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 LTC/Sub Acute Rehab.

OMG! YES, YES YES! I LOVE, LOVE this thread!

1. Family members: what makes your mother/father sooooo extra special; or the b***h neice that comes in who is not the RP that demands to know what is going on with the patient but cant make any decisions and management and social services caters to them anyway for fear that they may/will call the state.

2. Sorry A** CNA's: I was a CNA so I know the job. I hate how they take care of the same people daily but swear they didn't know that they have a personal safety alarm or how the resident is sooo contracted and cant turn themselves, yet they didnt know that they are supposed to have on moon boots to protect their heels or to turn them during rounds and as needed.:confused:

3. When nurses dont reorder medications whether they give them or not; if you see it only has two pills left, REORDER IT! At the very least, check the overflow drawer.

4. Lazy Managers: They always have something else for you to do as if you dont have enought to do already and they refuse to help with something minor like making a call to clarify information while you finish your med pass; guess that med pass isnt as important until the state comes or until the b***h family complains why mother hasnt gotten her medication yet because she just got off the phone with her but her call light is in her hand and not on.

5. Admissions Dept/ADON/DON: Admissions continues to be staffed with someone who has "no clue" what to look for, for an acceptable admission to the facilty. The ADON OR DON who appoves the admission, then the floor nurses are constantly being barraged with issues of constant falling and resident non-compliance not to mention when they approve admission of a patient from another facility knowing full well that the RP is currently suing the transferring facility and this is there 3rd, 4th, or 5th nursing home placement and all facilities have been sued by this family.

6. Paperwork: There is too much paper; and the facility wonders why they stay in so much hot water and has the nerve to be nervous when the State comes; maybe its because you have paper trail longer than the mighty mississippi. Its 2010, please upgrade to computer charting for all; it would make communication between disciplines much easier and you just might get your question answered instead of calling the nurse all the time worrying her to death.

7. Wandering Patients: Management and floor nurses wouldn't have to worry about elopement figures, the paperwork associated with elopement (including q 15 checks), notifying the State, the Family and the Doctor if your confused, independently ambulatory patients were on a safe, secure, locked unit where patients can be accounted for; if elopement occurs, it should be elopement off the unit, NOT THE BUILDING!

8. Supplies: PLEASE HAVE SOME! Im so tired of seeing CNA's having to "make due" with the linen,chux, barrier creams/ointments, and bathing supplies given to them that is NEVER enough yet they are expected to work miracles to keep the skin from breaking down; but, when the residents skin starts to become red and open up, the CNA's get blamed for not changing the patient in a timely manner (sometimes they dont in all fairness; see lazy CNA's) then everybody is pointing the finger at everybody cause nobody seems to know what happened and in the end it doesn't matter because guess what: THE CHARGE NURSES FOR ALL SHIFTS ARE THE ONE WHO GETS BLAMED eventhough he/she may not be aware of the situation;subsequently, the Nurse gets accused of "NOT CHARGING HER FLOOR" and it pits the shifts against one another cause everyone is trying to cover their a** which in turns makes the unit not function as a team; it becomes a situation where its every man for him/herself.

9. Skin Assessments and Shower days: Can we please get some organization Unit Managers/ADON/DON? How about the weekly skin assessment be completed on the residents scheduled shower days?:uhoh3: Wouldnt this make sense? Im sure. With all that the Charge Nurse is responsible for and has to remember, wouldn't it be courteous to the Nurses to do it this way? It would be helpful due to the repetition of the situation; at some point, Im gonna remember that Mrs. Jones gets her shower M-W-F; and for the Unit Manager and ADON when you're doing your skin assessment audit, you'll know which days to look for the weekly assessment to stay within compliance AND it just might cut down on in-house acquired wounds dont you think?

10. DON: Stop beliving everything your ADON and Unit Managers say PLEASE! I can understand that they are "supposed" to be your eyes and ears on the unit BUT some people cannot be trusted and sometimes have their own ulterior motives against certain staff members which causes unnecessary drama on the unit and the entire workplace. YES ADON'S and Unit Managers LIE, SCHEME, AND ARE CONNIVING! Some CNA's and Charge Nurses are harrassed on the job and not all cases of friction are harrassment, but it should be taken into account after so many times of repeated disciplinary actions against one particular person. If the CNA or the Nurse is sooo bad, their work is sooo poor and shoddy, and they constantly are calling off, then yes, suspend or terminate them; dont invite them to come back to work in the facility after the suspension. It's time that YOU my Dear Respected DON, be mindful of the people around YOU and deal with them accordingly as you would with a "expendable" CNA or Charge Nurse. GOOD STAFF ARE HARD TO FIND AND REPLACE. PLEASE REMEMBER THAT when you are so quick to be in agreement with your Managers about someone's personality and work ethic; if it were really true, they wouldve been gone long time ago, whether its by resignation or termination. And if not, what does that say about your management staff, whose word you stand by as "law.":confused:

Sorry about the rant; just my:twocents:.

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MMSE = mini mental state exam

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Specializes in lots of different areas.

Serving trays in the dining room first thing in the morning. And residents who NEVER use their manners. Sure enough to ruin my happy mood in a matter of minutes.

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Specializes in Geriatrics.

I have one to add... All the "extra's " who show up at meal time when state is there. you know, the DON, the med records, secretaries- that "help" pass trays. but really they screw it up because they do not know which resident is which. the only time they offer "help" is when state is there. do they think state really believes that they are such "team players"??!!

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Specializes in Geriatrics.

The DON that used to be a staff floor nurse that when she was a floor nurse, used to cut up with you and joke and laugh and was a great person to be around. But once she got "DON" behind her name, she decides to ridicule you in front of other employees, write you up for the stupidest things, and basically uses her title to belittle and humiliate all who are under her. ARGH!

Blessings, Michelle

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Specializes in LTC/Sub Acute Rehab.
I have one to add... All the "extra's " who show up at meal time when state is there. you know, the DON, the med records, secretaries- that "help" pass trays. but really they screw it up because they do not know which resident is which. the only time they offer "help" is when state is there. do they think state really believes that they are such "team players"??!!

Dont you just hate that! Mgmt will never know how much that burns me up.:madface:

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Specializes in LTC.

Finding garbage in people's beds- wrappers from dressing changes, oral medication syringes, etc., especially when the garbage can is right there by the bed. Or finding someone laying in a soaked bed after their foley was irrigated. Use a pad, a chux, a towel, anything!

Coming in at 7 am to a bunch of people laying in brown rings and 3rd shift says someone had a hangnail (I'm serious! apparently it took 3 CNAs to deal with a fingernail that night), or a "bunch of people rang their call bells." I hate to see what they would do with a hangnail AND having to wash and dress everyone, get them up, ambulate, serve meals, do showers, make beds, etc.

Residents who press the call bell while you're in the room with them. These are often the same residents who...

...won't let you care for their roommate for 2 seconds without desperately *needing* you for something. You so much as look at the poor roommate and the needy resident suddenly has to go to the bathroom or their hands are broken and they need you to move their box of tissues 3" to the left, or they suddenly want to tell you their whole life story... anything to keep your attention on THEM and not the other person.

Getting guilt-tripped by central supply for actually using supplies, and getting supplies purposefully withheld.

Other CNAs who don't reposition people without an explicit order to do so. I don't know about other facilities but in mine no one gets on a repo schedule until they have an open area. Why let it get to that point? You bring it up and they look at you like you have 3 heads and say "but that person's not on a schedule." Um, SO? That doesn't mean they HAVE to lay on their back all night and half the day!

Recreation people who take all your residents away before you get to toilet them. Or reposition them, put their orthotics on, get their vitals, brush their teeth, etc. But the most annoying thing is the toileting. Then they bring them back later and point out that they're full of pee or BM. Well no kidding.

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Specializes in LTC, Hospice, Case Management.

Nursing managers that think ALL floor nurses are lazy.

Floor nurses that think ALL nursing managers are lazy.

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Specializes in LTC.

Liquid med bottles with the medication all dripped down the label of the bottle and all dried... and liquid medication spilled in the draw where the bottle actually sticks fast, it's just disgusting for a bunch of nurses to be so sloppy. :banghead:

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New paperwork to "solve" some existing problem in addition to computer charting, the CNA charting etc, color coding sticky things. You may work in an office but I don't. If nobody had the time to do it the old way, nobody is going to have time to do it your way either. Quit complaining that nobody is doing it.

"Time management" Any time I have tried to use my time management skills ie; to suggest to a family member who breezes up to the med cart about missing socks that I have about 276 pills to pass right now, I will not look for socks right now, it doesn't go down well.

Family members who breeze up to the med cart when you're in the midst rummaging in the narc drawer. When I said "Just a minute" it did not mean "stand six inches behind me breathing stale ranch dressing breath on the back of my neck"

Other departments. Sorry, I know most of them have no clue how busy nursing is, but quit putting your responsibility on to nursing. We don't do it to you.

Patients who keep saying "It wasn't like this in the hospital" In the hospital they had double the staffing we do on this rehab floor. And it cost a lot more.

Oh yes and I agree with the central supply thing. If I work the weekend, I need more than two cans of jevity for my tube feeder. Don't lock the stupid supply cupboard all weekend. No, it wasn't me who didn't let you know I only had two cans on Friday night so save your condescending rant for the person who worked on Friday.

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The family member who says, "You look busy. I don't mean to disturb you, but..."

Well, you just did. WHAT?!

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Specializes in Geriatrics.

Back when I was on pm shift, I was on the phone with a doc, at around 445pm. Our administrator was chanting my name, trying to get my attention- I calmly said " I am on the phone with a doctor, just a minute" to which he replied "a doctor, at this time of day?" No kidding.. ya, the kicker was- did mrs so and so get her newspaper delivered today..... even those that work and run nursing homes may tend to forget it is a 24/7 job. yup, we are even open on holidays.

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