What Is the Problem???

Specialties Geriatric

Published

42 bed post-acute unit. 3 nurses on carts; one secretary, one unit manager. The 3 nurses ONLY do meds and treatments. For them to actually put an order in the computer or follow up on a lab is beyond their skill set. What happened to nurses who could take care of 20+ patients? They have fewer than 15 and all they do is pass meds and do treatments. I'm not talking trachs and Gtubes and multiple IVs. I'm the nurse manager and I do ALL the orders, call ALL the docs, follow up on ALL the labs. If I tell them an assessment is due they have a melt down.

Is it me? Am I from a time when nurses were expected to be able to multi task? I'm dumbfounded that they can't get out of their own way. PS. NONE of them are new grads.

Specializes in Internal Medicine, Geriatric Medicine.

Just to comment on the paystubs--my company has a VPN (we're all technically telecommuter) and we all log in to see our pay stubs. We can download them and save them as PDFs.

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But apparently some places are still operating in the 1980s. You don't even need a VPN. They could just create the pay statements in PDF format and email them to everybody.

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Specializes in Gerontology, Med surg, Home Health.

HERE is one of the problems: I got called to do dining room duty today even though I run the busiest unit--we had 6 admissions today.

I told the ADON it was a sh*& show because I was in the weeds, up the creek, behind the 8 ball (however you want to put it)..yup they said. The ADON didn't offer to help. She went into the sun room and watered plants!!! The DON yelled because all the orders hadn't been entered into the computer system yet. Hmmm...one me.....complicated system....and you want all the orders in for 6 patients within an hour??? No wonder your error rate is high and you're a 3 star facility. The ADON scolded me and said everyone needs to do dining room duty. Honey, I have no problem with serving food, but why pick me from the busiest unit when there are 2 case managers, 3 MDS nurses and God knows how many other people who could have helped out today?!?!? I've been an ADON and a DON an I NEVER would sit in my office (or water plants) when there were more than 2 admissions.

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I'm not sure how to feel on this one! (before I start, I've been a registered nurse for a wee 3 1/2 years) I work on a 44 bed rehab unit but only about half are actually rehab residents. Not even that. But my 2 LPNs run their asses off. If there's 3 they can actually get out after 8 hours. But the thing is there's 2 unit managers but I could easily handle the unit myself if there were 3 LPNs and 1 of me.

Now, I passed meds last weekend on a non rehab unit and between being pregnant and my back turning to jelly (pushing that cart murdered me!) and my lack of experience, I must say, multi tasking was not on my to do list that day! I had to have another LPN help me with one MINOR acute issue. This RN (starting ADON next week) is embarrassed!

But yes, I try so hard to get the LPNs to manage their time better but it doesn't work. If they took the time to order meds, they wouldn't spend so much time looking for them. If they had mediprocity open to talk to the pharmacy, they wouldn't have to walk up the hall and ask me to order something. If they would just take a manual BP or apical, they wouldn't have to try 3 times to get a correct reading on old equipment. If they did skin checks properly and thoroughly, they wouldn't be doing a more complex tx 3 days later... I just don't know how to support them. I try so hard but I'm busy myself attending hour long care conferences and an hour and a half long morning meeting...

I know they feel like the RNs just sit at the desk as do nothing, but I'm trying hard to catch up on care plans and round with the doc and review labs and... oy. I just don't know what to do. My DON and very good friend is amazing and was one of those nurses that could do it all but it seems like no one can do anything lately... and I hate to say it but I seem to be in that group! Maybe if I took a cart more than once a year it would be different.

I will say that my LPNs have a ton of charting to do compared to what used to be our standards. It takes them a good amount of time to do it. They also have to fill out the skin data collection forms that take forever and a day to complete. I still think that they have some time management issues. I would like to follow them around one day and see how they run the show. But we just got the eMAR system and I have to say, it's loooooads faster than passing meds and performing tx based on a binder...

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Specializes in Med-surg, telemetry, oncology, rehab, LTC, ALF.

I typically have less than 15 patients. I do all of the treatments, medications, input all new orders (since pharmacy likely won't or they'll put it in incorrectly) and call the doctor as needed for changes in condition, changes in medication, etc. My charge nurse calls the doctor for labs, simply because there isn't enough time for me to do that. Everything else is up to me and only me.

I would say that they need an increase in responsibility...and if they can't handle it, you need some new nurses who can.

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Am I the only one who feels that the situation the OP describes is how nursing in that setting should be? Safe patient load for each nurse, and the nurse is not distracted while passing meds or doing treatments, and the nurse might actually have time to spend with each patient which will allow her to treat the human being and not just the illness/disease/condition.

Im not saying nurses in that facility shouldn't know how to perform other tasks (in case the unit manger or secretary is out). I'm just saying the situation described sounds ideal if the future of nursing is going to improve.

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Specializes in Gerontology, Med surg, Home Health.

It makes the nurses too task oriented. They pass meds and do treatments without having a good grasp on lab results or MD orders.

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Specializes in Geriatrics.

Prior to taking on a traveling gig, I worked in a facility where my RN charge handled just about everything from calling physicians to entering orders and rounding. As well as a huge chunk of our assessments. I was a spoiled brat to be honest. I was able to concentrate on my meds and treatments and get done timely without a ton of stress. I took on a traveling gig where if the LPN can do it, the LPN does it. You work along side your RNs, not "under" them. And let me tell you what. I have gained more than a bit of respect for each and every RN I've worked under. Even those that I truly considered "lazy." It is no joke being responsible for everything but I take pride in being able to manage it.

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Specializes in Transitional Nursing.

I'm in new england and I have 30 patients, do my own admissions without a secretary (haha!!) skin checks and treatments. I think I need to come work with you!

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Specializes in Geriatric/Sub Acute, Home Care.

I do it all...meds to snaking toilets....we are still alive and well !!!!

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