Want to hear your pet peeves in LTC nursing

Specialties Geriatric

Published

Right now I'm having an issue with the night shift LPN. She is always crabby when she comes in and criticizes almost everything I do or say to her. Supposedly she has a bad home life, but she shouldn't take it out on me. Sunday evening when I worked, I was really busy...and when she came in, she jumped my case about all the changeover paperwork not being done. Every other facility I've ever worked in, this was night shift's job. I apologized to her and offered to stay over and help her with changeover. Her response? "I don't need your help; the only thing I need you to do is stay the hell out of my way!"

I'm seriously considering filing a grievance against her. I asked my preceptor yesterday when I happened to see her which shift is supposed to do changeover and she said nights. So this night shift nurse is really chapping my hide!!!

I'm sure I'll think of other pet peeves too....what are some of yours?

Blessings, Michelle

Specializes in Geriatrics, Home Health.
*Typed signs posted everywhere that issue ultimatums, followed by: "Thank you for your cooperation."

Memos at my job always end with "Thanks for all you do." I'm starting to hate that phrase.

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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. :D

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.

No, you did fine once you clarified. She's an idiot who is trying to overrule the physician and overstepping her scope. Good for you for not being sucked into it. It's only, you know, your license.

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Specializes in Renal/Cardiac.

I am glad I read all these posts because I am about to go into LTC after being in a hospital setting for 2 yrs and you all gave me a lot of nuggets to remember and one I want forget

Always "STOCK THE MED CART"

Gotta love it :)

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Specializes in LTC, rehab, medical review.
Like the bird said.........cheap, cheap, cheap, cheap...................I've worked places where we've done that.

I was an aid in an ALF where we had to do laundry.

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Specializes in LTC.
I was an aid in an ALF where we had to do laundry.

Oh I'd hate that. I can't even get my laundry straight at home.

They recently made the nurses play waitress in the dining room. Drives me up the freaking wall. Not just observe the dining room in case someone chokes, actually take the drinks, silverware off the plastic tray and bring the plate of food to the resident. It takes forever and more people have to come off the floor(instead of assisting total feed residents) to assist for this to occur in a timely matter. They could pay a minimum wage employee to do this. Instead they want a nurse off the floor for the whole dinner show and that takes a good hour sometimes and they wonder why we are signing out so late.

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My pet peeves echo a lot of what has already been said except this one:

The NOC nurse who is the self-appointed micro-manager of all the other nurses who talks badly about the residents!!! So and so is an @$$hole....oh so and so is crazy...so and so was talking coo-coo...that resident is a jerk....

It really angers me to hear her talk badly about these residents! Yah, sometimes I have my complaints, but I will never call them a bad name. I hope I never turn into that jaded and bitter of a nurse. Dang lady, if you don't like your residents, maybe you should leave the facility - or quit nursing!

Anyways, yes, an unstocked med cart boils my blood. I almost always get a crappy change of shift report....grr! :mad: Non-urgent phone calls, which are 99% of them, during med pass/patient care, that I get paged for like it's the Surgeon General on the phone. :uhoh3: Please.

Stacks of charts and orders for ME to do....half of which are from the day shift.

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Specializes in Pediatric Private Duty; Camp Nursing.
I only got through the first page of this thread and felt the old anxiety attacks again.. :uhoh3:

Oh, man, I felt the same way when I started reading this thread! I am still PRN at my old LTC/SNF, I just keep saying no when they call. I can't bring myself to do it again. I'm in peds home health care now, and get enough work that I don't need to go in to my facility. Ugh, they can't pay me enough!

Anyway, what bugged me was when these elderly drug addicts would repeatedly ask for their PRN Percs/Vicodin/Ativan whatever over and over. You tell them they just had one an hour ago, they have to wait until whatever o'clock, but they have no concept of time (or just don't care) and keep asking. Or they get the idea that we're supposed to come back in exactly 6 hours after last pill, all ready with the next one. They get angry when I'm not jonny-on-the-spot. I would repeatedly tell them, "This is not a scheduled pill. You have to ASK for it. I'm not allowed to just bring it to you without you asking. If you don't ask, I just assume you have no pain/anxiety/whatever."

Also hate it when families bring in food for the residents, then we store it in the fridge meant for our supplies, then during my med pass they'll ask (tell) me to get it out for them and microwave it. Of course not a CNA is to be found when that happens.

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Aides who fail to see the big picture....who you have to lead by the nose, no matter how long they have worked on the unit. Can't remember who is diabetic. Can't remember who is a daily weight, who needs to see the nurse before going in the dining room. Waiting til the end of the shift to report issues like 4 loose foul-smelling stools, then flushing the last one so you can't possibly knwo what's going on. Bringing residents out for breakfast with no teeth, glasses, hearing aids, and with hair uncombed.

AAAARRRGGGHHHH!!!!

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People who won't stock the med cart, especially when I end up running back to the med room *twice* during The Big Med Pass because of empty bottles.

People who don't reorder meds or supplies.

People who get offended when you ask them to restock the med cart.

Residents who expect you to fix their TV, cable, or glasses.

Families who expect you to give medications without a doctor's order. "It's only Tums!"

Broken equipment, including equipment that needs new batteries.

MDs who don't return phone calls.

MDs who put you through to voice mail, then get upset when you called 911 because their patient was complaining of chest pain (true story).

Managers who expect you to play waitress in the dining room.

Babysitting CNAs, especially when they're my mother's age.

Residents and families who don't believe I'm a nurse, despite the RN on my nametag.

This sums up my job PERFECT.

I hate when people don't believe I'm the nurse because of my age and MDs who you leave 5 voicemails for and they end up calling you back at 9 at night two hours before the end of the shift.

let see what else:

no communication of pertinent info b/t shifts

when youre super short staffed and the oncoming shift sits at the NS as my shift runs around as alarms go off and they do not move a muscle (I dont care if you havent gotten report yet if you see two ppl on a floor and 8 alarms going off you help!)

all the paperwork that goes with skin integrity issues (5 places of documentation for a 1cmx1cm bruise) ugh i know its important but theres gotta be a better way to save paper

doing change over on paper MARS by yoruself for 120 residents

family members who dont understand that behavioral issues do effect other residents and do not want their family member to be on any meds for out of control behaviors

NO FEEDBACK! I want to know if I'm doing a good job since I'm new

etc etc.

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Specializes in NICU, Peds, Med-Surg.

OH EM GEE!!! This thread is GREAT!!! Thank you for some of the LAUGHS!! I recently noticed we have one housekeeper who is wayyyyyyyy too involved in nursing issues, and it is getting WORSE!!! Honey, pllllleeeze stop wasting go to nursing school, THEN you can comment on things!!!

Nuieve....as you know, we are ALL stressed out sometimes, and LTC certainly isn't easy. The thing that stood out to me from your post that none of the others had was that it sounds as if you might be happier working with younger adults and/or maybe children or neonates.

I do not mean this in a rude way at all; I just wonder if you've considered that you don't actually ENJOY the elderly, so maybe you'd be happy with a different population. One of the reasons I say this is because you mentioned words like BORING and SLOW.

Oh, and to whomever posted the term "beanbag hippies"---I've never heard of that, but I'm going to google it. And whoever said "families with web md"....LOL and AMEN!

And yes, if ONE MORE CNA comes to me and whines about something INSIGNIFICANT one more time, I think I'll explode. I do NOT need to hear your junior-high school drama ----talk to me about the RESIDENTS, and more importantly, TAKE CARE OF THEM, or find another job----PLEASE!!!!!!!!!!!!

I am also getting VERY VERY tired of CNAs constantly QUESTIONING how we do certain things or going behind our backs. THe other day, one of them kept going on and ON about how a catheter was clogged. Um---NO---the urine output is FINE, and so is the color. Please stop running to the OTHER nurse to report the nurse that you THINK doesn't know!!! I go to irrigate it a couple hours later, and everrrrrrrrything was fine. Honey, once you get a license, THEN you can question me or worry about it.

I've started getting SOOOO tired of the aides taking up VALUABLE time questioning and doubting us that I've purposely started talking about lab values LOUDLY so that they'll understand that until they get the WHOLE picture, please just stop wasting time questioning us and gossiping about us to the other nurses. I swear I'm going to start asking them what so and so's most recent PT/ INR was, etc.

....and when they complain that so and so is "ALWAYS SOAKED", I'm going to ask them "oh yea, did you see how the doctor came and changed their Lasix order? How DARE he? I wonder if it's a postassium-sparing type or not---what do you think?"

Many of my older coworkers and I who were also aides in the past agree----when a nurse asked us to do something, we just DID it....period! I would NEVER have questioned a nurse's many reasons for anything, I just DID MY JOB.....Even when I began nursing school and started KNOWING more ---I knew i was still in the Aide role, and I kept my opinions and negative thoughts to MYSELF.....why is that so HARD!!???? Of course I do not mean ALL of our CNAs are like this, but we have a few that think they have a phD in nursing and it's getting on my last nerve!!!!!!!!!!!!!! :roflmao:

Oh, and one thing that REALLY, REALLY makes me want to leave LTC (even though part of me REALLLY loves it, and I LOVE my residents!!!)----the 98 year old full codes---as some of you have said---I have a very, very emotionally difficult time with that.....:no: I just can NOT break a 98-year-old person's ribs and then hear that they are now in ICU, intubated, and suffering.....nope, it hurts my heart terribly---I pray about this A LOT..... :(

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Hmm, I don't think a CNA should blindly follow the orders of a LPN or RN. Even CNAs have a duty to question orders they feel will harm their patients.

I think the real issue is CNAs who go into know-it-all mode. I've noticed that once a CNA starts nursing school they have a tendancy to become too big for their britches and start questioning everything based on the nursing school lesson of the week. You know what they say, "A little knowledge is a dangerous thing..."

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Specializes in NICU, Peds, Med-Surg.

Yes Brandon, I totally agree with you that NO ONE should blindly follow an order if they feel it could harm the residents!!! And we DO have some very wonderful aides who take GREAT care of our residents, and if their questioning is out of CONCERN, I LOVE that!!! :)

What I'm referring to specifically are things that we don't have TIME to always explain to them, especially after we have NICELY asked them to do something, and it is something that would in NO WAY harm the resident. Example---. MAJOR drama we had the other day where the ongoing CNA was accusing the offgoing CNA of not changing the resident an hour ago, as she had---and we KNOW she had---. The resident is on a lot of Lasix, but EVEN IF SHE WERE NOT---the point is, she is SOAKED and we need to care for her!

While the ongoing CNA was crying and threatening to walk out and the offgoing CNA was screaming and threatening her, another nurse and I went to change the patient---the drama can WAIT! Ugh!

Also, we have a few CNAs that will question EVERYTHING, and there just isnt' TIME.....!!! Another example, we have one who wants to know WHY we choose the deltoid versus the vastus lateralis, etc.....not only that, wants to WASTE TIME by questioning the gauge of needles we choose....seriously??? Not a student, hates the job, doesn't seem to like the residents.....and wants to run around saying "WHY is she using that gauge needle?", etc....serrrriously??? Please just go TAKE CARE OF THE RESIDENTS or quit....PLEASE!! (and yes, person has been written up a LOT, calls in A LOT, but the boss just LOVES this person, for some unexplicable reason). Oh wait, I'm sorry--this person has a pulse and actually does SOME work sometimes...of course they'll keep them!

I should clarify, also---I LOVE to teach CNAs who are either wanting to go to nursing school or already in school (when I have the time!!!) . The IM injection example above is not that he was wanting to be TAUGHT---they were questioning EVERY little thing the nurse was doing just to try to get her in trouble....very, very, annoying!!! Then spends MORE time going around and telling all the other aides and nurses how HORRIBLE this one nurse is.....really? So tell me about why her choice of muscle and needle gauge were wrong!?? NO--- go and take care of the residents, please!!! In the time he's taking to criticize us, he could've given a shower!

Oh, and we also have several aides gossip and CRITICIZE us about how they think a DNR should be handled.....again ---if they are sincerely wanting to LEARN, I am happy to teach. I am talking constant criticizing and malicious gossip from some that have NO real interest in good care of our precious residents, and/or no interest in nursing school or learning more....just out and out waste of time criticizing nurses....

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