WHERE DID I GO?

Has anybody out there been asking that question?  Where is the Geriatric Raging Blogger?  WELL....here I am!!!  I have been here all summer. Unfortunately all I have been doing is working, working, working. Five 12 hour shifts a week, some weeks even more.  None of which was voluntary. Just schedualed that way weather I wanted it or not. IT HAS SUCKED!!  The summer is done, school starts tomarrow and the entire summer was waisted. The only thing I have for it is some extra money to work on the jeep, and I'm really really tired. My house is a mess, my laundry is in a constant mountain and I am constantly overwhelmed by what I am not getting done and guilty because when I am not working, I just want to sleep.  Oh sweet sleep, how I have missed you!!!  As I am sitting here typing I am thinking of how good it would feel just to close my eyes and sleep. 

There is a light at the end of the tunel, but right now it is a very dim light.  They have hired a new nurse...YEA!!!  So why is the light so dim?  Well, because this nurse will be my new partner.  That means he is who I work with every night, which is fine, accept for the fact that he has never worked in a nursing home before.  He has only done home care, that is...one patient at a time, Not 40 to 50. Talk about a whole new world.  OMG, he is going to hate it...probably....I mean I hope not, but probably.  I just am not sure he knows what he is getting himself into.  Keep your fingers crossed for staying power. Because my luck, he will quit just in time to ruin Christmas.

Gosh, I am usually so much more optimistic.  I really need to find some happy in my life.  But here is one reason I keep going.....

(in your mind picture the man in this story with a very heavy southern drawl)
A couple of weeks ago I had been going through the worst 10 days of my nursing career. I walked out of work sat in my car and was physically and emotionally too tired to even drive.  I had 2 days off that was very much needed. I came back to work in a slightly better place but still wanting to just throw in the towel.  One old man seen me, came up to me, put his arm around my shoulder and had this conversation with me....

Nurse Lisa Honey, are you back? Are you my nurse tonight?

Yep, I am, all night.

Good, good, Nurse Lisa Honey, I am glad your my nurse tonight.  I miss you when your gone. I loves you Nurse Lisa Honey!!!

Awww... melt my frozen heart he did.   One old fella, a hug and some sweet talkin got me to put my resume away.  I am way too easy.

In the world of being a Geriatric Nurse, I have been in emotional hell lately.  I work with the same approximately 50 patient each night and you can't help but get attached. In the last 2 to 3 weeks I have 7 of my patients pass away, one of which was my own Grandma-in-law, who I adored.  I have been brought to tears more than once by more than one nurse by offenses that are so awful they should have been fired immediately and investigated by the board of nursing.  I have been personally slapped in the face with the fact that administration really only cares about the things that State sees, and if staffing is a issue, it is almost impossible to get fired. So sit on your ass, do nothing, and as long as you chart that you did it, your golden.

Then to top off the good time that the last couple of weeks has been, during my one day off, they posted and had a meeting announcing that our company was bought out by another company. A company that I have worked for in the past, know for certain that loyalty to their employees is words that don't fit in their mouth and have the scruples of a criminal defense attorney.  
OH Yeah, and they gave us a 4 day notice that the nurse's hours were changing.
I really don't know what else was said, because like I said, the note was posted about the meeting and the meeting was had all within the 34 hours that I had off work.  Thanks for the phone call boss people!!!

Ok, so on a lesser whining side, what keeps me there?  The little old lady that pats me on the cheek and says..."they just don't come better than you".  Who cares if she says it all of us, she says it to me and it makes me feel special.  Then there is my CNA's who daily say "Lisa, I am so happy your here. I hate working days your not here". I know I don't have the most perfect CNA's, but my night shift crew is pretty darn good, and I know they love me so much, because my counter part on my days off is useless. BUT, I hope part of it is just me. That I have been a good role model.  That I have showed them that when I am hard on them and demand that things be done well, that I do it out of the love of our patients.   I hope they know, that I know just how hard their job is.

Got called to the Boss's offices

So, this morning I got called into the Boss's office.  Both of my Boss's showed up early this morning, earlier than usual.  When they walk in I was in a frantic search for a lab result for a patient that was going to the hospital to have outpatient surgery. This patient wasn't mine, but it was important to send this info to the hospital, plus her medication, and her nurse didn't seem to think it was necessary.  This patient was sent back home from having surgery the week before all because this lab was too low and currently it was just barley high enough. IT WAS NECESSARY!!!! My boss came up to me and said, "why are YOU doing this".  I reply because it needs to be done, and I can't find that lab report, I don't know where she put it."   Again she asks, "yeah, but why are you doing it".  I say while I am still frantic because the patient is late and transportation is leaving and I didn't know the other nurse hadn't gotten it read, "BECAUSE I THINK SHE NEEDS IT AND SHE THINKS IT'S NOT REALLY NECESSARY".  So my boss walks away at that point and comes back to me later when I should be off work already and the other nurse is long gone and tell me they need to see me in their office when I am done.  I go in there later and ask if I am in trouble and she says "well yeah, sort of"  Then says "You have to stop helping her, she gets out of here every day on time, and you are always late still trying to get your work done."

I don't know what to do, I can't just say, no if someone asks me for help.  I am not that kind of person.  I tried to explain to her that it's not that she asks me to do a lot, but she constantly asks me questions, and they are usually really simple questions that she could find the answers for but since I am right there, she asks me, and I end up being the one looking for, whatever she was looking for, or doing on the computer what she was asking about.  Most of the times she could figure all of it out on her own and if I am not around, she does.  Each time she interrupts me trying to do my work, it takes me another 7 or 8 minutes to get my brain to focus back on what I was doing. Especially if I am trying to chart my nurses notes.  I have to re-read the whole thing and figure out where I am at in the note.  It is EXTREMELY frustrating.

I have been taking a laptop and putting it on my cart and doing all my computer work and book work standing up. Taking it all the way down the hall. That way she has to come and find me if she has a question and so far it is working.  She only comes and finds me if she has at least put some thought into her question and still can't figure it out.  She still finds me....a lot, but not near as much.

My major frustration is just people not doing things right.  There is constantly orders taken off wrong that I find and have to fix or other nurse's not setting priorities.  Making patients wait on pain meds until they are done with their med/insulin pass. Or waiting to call a Dr. to tell him about a new admit and get orders for meds until mid-night, or not getting a new order for an anti-biotic out of the e-kit until the middle of the night because you were finishing up some of your other routine things.  This just frustrates me so much. A patient can feel so much better after a single dose of anti-biotics sometimes. Why not take 5 minutes, give it now, rather than wait literally 5 to 6 hours until your caught up.  Sometimes feeling a little bit better is the difference between eating breakfast or not.  Most of these geriatric patients eating is imperative to healing.

Heck, I don't know what they expect.  I told them I think she has Dementia.  How can they not expect me to help her.  I guess I will continue to get fussed at until she learns more or something. I can not sit around and watch things not be done right, and I certainly can not help someone if they actually ask me for help.  I can be incredibly bitchy at times, but I am no Bitch!!!  There is a big difference.

OK, well I am done with this rant. I am hungry. It's time for a PB&J!!!

It's about time to be the Hated Bitch Nurse again.

I feel myself teetering on the edge of my mouth getting me into ALOT of trouble.  I have been the "Bitch Nurse" that everybody hates to work with because I expect a higher standard of care.  It sucks!!  Nobody likes to be hated by all, but after a while people get used to you and realize that you are not so bad and what you expect isn't so bad and what I expect becomes their habit.  After a while, like in so many nursing homes, people leave and you get a new crew with bad habits, that have been trained badly.  A lot don't know better and A lot don't care and I have to go back to Super Witch.  I really do hate being that person. I hate coming to work and having to be upset by something everyday, but I see it happening almost daily again and I feel myself getting to the spot where my mouth is going to pop open. When that happens, the crap just fly's out and I find it overwhelmingly hard to stop myself. I know I should deal with issues when they come up, and not let things get to the point where venom flows from my face, but I'm human. I like people to like me.  I hate the months that go by where people talk behind my back, because they think I am mean and they twist my words so whatever I said was ridiculous and demanding, a flat out lie, or a defamation of their upstanding superior employee character.  Each talking crap about me, to someone, who repeats it to someone, who can't wait to tell me, not that they don't keep on repeating it to others as well. This is the reality I have found of working in the world of a woman dominate field. Gossipy and bitchy, not liking to be criticized even if it is constructive.

Lately it has just been so hard at work. The patients have been impossible and they seem to go crazy about 30 minutes after I walk in the door to put me 3 hours behind, then I spend the entire night trying to play catch up, for which the most part I fail at and end up leaving 2 hours late every day.  I can't remember when I made it home before the kids left for school last.

Let me bang out a few examples of the things that are making me NUTS...
Not filling out orders correctly, only completing half of it.  It is a very multi-step job, and when it is not finished, the nurse that finds it has to fix it, and since it only seems to bother me that it's not done right.....IT"S ME!!!

Not obtaining orders at all.  I had a patient that had a skin tear, when I went to see what the order was because her bandage came off, she had orders for 2 skin tears that were already healed and NO orders for the two that she does have.

Letting things go, when you are told about something.  I told about a resident get congested 2 nights in a row, and yet nothing was done about it during the day. The Dr. does not want me to call him after hours to tell him a patient is getting a cold. Don't let it wait until I have to because he has a fever or he is having difficulty breathing.

Not turning patients...When you go in to check someone and they are dry.  YOU STILL HAVE TO TURN THEM!!!  Not only is there skin delicate and breaks down easy, but dang, I am only 40 and if I lay perfectly still for 2-3 hours, I hurt and ache and it painful to move. I can't imagine what it would be like to be 90 and someone make you lay in the exact same spot for 4 to 5 hours, because I can't move myself.

WASH YOUR DAMN HANDS!!!!  OK, yuck on you if you don't wear gloves. I would much rather you would, but OMGoodness, for the love of all that is holy WASH YOUR DAMN HANDS.  A couple of days ago I seen someone put their hands on a patients wet pads.  Actually I did the same thing.  I just went to pull him up like he asked and he failed to inform us that he was wet.  I stopped, washed my hands and applied gloves.  The other person, said, what is he wet, touched his pads, said "oh, he is" then wiped her hand on her shirt, and kept on going.  Honestly, this is where I should have blown my gasket, but really, I was immediately too shocked to comment and couldn't really while there were two patent's in the room, and by the time I was done, and already way late and taken advantage of for being asked to stop what I was doing to do this task anyway (there was 2 aids in the room), I forgot to pause in the hall to deal with it, but now that I am on a blogging roll...might I just say...ARE YOU KIDDING ME!!!!!

Ok, so that was some long examples. I would like to say that I am in no way saying that I am a perfect nurse or a super employee, because I will be the 1st to admit that I am not.  I have ADD, so focus is not my forte'.  I am very easily distracted which also puts me behind a lot.  If I get a chance to procrastinate, a lot of times I do.  I let people take advantage of me.  I have difficulty saying no, even when I am late, and behind and feeling overwhelmed.  I take over things, I fail to let people learn from me, because I would just rather do it  right, than explain it and risk them not doing it the way I think they should.   AND THE WORST...I forget almost everything. My memory retains things about 30 seconds. If I don't write it down, it's gone, and if I do write it down, there is a very good possibility I will lose the paper I wrote it on so it will be gone anyway.

OK, well that is enough. Chances are if you are one of the few that get to read my venty jumbled mess of words, then you are not among the people that are irritating the crap out of me so the only thing you need to worry about is possible blood spatter when that one co-worker just happens to have broken the camel's back.  (just keep some of those sani-bleach wipes in your pocket, they kill blood germs) ;)

One REALLY long night

Last night was a particularly hard night. 1st off, I know it is not nice to say, but my Co-nurse, might possibly  have some dementia herself. She is the RN charge nurse, the final decision maker. The one you go to for advise or consult. YEAH RIGHT!!  She is only worked at the facility for a couple of months, and still needs some procedural guidance as far a paperwork and such, but I shouldn't have to still spend so much of my time telling her what papers to fill out, or telling her to do things one step at a time because multiple steps are overwhelming.
OK, on to #2 one patient has been moved to comfort measures only.  This is an end of life treatment where all you do for the patient is keep them as comfortable as possible.  Lots of family that didn't get much warning, daughters that are finding it hard to let go (not that I blame them) and one patient that just is NOT comfortable.  Requiring ALOT of attention to aid in her comfort.  Not that I mind one little bit at this point making her comfortable is my #1 priority.
Now to #3 one patient with a mental disorder that is giving me a mental disorder. I cant really say more than that due to patient confidentiality but lets just say she is sucking up WAY more than her fair share or my time. Now for #4 Little Miss Behaviors, laying in her bed screaming my name or my nurse's aids name to the top of her lungs all night long for one little ridiculous thing or another such as.."I dropped my tissue" or "can I have some more water" when she still has half a glass. Cover my feet, uncover my feet, turn up my air conditioner 1 degree, turn down my air 2 degrees, move my left foot to right might 1 inch, my heels touching the bed" and so on and so on. All this screaming all night wakes up #'s 5, 6, and 7. Who would not have known they needed pain pills or cough meds or 986 trips to the bathroom if she would have just used a call light to drive me crazy.  #8 Fall..."I just fell on my butt" at least he is happy..lol, but no less paperwork for me.  #9 Skin tear, huge, mean old woman that does NOT want washed off never the less bandaged. #9 again...She bit my CNA....#9 again, man she really does not like that bandage...ugg, she has to wear the bandage.
So, here is # 10 and it is a biggy...by 3:30am, not one nurse's note done, not one incident report done, books not signed, NOTHING.  When I do sit down at my computer to start to compose my thoughts my co-nurse stands besides me and starts to draw a picture, stating "don't mind me, this is just something I do".  I try no ignore her (I have ADD, so this is not easy for me)  Luckily it doesn't take more than 15 to 20 minutes. She then shows me that she is standing there sketching my profile.  This is so ridiculous that all I can do is laugh.  My brain is spinning in so many circles that I am not sure where to chart first and my co-worker is sketching my face.
The one good thing about tonight was my CNA's they all came through for me last night. They covered me, one stayed late, one came in early, one picked up the slack.  They got things done and if they could handle things they did and only asked me for help when they had to.  They don't know how much I am grateful to them.  They rocked!!!

PS..The #'s above were only my patients. I could have assigned some #'s to some patients on the other side that needed my help, but I am trying to block those out..lol.

So FRUSTRATED

A friend and co-worker recently put up a post on facebook who posted this.....

I'm ready to find people who care about what they do and are proud of their contribution otherwise the other people should not deplete the oxygen of people who strive to make a difference and do care about their work and accomplishments

It kinda what got me to finally start this Blog.  I wanted to scream at the post "PREACH IT MY BROTHER".  I have been so frustrated lately.  I know not everyone that is hired to work in a nursing home is going to have the passion for it that I do...but...really?...Do they not even care?  Do they not see these little old people as human?  Do they have no work ethic at all?  Do they not feel guilty when they get home for doing LESS than half-assed work.

I just don't get it.  When I get off work, I sometimes can not sleep because I think of stuff that I didn't get done or something that I forgot to pass on to the next nurse.  I literally can't sleep or have dreams about it if I do sleep.

I just don't get it. How playing on your cellphone, or getting to your break at the exact scheduled minute is more important than taking care of your patient that is begging you to take her potty.  I have had nights where I have needed to pee for HOURS because I was just too busy to take 2 minutes, never-the-less and 30 minute break.

I just don't get it.  How someone can leave for the night knowing that their patients aren't clean, dry and comfortable.  If you don't care about your patients do you not even care about the mess you have left for your co-workers.

OK...so this is a short post, my rant is done for tonight.  I know that this blog will reach NONE of the eyes that I would like it to open, but maybe a few will read it that I know share in my frustrations and it will make them feel better knowing that someone else "just don't get it" either.  If you are that person, just remember these few words.....Take a deep breath, count to 10, close your eyes for 5 seconds, then walk away, because if you punch them in the throat....You will end up being the one in trouble...lol.