, registry

2001-2005= left nursing took masters as an excuse

2005-2011= worked 1:1 in home care

2011= RN refresher

2012= home health doing ok

2013- present==== not lasting in facility, job hopping cuz of performance. Resigning before getting fired

meanmaryjean, DNP, RN · Dec 20, 2016

1:1 home care seemed to be a good fit. She can do all the 'fluff-and-buff' type details her heart desires and will, in doing so, likely endear herself to her patient and their family.

llg, PhD, RN · Dec 20, 2016

I think it is a mistake to blame the NICU job for everything that happened afterwards. The NICU job was not the cause of her problems -- it was simply the 1st RN she had, and it didn't work out -- just like the rest of her RN jobs have not worked out.

You say she "challenged the RN boards." I assume that means she did not graduate from an RN program. That might be part of the problem. Just because you can pass a test doesn't mean you can function well in the RN role. Your mom never had the education to be an RN -- she never experienced the supervised practice that RN students get. It sounds to me as if she is being overwhelmed by the RN role because she is not prepared for it.

Mr. Nightingale · Dec 20, 2016

She finished in the Philippines and has her BSN. I honestly think LVN or RN, work is work and it ends up being a routine. We nurses deal with life and its a no joke job. My take on this is that 30-50% of new RNs quit nursing before the first year- she was part of this statistics and did a comeback which is not going so well. Its weird cuz I think she has some type of nursing PTSD- her struggles in her job that pull her are going too far and beyond- like extensive charting, not doing "shortcuts", formal assessments which makes her look like weak one where in fact cannot be 100% true. Its weird. I guess I'll rest my case. Probably hope she can get a clinic job and do fairly well.