Want to hear your pet peeves in LTC nursing

[mondkmondk]

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

[Nascar nurse, ASN, RN]

I'm part of nursing management - mine may be a little different

1. Some of the lame call off excuses by the repeat offenders - then they get mad at me for call off write up!

2. Begging and pleading the admin. not to take the latest referral due to their history of combative and non-compliant behavior in the hospital that requires PRN Haldol (which we WON'T be allowed to give them). Why would they think they're going to be any better here than at the hospital.

3. Being at a corporate mandated event, all the bells/whistles, corporate people crawling the room with no apparent task at hand, over-the-top presentations/meals, etc. All the while, the other managers are back at the facility trying to figure out how to cut out 4 hours of nsg time to save the budget. Makes me want to stand up and scream.. save the $100 gas reimbursement, the 2 night hotel fee, all the fancy meals, the cost of using the convention room, the cost of the added entertainment AND if you did all this MAYBE..JUST MAYBE I could count actually pay for that additional 4 hours of nursing time/day.

4. As someone else said.. mock surveys = Please - oh - please. Wouldn't be so bad but it seems it never focuses on what the real surveyors focus on - so don't waste my time.

5. State surveyors. I have dealt with many auditor type people, including many government agencies. Our particular state surveyors can just be *******. Our group can really be evil. Picture trying to plead your case about an issue, and surveyor is sitting across the table, swinging her leg around, chewing/popping gum and says "bullsh**". Wow They have all the power and they know it and abuse it.

6. Lazy, lazy, lazy nurses and aides.

Better quit. I can feel my B/P going up and it's Friday night, I should be forgetting this stuff for the wkend.

[calliesue]

Thanks for asking. Lets see where to start..

1) micro managing supervisors. I have been a nurse for a minute now, so I don't need you to tell me that I need to call the dr with condition changes, get consents for psychotropic meds, call the family re new orders etc.

2)Nurses who don't do those things even though they know to too.

3) shift to shift fighting.

4) lazy nurses who write orders on the lab reports, write the T/O and then can't seem to file the report. Really you have the chart right there. Open the tab that says lab, and file the report.

5) Nurses who always shove their work off on other nurses and leave the desk a wreck.

6) nurses who act like they can't hear their pumps beeping, or who ignore pt personal safety alarms.

7) Unwitnessed falls, 20 page incident reports, neuro checks.

8) having to do mmse on pts with dementia/alzhiemers.

9) alzhiemers pts on the medicare hall.

10) management by crisis. Listen to your floor nurses when they tell you there is a problem, work with them proactively and then you won't have to run around screaming "The Sky Is Falling!!!"

11)Family members with web md

12) dinning room duty. I swear some of the patients were beating on their plates with silverware the other day.

13)Families who think their loved one is your only pt and highest concern

14) crash carts that aren't stocked. Oxygen regulators that don't work but are still in the 02 closet.

15) paramedics who second guess Dr orders to ship a resident out, and the judgmental way they sometimes talk to nurses. " Exactly how long has the patient been like this?"

16) Being expected by management to do another nurses work.

17) Being asked in am meeting, Did nurse A call the family? I don't know, I am not nurse A.

18) Being called out in am meeting for something don does not want ordered anymore, but never bothered to communicate to staff.

19)State Surveyors, but you all are right, corporate nurses are worse.

20) Extra forms to fill out and " core systems" made up by some RN BSN who probably never worked the floor a day in her life.

( no disrespect intended to any RN BSN on this board .) I wish I was an RN BSN.

Sometimes a career change to something like truck driving seems like a good idea.

[SuesquatchRN, BSN, RN]

1) State

2) Writing care plans to cover our butts rather than drive care. See 1.

3) Shift wars.

4) Resentment between levels, i.e., CNAs to LPNs, LPNs to RNs.

5) Nurse-itis. If the resident needs to pee toilet him, don't wait for him to soil himself and lose what little dignity he has left.

6) Proprietary behavior.

7) Not being able to get the best supplies due to cost. Example: our wound nurse have us a sample of an incredible product for deep wounds. Had a guy whose decub was down to the BONE. Cartilage showing like a chicken bone. Within ONE WEEK we were just waiting for the dermis to granulate in. Now we're back to collagen sheets. DNS won't buy it. You really think another YEAR of treatment with gauze and saline is more cost-effective?!

8) Families who ask why Dad, in end-stage Alzheimers with Korsakoffs, tube-feed, diabetes, atrophied frontal lobes, isn't getting better.

9) Families who find a need to call once a week to complain about the care Mom is receiving. After talking to the nurse on during their visit. Then saving all of the calls for a big one to the DNS. When Mom is being cared for marvelously.

[makes needs known]

Wow! I'm ashamed to say that I am probably guilty of some of the things everyone complains about. And the reason is that I'm not perfect, nobody is, and there is too much work to be done, and not enough workers.

[teeniebert, LPN]

alzhiemers pts on the medicare hall.

Amen to that! Right now we have an aide on light duty, so she sits in the lounge with the sundowning/self-transferring residents so the rest of us can actually get some work done. When she's back on active duty, I'll be turning in overtime slips every night again.

[NurseNinaFla]

Not enough time to do things right too much work etc..were all in the same boat

Stock the carts its common courtesy :igtsyt:

[southernbeegirl, BSN, RN]

1. repetitive call ins by staff that then are the loudest complainers of having to "work short" when someone else calls in.

2. call in excuses that you KNOW are not truthful just so they can lay out of work.

3. family members

4. nurses that sit around and constantly talk about other nurses and how 'stupid' they are when they make bigger mistakes than the ones they are talking about!

5. hearing the DON constantly whine about the nursing budget when she allows 'certain' people to have all the overtime they want.

6. family members.

7. the admissions dept being forced to accept any and all admits, regardless of acuity, level of dementia or history of combativeness. then administration saying 'we know this is hard but we all have to do what we can to help the company' type answers. Dont pee on us and tell us it's raining!

8. family members.

and last but not least....FAMILY MEMBERS!

[meluhn]

My pet peeves about LTC

1.the nurse pt ratio

2.Endless mind numbing med passes

3.CNAs that are just all around irresponsible, childish and can't be counted on to do their job (some, not all)

4. Boring, same thing everyday.

5. Counting narcs.

[Auntiegrade_Amnesia]

Oh Dear...The list is loooong, but if I HAD to pick a Top Ten, it might go something like:

1) CNA Babysitting: Should be neither desired nor required. If the CNA in question is not doing their job, then please FIRE THEIR A$$, but do not expect me to babysit them. I don't have time.

2) Picking Up Strays: Facilities who will admit anything and everything just for the sake of census. If I wanted to work with psychotic, violent patients, I would have applied at the State Hospital.

3) Drug Seekers: Those who never ask for a PRN pain med because they are in pain, but rather ask, "Is it time for my pain pills, and if it's not, then what else can I have?"

4) Attention Seekers: "Can you put a bandaid and some of that antibiotic ointment on my hangnail...its killllling me!"

5) Family Members: nuff said.

6) Backbiters, Bickering and B*tchery: Get enough of that from the patients. This isn't junior high.

7) The Overnighters: Out of town visitors who have mistaken the facility for the Holiday Inn, and me for their waitress.

8) Pharmacy Consultants: May someone decrease their xanax someday.

9) 99 year old Full Codes: Really??

10) The Bane of my meager existance: The all important, show stopping, drop everything right this minute and locate the pair of missing socks.

[montinurse, BSN]

The day nurse (M-F no weekends) who probably hasn't (and can't) worked a shift or the floor in how many years, sniffing around my unit finding stuff wrong-and pointing it out loudly! Rather than get defensive, I just keep my lips zipped and let the nurse pass through.

"So and so" needs a pillow case. Go Get it!

Hearing co-workers problems, the same ones ALL THE TIME.

Being handed a list of BM's. Mrs Smith has had one small in 3 days!

Residents who c/o loose stools, fiber's ordered, then c/o constipation. "Wait, I can't remember if I want my colace today."

Routine pain pills and those who think they will die of pain if not given at that time. Pain level is 9 but I'm still ambulating to see you, and gossiping about the "weirdo" across the hall. "What's wrong with him anyways?"

Doctors who won't insist the patient go to routine motrin or tylenol instead of all these dang narcs!

And if you're still reading this, I have to say that I'm my biggest pet peeve-for letting these silly things get to me at times! Phew~felt good to get those off my chest :)

[*bettie*]

umm, forgive me, but what is ) having to do mmse on pts with dementia/alzhiemers?

[scoochy]

All the prior posts have expressed my "peeves;" the three that are THE absolute most bothersome to me are:

1. the resident who falls time and time again, and his/her room is at the end of the hall, nowhere near the nurse's work area;

2. Ignoring resident safety alarms...oh, this gets my ***out;

3. The ADNS who makes rounds, and treats you like you have not a clue what is going on with your residents....PIA!!