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Discussion

Too slow, not using "common sense", am i being unsafe or am i missing something big?

I've been at my LTC facility since late May. I've been off of orientation for 3 weeks now. I have had a really complicated resident for the past few days, trach, j-tube, etoh w/d... I've been doing alright, but the nurse I reported off to today gave me crap, as he always does when I report off to him. I tried very hard to have all of my ducks in a row for him, but still struggled. One of my tube feeds was supposed to start at 2p and I hung the bottle, but the feed wouldn't run. It kept saying the tubing was clogged, despite a visual check and several flushes. I turned it off and noted to come back to it. When I reported off to him, I had hIm com in with me to check it out. He yelled at me for not getting another nurse to help me start it and ended up just chucking the whole set, starting over. I also stopped a feed and forgot to unhook it from the resident and flush. This was maybe 5 minutes and I made sure it was done before I left. He told me that I needed to get myself together or I would get fired over this behavior. That I wasn't using common sense. I'll admit I felt a bit rushed, but I stayed until 4:30, making sure I didn't leave him any loose ends.

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    I'm a tough boss but even I wouldn't fire you for that. Can you ask for a little more orientation? Is there someone you can talk to about the other nurse's crummy attitude?

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    I'm a tough boss but even I wouldn't fire you for that. Can you ask for a little more orientation? Is there someone you can talk to about the other nurse's crummy attitude?

    I could try to ask for more orientation, but my former preceptor and I are now on different schedules and I'm "in the numbers", so I'm sure they'd have to pull someone to cover for me. The other thing is, that I don't know what I still don't know, like little details that it was assumed I knew already, like the thing with the feeding tubes. I have a great educator on staff and a unit manager who mans the desk and helps with resident care...I think I just need to work on a.) asking for help and b.) knowing when I need help or don't 100% know something.

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    Don't hesitate to ask the UM for assistance during your shift, that's how you'll learn. Tube feedings can be problematic-you can spend so much time trying to clear a tube that won't run to discover something stupid like the tubing has popped half way out of the pump housing. It happens. FYI-never just turn the pump off without disconnecting and flushing right away. You don't want to run the risk of it becoming clogged later on. Something else you might do is always go to that resident first after report and give a quick flush and check everything out.

    Don't let this person intimidate you and insult you because that is what he is doing. You have to stand up for yourself in a professional manner now. If you can try to do it within earshot of the UM or another staff member.

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