Want to hear your pet peeves in LTC nursing

gentlegiver, ASN, LPN, RN · Jul 6, 2010

I work 11pm to 7am - My Pet Peeves:

1.) Having to do ALL the editing for change over on this unit even tho I'm only there 2 nights a week. Others on 11 to 7 should do it, help from the other shifts (IF they have a rare spare minute)is appreciated!

2.) getting a shift report from a nurse that basically has nothing on it (she left early and said everyone fine, they weren't!)

3.) being told everyone's perfect, finding a Pt in resp. distress 2 minutes after taking the floor.

4.)Walking in on a PT who is dieing and no one bothered to contact the on-call to get orders for Roxanol, O2, RN pronouncement etc...

5.)My CNA's getting blamed for complaints from patients who say "night shift" (even tho they say the names of CNA's on 3-11 shift).

6.) 3-11 shift using the last of the briefs, towels, facecloths, and not asking the shift supervisor to get more for 11-7 (supervisor leaves at exactly 11pm & supplies are locked up)

7.)When the CNA's complain to me that other Nurses refuse to answer callbells, have walked the entire length of the unit to tell a busy CNA in room 101 that the patient in room 125 needs a bedpan. (less time to put the Pt on the bed pan than to walk down)

I have more but it just depresses me to think of them right now.

Forever Sunshine, ASN, RN · Jul 6, 2010

I work 11pm to 7am - My Pet Peeves:
7.)When the CNA's complain to me that other Nurses refuse to answer callbells, have walked the entire length of the unit to tell a busy CNA in room 101 that the patient in room 125 needs a bedpan. (less time to put the Pt on the bed pan than to walk down)
I have more but it just depresses me to think of them right now.

I will not answer callbells during a medpass. I can do the CNAs job.. but they can't do mine.

prinsessa · Jul 8, 2010

I would love to help a resident on a bedpan but generally I don't have time. Most of the time I don't take a break or lunch and the CNAs never miss theirs. I don't mind out helping with lifting a patient up or moving a patient but I have way more patients than the CNAs do. I think most of them do a wonderful job but there is no way I have time to do more than I am already doing.

itsmejuli · Jul 11, 2010

There's no key in the entire building for the supply room that got accidentally locked. If the room never gets locked, why is there a lock on it and nobody has the key?

esperanzita · Jul 16, 2010

In addition to everything already mentioned, here are some things I face at my facility:

*Typed signs posted everywhere that issue ultimatums, followed by: "Thank you for your cooperation."

*Nurse managers who diagnose patients.

*Family that insists on having unnecessary procedures done to their family member, e.g. removal of a benign, barely noticeable lump. Where are these people when I am administering painful follow-up care to their loved one, as the loved one (aka my patient) screams "NO!", punches at me, and breaks down crying?

:banghead:

jrw03282009 · Jul 16, 2010

So if I start in LTC like I am planning on, here are the things I need to make sure I get right:

1. Always, always, always stock the med cart

2. Dont talk about the other nurses

3. Keep after the CNA's

4. Stock the med cart

5. Smile at the family all the while thinking how stupid they are. (WebMD doesnt hand out med degrees anymore right?)

6. Make sure I chart in the 100 pages required for each pt/shift

7. Keep paper in the fax machine

8. Stock the med cart

9. Look for three diapers, when I find them, start yelling for the CNA I didnt keep after

10. Ignore the (@&$ that interupt during med pass

11. Tell them to empty the dang trash, I dont need to know how full it was

12. Stock the med cart

13 Last but not least, keep a pair of green socks and a purple straw in my pocket

Oh, and stock the med cart

(BTW, I sat here for two hours reading this thread laughing the whole time, I couldnt stop. I learned LOTS from it!!! School could never teach this much stuff! :yeah: :lol2: :lol2: :lol2: :yeah: )

Forever Sunshine, ASN, RN · Jul 16, 2010

So if I start in LTC like I am planning on, here are the things I need to make sure I get right:
1. Always, always, always stock the med cart
2. Dont talk about the other nurses
3. Keep after the CNA's
4. Stock the med cart
5. Smile at the family all the while thinking how stupid they are. (WebMD doesnt hand out med degrees anymore right?)
6. Make sure I chart in the 100 pages required for each pt/shift
7. Keep paper in the fax machine
8. Stock the med cart
9. Look for three diapers, when I find them, start yelling for the CNA I didnt keep after
10. Ignore the (@&$ that interupt during med pass
11. Tell them to empty the dang trash, I dont need to know how full it was
12. Stock the med cart
13 Last but not least, keep a pair of green socks and a purple straw in my pocket
Oh, and stock the med cart
(BTW, I sat here for two hours reading this thread laughing the whole time, I couldnt stop. I learned LOTS from it!!! School could never teach this much stuff!:lol2:)

When chaos hits us and everyones yelling and running around like chickens(nurses and residents).. I think.. crap they didnt tell us about this part in school.

SuesquatchRN, BSN, RN · Jul 16, 2010

*Nurse managers who diagnose patients.

I routinely call the doc to say, "Hey, I think Mary has pneumonia." Or a UTI or whatever. That's objectionable?

esperanzita · Jul 17, 2010

I routinely call the doc to say, "Hey, I think Mary has pneumonia." Or a UTI or whatever. That's objectionable?

Well, what you're describing is the more typical, humble, safe, and helpful practice. Here's an example of where I was coming from (happened last week):

Doctor ordered a doppler ultrasound to rule out DVT, as patient is having symptoms of DVT. Nurse manager comes in, looks for Homan's sign, then announces: "This patient does not have a DVT. Cancel the doppler." Fortunately, the charge nurse opted not to cancel the ultrasound. Lo and behold, the patient has a DVT.

I don't know. I don't think there's anything wrong with notifying the MD that a patient has symptoms of __insert medical diagnosis__. I guess I'm just talking about my nurse managers who insist that a patient has, or doesn't have, __insert medical diagnosis__, without consulting the MD. Then, they order us to act based on their belief. As the example showed, this practice can threaten the patient's life and our licenses.

Does that make sense?

:confused:

:)

CapeCodMermaid, RN · Jul 17, 2010

Homan's sign or lack of has been disproved as reliable determination of DVT. I tell docs all the time what I think is wrong with the resident or what test I think should be ordered. I certainly wouldn't cancel a test to rule out a DVT.

SuesquatchRN, BSN, RN · Jul 17, 2010

Doctor ordered a doppler ultrasound to rule out DVT, as patient is having symptoms of DVT. Nurse manager comes in, looks for Homan's sign, then announces: "This patient does not have a DVT. Cancel the doppler."

Plenty wrong with that. She doesn't have the authority to do that. Argue with the doc, yes, cancel, no.

esperanzita · Jul 17, 2010

Homan's sign or lack of has been disproved as reliable determination of DVT. I tell docs all the time what I think is wrong with the resident or what test I think should be ordered. I certainly wouldn't cancel a test to rule out a DVT.

As she was "ruling out" a DVT with Homan's sign, I told her I didn't feel comfortable ruling it out based on this. She gave me warm fuzzies: "This is how you learn! You'll get more confident as you learn." I left and made sure every other nurse on the unit was up to date about Homan's lack of accuracy and the threat of dislodging a clot while doing it.

Sorry, I didn't mean to put you guys on the defensive. I'm trying to pinpoint a particular behavior that happens at my facility that is a pet peeve, but I'm not doing a good job.