The Human Tornado

[KateRN1]

Here's a story for you all. I'm sitting in the conference room, finishing up an admit pack and writing a care note on the two patients that I saw today. (I'm PRN.) This is a fairly new agency, with new paperwork, but we've all been inserviced on it and, frankly, I don't think it's all that much for an OASIS start of care. As I'm gathering, making copies, etc., in comes another nurse I'll call Tornado. First thing she growls is, "Is she here?" meaning the DoN. I say, "Ummmm . . . no." Now I've only met Tornado once in an inservice/staff meeting on how to fill out this paperwork, but can't say I was impressed with her attitude at that time.

Once she discovers that the DoN is not in the house, she begins a tirade about "nasty grams" regarding her paperwork not being completed properly, needing to fill out the rest of the information, complaining loudly that it's just too much bullsh!t, it's all the DoN's fault, it doesn't have to be this difficult, on and on and on, ad nauseum. The problem stemmed from this nurse admitting two patients, a couple who live together, and she had indicated the same visit time for both (say 1200-1400). When I pointed out that technically the time had to be split between them, she went ballistic on *me* for having the audacity to speak against her. There was another problem where she didn't "code" medications on the intake form, indicating whether they were new, changed, long-standing, etc. As I'm looking at the med sheet she filled out, I also make the mistake of telling her that they can't be in "nurse speak" but must be in plain English since they are left in the home for the patient's referral. You'd have though that I'd called her mama a floozy.

I quickly gathered my things, finished up what I needed to do, and promptly left. But not before I'd mentioned something to the receptionist about how I'd never take the case manager position that had been casually offered to me for not wanting to deal with people like that. Like an idiot, I later said that I would do it part time. Where's that fish-smacking smilie when you need it?

[caliotter3]

I started on a case that had several nurses that had been with the client through several agencies for years. I commented to one of the nurses about her charting. Don't remember what it was, but it was a serious discrepancy, and I was warning her so that she wouldn't get called on the carpet for it. Oh, did she tell me off! So, I told her "Ok, do or don't do what you want. I was just trying to help you." Within a month, I walked into the office one day and was taken aback by the fact that it was so quiet you could hear a pin drop. There was this nurse, with a stack of charting, sitting at a table as busy as could be. She spoke to me and said she had been there for two hours already redoing page after page of charting. I was polite, but couldn't feel sorry for her. I had attempted to help her and she insisted on doing it her way. I was out of the office in a heartbeat. Everyone there was shooting this nurse the nastiest of looks and I didn't want them taking it out on me. I could see them blaming me for her incorrect charting. The moral to this story: don't assume that someone is pulling one over on you when they mention something. Some nurses subscribe to that unwritten code of helping their coworkers. We help each other when we can. But no one will help somebody who climbs down their throat for no reason at all.

[KateRN1]

What seems patently apparent to me, but apparently not to most of the other nurses there, is that it is our charting that makes money for the company. If we don't document appropriately, the company is denied reimbursement. If it happens consistently enough, either the nurse gets fired or the company goes bust. It doesn't take a rocket scientist to figure out that it really is in *our* best interests to do things appropriately from the start. Eh. What do I know?