xjwsforChrist

As many of you know I work at a nursing home as a nurse. I have the hardest hall (medicare) which of those nursing professionals, would vouch, is a very difficult hall. It feels like a ICU place. There are 5 halls in the entire facility. Station 1 has 2 halls on it and station 2 has three.

I ask to bitch about this, because of what happened monday and tuesday and wednesday the following days. I work 2 doubles 16 hour shifts on saturday and sunday. (school during the week) I repeatedly have requested to get off the medicare hall, as i've repeatedly stated the amount of work there requires at least 2 nurses for my hall alone. There are days where everything is SMOOTH and I get out by 11:30pm.

Saturday, was a nightmare, followed only by sunday, which turned out to be an extention of over exhaustion. I show up to work at 7am-ish. No one likes being there. I clock in and have a smoke. (oh yeah, I started smoking again, after stopping for 8 years because I couldn't handle the stress level of this hall). I begin my medication-pass and sure enough, already i'm hearing every five mins or so 'so and so needs a pain pill.' I look at the Medication Administration Record, find what pain will they receive, sign out the back of it with the date, time, my initials and effectiveness. I flip open the same page, sign out the date, time, my initials, the route of administration, the reason for giving medication, it's effectiveness, then my signature. I flip open to the front of the Medication Administration Record (M.A.R. from now on) and sign out the date, the time, the medication, the reason, the location of pain, it's effectiveness, the pain level, my signature. I then open up the narcotic book. Sign out the narc, the date, the time, the amount available, the amount used, and the amount left. This usually takes approximately 3 mins, if uninterrupted. This also means that it's just ONE patient i've done this for. We also have patients that falsely accuse the staff of not bringing or giving them their narcotic medication. So, there's another paper. The date, the time, the medication with dose, then my initials, then the patients initials for having received the medication. I go and give the medication to patient in Bed A. As soon as Bed B says 'Is this my pain pill?" and I give it to them, bed B says "Can I get a pain pill please?" So I repeat the process and come back before I have to give the mandatory 9am pills that need to be done by 10am and can't be given before 8am. I start punching out the pills one at a time, making sure i get everything I need to give them, while being interrupted that so and so needs a pain pill in another room. I stop wher ei'm at repeat the process again. I look at the Medication Administration Record, find what pain will they receive, sign out the back of it with the date, time, my initials and effectiveness. I flip open the same page, sign out the date, time, my initials, the route of administration, the reason for giving medication, it's effectiveness, then my signature. I flip open to the front of the Medication Administration Record (M.A.R. from now on) and sign out the date, the time, the medication, the reason, the location of pain, it's effectiveness, the pain level, my signature. I then open up the narcotic book. Sign out the narc, the date, the time, the amount available, the amount used, and the amount left. I go into bed A and give them the medications and the CNAs have not given the water to Bed B, so he asks for it. You tell them to ring the call light for CNA assistance and the CNAs are lazy as hell, and yell at you and make up excuses like 'I JUST GAVE HIM some water!' when you know you havn't seen the Ice water being pushed down the hall for refills and it's only 8am. So instead of dealing with a retard, you get the water, go back to the cart and try to start the first routines you were doing. It's illegal to keep them in your cart already popped from their package but you can't start over, it took 5 mins just to get at least the medications you were suppose to give, making sure you're not giving them PM coumadins or the right type of insulin, levemir vs novolog etc...that's given in am for the duration of the day. And family member approaches you and says 'Why is my mother still not dressed?' So you stop and turn to the family and explain that the breakfast has just been served and the CNAS were doing their care after breakfast and giving showers. The family member gets upset and says 'NO she needs to be taken care of NOW.' So you go find the appropriate CNA and say 'you're patient in room 340592845 needs to be dressed, the family is here and they want them dressed.' The CNA yells at you and says "I'M NOT DONE PASSING OUT BREAKFAST i'll do them AFTERWARDS' you tell the CNA 'I know but they want it done now, and I don't need them yelling at state board of nursing about neglect' she responds 'THEY AIN'T GONNA DO THAT! .' and walks away. I notice 4 mins later while the family is visitng the patient, the CNA is leaning up against the wall and talking to the other CNAS. You approach them and say 'you need to do that' .....she responds 'THE TRAYS are coming OUT, i don't; have time for dat' You go back to the family and say and forced to say 'I'm sorry but the trays are coming out, can you please give us thirty mins and i'll be sure to have it done.' The family member gets mad but understands to a certain degree and says how HORRIBLE the staff is, knowing full well she's saying 'How HORRIBLE you are at your job.' You walk out of the room and get back to your med pass on the first patient for the 9am routine medication pills. You get them ready and walk into a room and introduce yourself and offer the pills, and the patient says he doesn't want them. You offer the benefits of taking Blood pressure pills and importance of insulin etc.. but the patient starts yelling at you saying 'I SAID NO!' ....mean while, patient in bed B says "Can I get a pain pill?" So you go out to the MAR and circle everything that you just threw away and write 'patient refused all am medications and uncooperative with medication administration saying he does not wish to have his medications today.' You then look at the Medication Administration Record, find what pain will they (BED B) receives, sign out the back of it with the date, time, my initials and effectiveness. I flip open the same page, sign out the date, time, my initials, the route of administration, the reason for giving medication, it's effectiveness, then my signature. I flip open to the front of the Medication Administration Record (M.A.R. from now on) and sign out the date, the time, the medication, the reason, the location of pain, it's effectiveness, the pain level, my signature. I then open up the narcotic book. Sign out the narc, the date, the time, the amount available, the amount used, and the amount left. You then take the time to get the rest of the medications for Bed B and go into the room, and theres no water in the cup. You go out grab some water from your cart and take it in and the patient says 'I don't want water, can I get some juice' ...you take the pills with you down the nourishment room grab some juice, come back, and give it to the patient, throw it away and the patient says 'Whens the next time I can get my pain pill again?' ....you answer his question and walk out.

1 room down....13 to go.

You get done about 11am, but it's time to do your charting on the 11 of the rooms with patients. You begin to start your charting sitting at th enursing desk and keep getting interrupted by the family members that want something. You stop and start doing whatever they ask, and them getting angry for things not done. When you sit back down, you start your nursing notes and notice the CNAS have not done and neglected to do the vital signs. You ask them, and they havea n excuse as to why it's not done and yell at you as if its YOUR job to do them. You question what their job is, if they are not to be a certified nurse ASSISTANT. You continue about 3 of the nursing notes, but now it's time for accuchecks. it's 11:45am now and you go in and do the accucheck and the family asks why this wasn't done sooner, that it's suppose to be done 30 mins before. You explain that the meals have not come out yet, so you can do it now, and give the insulin and do everything possible to make them happy. They threaten you with state again, saying they are not happy. They then ask you to do little things that the CNAS are suppose to do but havn't done, and you get back to your cart 5 mins later, all the while grilling you on things that arn't done. You smile and do what you can to calm the situation and leave on a descent note with them. You then continue to the next accucheck and do them and so on so all 3-6 accuchecks are given. by the time your done with that, it's 12:30pm ...you sit down at the nursing desk to take a min of break and you get a phone call from the Admissions department saying 'you're going to have an admission '

You refrain from yelling at him/her and say thank you politely, afterall he's also probably 'just doing his job.' You ask what time the admissions coming and they tell you 3:30pm they'll leave the hospital and get there at 4. You ask for the 3008 which states majrity of information of the billing and doctors etc.. and they say it's in the fax room and since it's the weekend, they're not in so you have to go down and get it from the fax machine, all the while, walking past patient family members that are stopping you and asking you to do things, cause they know you're the nurse. You get the paper and all other documentation and realize that all the medications for discharge need to be clarified because it says 'continue ' and other papers say 'discontinue' of the same medication after discharge from hospital. You start getting together an admission packet that needs to be filledout. MARS that need to be written up for every medication, accucheck, sliding scale, diet, type of liquids they're allowed to have, further nourishment such as snacks etc.. But all th einformation is ambigous and you need to wait for the patient's arrival with the actual discharge packet from hospital. You gather the Assessment paper (5 pages front and back) that needs to be completed when patient arrives. All the while the supervisor is asking you 'this and this is not being done, you need to do this.' while she sits on her fat ass looked around the facility. You get the authorization to treatment consent form, Turberculosis screening form, inventory sheet of belongings brought to the facility, orientation paper of education that you need to fill out, . You hear overhead '[Voices] you have phone call on park 1' You run to the phone and have a family member asking about their loved one. You ask them their name, go to the chart and verify they are allowed to know information about the patient and give them information. They keep you on the phone for 10 mins while your trying to get off and get ready for the admission. Meanwhile a CNA approaches you and says so and so needs a pain pill. So you look at the Medication Administration Record, find what pain will they receive, sign out the back of it with the date, time, my initials and effectiveness. I flip open the same page, sign out the date, time, my initials, the route of administration, the reason for giving medication, it's effectiveness, then my signature. I flip open to the front of the Medication Administration Record (M.A.R. from now on) and sign out the date, the time, the medication, the reason, the location of pain, it's effectiveness, the pain level, my signature. I then open up the narcotic book. Sign out the narc, the date, the time, the amount available, the amount used, and the amount left. You give the patient their medication and another patient approaches you while your running down the hall and says "I have a doctors appointment on monday can you make sure it's done" You explain to the patient, as soon as you have time, infact, i'll bring it to you when I give you your afternoon medications." they agree and you get done with that. As you get back to your cart trying to sort out what needs to be done a patient comes up to you and says they only got TWO of their 9am medications. You pull open the mar and notice a full list of medications. you go into the cart and look and see only 2 medications there that came. You call pharmacy and ask them what happened, and they said they only received two papers yesterday on the admission of the new patient. You explain to them there's three papers and realize the previous nurse had faxed the papers and walked away from the fax machine and two of the papers got stuck together. Which means that a whole list of medications were not sent and the patient is becoming angry and upset and threatening to call someone about this. You explain the problem and say 'i'm faxing the meds and they're on their way.'

you go back to the nursing station only to have 4 charts with 4 orders in each chart sitting on the counter that the physical therapy department left for you to execute. You take off the orders and fax to pharmacy and sit back down to the next and the next and the next and do what you can with your admission. It's now 1:30pm. And you need to do your 2pm dig run. you realize only 3 of the nursing notes are done, and still don't have the full packet for admission, and stop and go do your medication run. You start your medication run and dealing with issues that patient is complaining of this and that and this and that, and family members saying this and that and this and that. Seems everytime you're on the floor, or even at the nursing desk, people approach you and want something done. You start to avoid m aking eye contact. Seems people wont' talk to you if you wont make eye contact, and only the really angry ones approach you either way as if you're the sole reason for their 'injustice.' You get done with your medication run and another nurse puts lab orders that came back for PT-INRS on your desk that need to be called to the doctors.

You open the patients mar find out which coumadin level the patient is on and call the doctor......no answer. You leave a message and start your nursing notes again and hear '[voices] you have a call on park 2' You pick up the phone and pharmacy is on the phone saying that they need clarification on so and so's meds and their records are different. You go to the chart, find the correct medication, realizing that the previous nurse failed to do something, write a telephone order of clarification and send to pharmacy and put it in the doctors folder and get back to your charting, when a CNA approaches you and says Mr/Mrs so and so is on the floor and had a fall. You drop everything you're doing and run down the hall way finding the patient on the floor. You begin your assessment, asking fo rpain, performing range of motion to locate and factures or injuries, and you hear '[voices] you have a doctor on park 2.', You assist the patient back into bed and run to the nursing station all the while telling the CNAS to get vitals, which they get bitter and angry about and still havn't done from the morning. You get on the phone tell the doctor of the laps and get all the pertinent information of new orders.

You open the patients chart, write out a new telephone order for new doses, write it on the MAR and fax it to pharmacy. You then go hunting for your fall assessments. Because it's an 'unseen' fall Neurochecks have to be done with vital signs. every 15 mins times 4, then every half hour for 2 hours, then every 4 hours times 16. You pull out the paper and finish front and back of what happened, including all patients information and person/family you're going to call at which time and who etc.. Then you fill out the lawyer paper which states the same information but you have to sign it because it happened on your shift and if this goes to court, you're held response. Then you take the witness statement paper, go to the person that found the patient on the floor and ask them to fill it out and they yell at you saying they're unwilling to to do so. You convince them to do it cause its part of their job since they found the patient, knowing that they're probably not going to report it next time so they don't get held legally responsible. You contact the family member and explain.....and well yeah some are understanding, others are just down right angry.

The new admission hasn't arrived and you hear [voices] you have a phone call on line 3' you pick up the phone and the admissions department says 'You have another admission coming in" You run back to get the faxes and and start an additional admission packet even though the first one isn't done. All the while being talked to be CNAS that so and so needs this and that. Now it's been 4 hours since the last pain pill was given to your first patient, so he rings the call light, and since it's PRN (as needed) and not routine, he hits that call light EXACTLY when that four hour mark has been hit and asks for a pain pill. So you look at the Medication Administration Record, find what pain will they receive, sign out the back of it with the date, time, my initials and effectiveness. I flip open the same page, sign out the date, time, my initials, the route of administration, the reason for giving medication, it's effectiveness, then my signature. I flip open to the front of the Medication Administration Record (M.A.R. from now on) and sign out the date, the time, the medication, the reason, the location of pain, it's effectiveness, the pain level, my signature. I then open up the narcotic book. Sign out the narc, the date, the time, the amount available, the amount used, and the amount left.
Now it's 4:30 and you're behind. You have to start your 4-5pm medication pass. You start your medication pass, but there's been a change of shift at 3pm for the CNAS. So now you're work load becomes lighter by the amounts of waters you're getting cause you know you're getting some really good CNAS that work evenings. You go through your med pass and your 4:30 accuchecks and all the while people wanting this and that, but the CNAS are reliable and work with you. You get done with your 5pm med pass at 5pm because now you've been cutting corners and rushing and signing thinggs out where your signature is unrecognizable etc... Now the second person that wanted a pain pill wants one.So you look at the Medication Administration Record, find what pain will they receive, sign out the back of it with the date, time, my initials and effectiveness. I flip open the same page, sign out the date, time, my initials, the route of administration, the reason for giving medication, it's effectiveness, then my signature. I flip open to the front of the Medication Administration Record (M.A.R. from now on) and sign out the date, the time, the medication, the reason, the location of pain, it's effectiveness, the pain level, my signature. I then open up the narcotic book. Sign out the narc, the date, the time, the amount available, the amount used, and the amount left.

Then the patient who asks for the doctors appointment verification calls you for information and you run back and find the information come back let him know and walk out. As you walk out, you're new admission is here, and it turns out to be another pain pill person. You grab the folder they give you and start filling out all their medications, and need clarification on two medications, so you call the doctor and he answers and clarifies and you write out another clarification order and fax to pharmacy. You then take your Physicans orders you've written out for the new patient and tell the other nurse that it's done if she could look them over and co-sign them because pharmacy wont delivery unless there's two signatures of people confirming that they're the right medications to give. She doesn't do it cause she's down the hallway doing her run. You get your paperwork and get down there and start your assessment. Which takes about an hour.As soon as your done A CNA comes up to you and says 3984320 needs a pain pill. You realize that you don't have the narcotic, so you have to call pharmacy and get an authorization from the Emergency kit. The pharmacy states they don't have a new script for that narcotic, so you tell them that they need to call the doctor and ask him for a verbal over the phone. Pharmacy says they wont call the doctor unless the doctor knows he's about to get a call. You explain that the doctor prefers a direct call from them instead of us because that's how he does it and the last time we called he yelled at us for calling him insterad of having the pharmacy call him directly. Pharmacy gives you an attitude and says 'so we get yelled at instead??? we're not calling till you have'.....now you have to be tricky and ask the other nurse to call because you don't want to LIE and say he knows when he doesn't. The other nurse calls for her orders and interjects that they call, she lies and says 'he knows' and the pharmacy calls. You get a call back and get the autorization and run to the other unit in order to get an E kit because for some reason they don't have an EKIT on your unit. You fill out the paper on the ekit that says Name, authorzation number, time, date, sealed tag number, new tag number being put on, which facility and medication taken with dose. You get all the stuff done and run back to the station and find the second admission on a stretcher in the middle of the hallway as the transport services just gives you the packet and walks out, leaving you with the patient. Now you have another set of physcians orders to write out, search, another set of assessment that needs to be done, another set of confirmation, another set of labs, doctor appointments, etc ...

this continues on till 11pm when the next nurse comes on, and you realize it is one of the laziest nurses you're ever going to meet. She doesn't help you with the admissions, she actually is currently on her cell phone, facebook posting, while you havn't even finished the first admission. You get home at 2am...you're beautiful girlfriend is waiting at home to greet you, but you know she doesn't cook so there's no meal waiting. Not that she should cook for me or anything, but anyone, including women, would love to have a nice meal instead of having to cook. You go to sleep practically hungry and wake up at 6:30am, to do it again.

This time however, it's March 1st. And the people that were suppose to transfer ALL the MARS from previous month that were printed didn't do a good job...so you have to write out four of the known mars that need correcting, but unaware of all the medications that weren't transscribed correctly or weren't even on the mar to begin with. .....

Same nonsense the second day, but this time, no admissions....CNAs come running to you in the evening and say 'So and so isn't feeling well' ......you look at them, and realize they're about to have a stroke.....and have to send them out......

It's 2:30am and you realize that the nurochecks sheet where the CNA should have filled out during 7am-3pm and 3-11 weren't done. You look at the nursing notes, and notice only 3 were done from yesterday, and you have another full day to do another set, and you notice the vitals for those nursing notes....weren't done on 7-3 again. You leave the second day at 4am. Even though you came in at 7am the day before, after a 2 hour broken sleep. You over hear a conversastion with another nurse that was talking to one of your good CNAS and complaining about how the wounds weren't done and you hear the cna say this:

"WHAT the hell???? WE HAVE BEEN DUMPING this SHIT on [VOICES]! NO ONE during the week does the work! WE REPORTED to the nursing on MONDAY AND ALL THIS WEEK for this and that, and no one did it! NO ONE did NOTHING! WE TELL ourselves when [VOICES] COMES in on the weekend, he'll TAKE care of it because NO ONE is doing anything!!!!!!!!!!!!!!!!!!!!! '

Nurse 2: "Yeah this place is horrible they hired someone that isn't doing a good job on the week days"

CNA: "NO!!!!! THIS HAS BEEN GOING ON FOR MONTHS!!!!!! WE'VE BEEN DUMPING ALL THE PROBLEMS ON HIM FOR MONTHS BECAUSE NO ONE HAS BEEN DOING ANYTHING ABOUT IT EXCEPT HIM!!!!!!!!!!"

I know this is a little self glory..here...and i'm sorry...i don't want to get 'humbled' somehow here, but i'm exhausted....The point wasn't to self-glorify by typing this up, so please don't overlook this entire experience as self glory but rather sheer, exhaustion.

I can't keep writing about this, it's been almost 2 hours.....I have a test tomorrow, in math i havn't studied for. My brain was so exhausted and overwhelmed that it took 3 days for it to calm down...and that's only because I meditated for 40 mins. The sheer over whelming exhausting feeling of having 10 bee's buzzing around in your brain and you have no control over them....for 3 days. (while i go to school).

I go through shit like this....as a nurse....

If anyone is interested in hiring me...OUTSIDE OF NURSING...for ANY JOB with descent pay.....i'm begging you not to think i'm lazy and wont do the work.

That's not mention the favortism that exists at work. How you get the hardest hall, and every other nurse is laughing at you while they're watching porn on their cell phone or face book on their new app while you run around like a chicken with it's head cut off. that's not to include all the stuff you couldn't finish that they get upset wtih you during the week and they have to do it. that's not including the anger you get when your significant other wants attention whether emotionall, sexually, physically (cuddling) or something as simple as watching a movie. That's not including all the 'change of conditions' that weren't done during the week, but were left on you because no one else is working or doing anything while their there, except med pass and labs. That's not including the time you go home praying that non-existance would be better then this, where you becoem emotionally numb and upset. That's not including watching individuals sit on their butt telling you to do something when they can do it. That's not including the spiritual growth you wish you had and the demons that torment you on a daily nightly basis you can't control. that's not including the homework and stress of paying rent and electricity etc..., That's not including self hatred, and desire to break into the music business somehow but no one's helping. That's not including the time it takes to cook food for yourself. That's not including the living paycheck to paycheck, Even though you're a nurse and work 32-40 hours a week. That's not including the enslavement you feel when you can't do anything else in life cause you don't have a degree in that or this or that. That's not including the lack of promotion because they want an RN in place of that management position in stead of an LPN, even though the risk manager, unit manager are not RNs. That's not including.....feeling trapped at 32 years old, feeling this is the rest of your life. That's not including knowing no one truely knows how this all really is affecting me. And then........you have your mental illness of PTSD and BPD. or your voice begging over and over and over again 'please stop please stop tormenting me' and your not even at work. 'Please don't hurt me please make it all go away, please help ' etc...etc.


Thats not including knowing, it'll happen all again, next weekend...

The absolute last thing anyone would think reading all of that is that you are lazy and won't do the work, Voices.


I don't think you posted for self-glory either... but at the very least someone noticed the extreme workload being placed on you. That can at least bring some justification/corroboration for how you feel.



You sound like you're drowning, and you probably can't get much time to try and think clearly about all of this. I do remember before you started, you posted that it was going to be really tough for a few years because you had to keep working a lot, but also go to school full time. I am sure that the overload at your job is not helping with that. Is there any way you could switch to another nursing job, a far less stressful and overloaded one?


Maybe you just need to vent. Let off some steam. Or remember that this is going to come to an end at some point, because you will at least be finished school. School must be out soon too right? A couple more months until the summer? Can you hold on until then? Put in a complaint at your work, that you need better and more help? If the patients are being neglected or are potentially in danger because the nurses are run ragged, then that is something that management should be addressing.


And if you are truly in despair and do not think you can make it, then reevaluate your priorities and what you want. Because we can get so caught up in what we think we should do or have, or the goals we have set for ourselves, that we can miss that everything we thought we should be doing is actually making us miserable.



But... if this is really what you want, and you want to continue, then breathe. Do YOUR job the best you can. Distance yourself from the complaints of others and the unhappiness of others (as in do not take it personally, or feel that you have failed personally when others are dissatisfied, especially when you know that you are doing your best and then some) That doesn't mean neglect your patients or protocols or anything. But DO speak to your higher ups to let them know your concerns. For one, that should be THEIR concern to fix, and for two, you are at least on record as having asked for help.

Especially if anything goes wrong with patients or meds or accidents. Something that exhaustion (or neglect on behalf of the others who are working with you, according to your account) can lead to happening.




Again, sometimes it just helps to vent, I know. So take anything I said above, or leave it, as you choose. You know your situation better than I do.


Better yet, ask Christ what you should do. So that you do HIS will, because He knows better than we do... rather than your own will. Then listen. If you do hear Him telling you what to do, then my advise is that you listen. Because when we DON'T listen, we often make things harder for ourselves then they have to be.

And really, as long as you are listening to Him, then does it matter where your path takes you? The path that we want to be on IS the path that follows Him... WHEREVER He leads us.


I needed reminding of that often myself.


Peace and love and strength to you Voices, and may you have ears to hear our Lord on this or any matter, and the faith to listen and obey,
your sister and servant, and fellow slave of Christ,
tammy

Dear Voices....

WOW! I am exhausted just reading your rant LOLOL!!! Glad you got it out. It's probably not even all of it.

You must enjoy or at least did enjoy what you do to be able to last this long.

Tammy offers some good advice.

I hope you can get to a point to get a break, some relief at work or maybe something else is coming your way. Drowning and the stress that comes with it along with no sleep will destroy your health. Take this burden to our Lord and ask him to help you with it.

Thanks for releasing this here with us, love and some peace for you my brother, your sister in Christ, Kim