That's MY JOB!

Posted
by %D#2 (Member)

An AL pt of mine has had stroke after stroke after stroke after stroke. Was sent back with an order for hep drip.. Which we don't do in my facility.. Had another stroke so I convinced family member to transfer her to a more skilled facility. I now am looked down on by administrators because the patient is now in a better place equipped to handle her condition and the daughter said she is so much better. But administrators only care that they lost about 4k a month from this wonan.. So I'm the bad guy. Makes sense right. May I remind them that I went to school for nursing and not for business? I did the right thing for my pt who was under MY CARE. I did MY JOB. Not letting this get me down. Had to vent.

xoemmylouox, ASN, RN

Has 13 years experience. 3,150 Posts

So often in nursing, being a patient advocate puts you at odds with your employer. Their interest is not the same as yours.

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 25 years experience. 20,878 Posts

Being a great nurse and a great employee can be diametrically opposed.

CrunchRN, ADN, RN

Specializes in Clinical Research, Outpt Women's Health. Has 25 years experience. 4,373 Posts

Awesome job. You rock.

%D#2

298 Posts

Being a great nurse and a great employee can be diametrically opposed.

I'd rather be a great nurse lol. I'm a great employee in many other ways.. I just don't see my patients as a money bag and that's something that will never change, even if that makes them hate me

dream'n, BSN, RN

Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych. Has 29 years experience. 1,149 Posts

I agree, you can always get a new employer. But you have only one conscience and license. I like being able to look at myself in the mirror and being able to sleep at night.

NickiLaughs, ADN, BSN, RN

Specializes in Emergency, Trauma, Critical Care. Has 13 years experience. 2,380 Posts

I worked at an ALF that routinely would have me evaluate pts and when I turned them down because they weren't appropriate for our facility, I got hell from admin. I met with the recruiter several times to explain our scope and limitations but with no nursing background, she kept getting these heavy duty full care pts who really needed a SNF.

I bended on one pt for her because of how low census was and I was constantly getting harassed. In reality he should have been on hospice in a higher level facility. The aides too great care of him beyond what they should have had to....I quit shortly after that because they obviously needed a stronger personality to stand up to them and I was too young for it at that time.

the reality is they will keep pulling that crap, you will always be at odds with them because they're looking to keep money rolling in.. Sadly that's their job, and you are on the other end to protect the patients and your license. Good for you for being strong. :)

nynursey_

Specializes in Med/Surg/ICU/Stepdown. Has 3 years experience. 642 Posts

In my brief (relatively brief--2 years) time as a Med/Surg nurse, I have come to realize that being a good patient advocate doesn't make you any friends. You'll be at odds with everyone from case management to family to physicians. Ultimately, those people are not owed anything by you, but the patient is.

I tell new nurses that if they can't find the cojones to do what's right and maintain a stiff upper lip when they make enemies, nursing may not be for them.

ktwlpn, LPN, RN

Specializes in Med Surg, Homecare, Hospice. 3,844 Posts

AL is all about the money.We have admitted a number of residents in horrific conditions from several local AL chains.Once they run out of money they are bounced....awful

%D#2

298 Posts

I worked at an ALF that routinely would have me evaluate pts and when I turned them down because they weren't appropriate for our facility, I got hell from admin. I met with the recruiter several times to explain our scope and limitations but with no nursing background, she kept getting these heavy duty full care pts who really needed a SNF.

I bended on one pt for her because of how low census was and I was constantly getting harassed. In reality he should have been on hospice in a higher level facility. The aides too great care of him beyond what they should have had to....I quit shortly after that because they obviously needed a stronger personality to stand up to them and I was too young for it at that time.

the reality is they will keep pulling that crap, you will always be at odds with them because they're looking to keep money rolling in.. Sadly that's their job, and you are on the other end to protect the patients and your license. Good for you for being strong. :)

Thank you! We have a ten bed sub acute unit and those patients seem appropriate most of the time but in AL there are so many people who should be in subacute.. If they wanna keep taking these patients they should expand our subacute. But as an LPN I do not give hep drips. I give lov injections, warfarin, I can give hep subQ but a drip needs RN there. And even if I were an RN, a drip for a pt needs closer monitoring than I can provide

%D#2

298 Posts

In my brief (relatively brief--2 years) time as a Med/Surg nurse, I have come to realize that being a good patient advocate doesn't make you any friends. You'll be at odds with everyone from case management to family to physicians. Ultimately, those people are not owed anything by you, but the patient is.

I tell new nurses that if they can't find the cojones to do what's right and maintain a stiff upper lip when they make enemies, nursing may not be for them.

I'm too nice sometimes but this place has given me tougher skin. When I was new I was being told to do things I knew were wrong, like admitted freshly post op patients back to our facility but it's taken a lot of guts to finally say NO that is NOT okay for this pt. Plus these patients are like my family. I have to look out for them because sometimes no one else will

%D#2

298 Posts

AL is all about the money.We have admitted a number of residents in horrific conditions from several local AL chains.Once they run out of money they are bounced....awful

And you know something I found out? AL does take medicaid.. But they don't want to! They turn patients away for ones who will pay more money.