Being the Director of Nursing for a psych facility is not the cush job it first appears to be.

  • 0625. Arrived at the facility. Met at the door by two NOC staff with their updates, complaints, and emergencies.
  • Five eloping patients tried to leave over 100 times during the day shift.
  • Four resident assistants reprimanded for leaving door alarms unarmed.
  • One computer meltdown finally fixed after four days with no connection.
  • One dying patient in pain and with sinking O2 sats assessed and comforted. Hospice notified but tells me “We’re pretty busy today, can you handle it?”
  • Two crisis family meetings.
  • Four missing syringes of morphine.
  • Nine calls to the VA and hospice to order more morphine.
  • One meeting with a parole officer, one meeting with an angry parolee.
  • Five calls to MDs to adjust meds.
  • One resident transported emergently to the ER for chest pain.
  • One solid beating of the DON (me) by an angry bipolar who wanted to leave the back yard. One pair of broken glasses.
  • One new exterior gate latch purchased and installed by the DON to prevent further back yard escapes.
  • One trip to Shopko for toilet paper, butt wipes, and gloves.
  • One extremely unsavoury coccyx wound repacking on a screaming resident.
  • One hemorrhoid tucking for a resident who’s spitting on me.
  • One call from and collaboration with an ER doc.
  • Nearly 400 meds found in a closet from 2010 logged in and destroyed.
  • Over 110 HIPAA act label violations found in a mailbox and remedied.
  • Two missing psychotropic med scrips tracked down and original orders refaxed to pharmacies.
  • Two wound care packages ordered.
  • Two staff fights refereed, the staff’s July schedule approved, and three more staff schedule disagreements handled.
  • Another 150 pages of protected patient information shredded.
  • 26 residents rounded on twice.
  • Multiple hugs administered.
  • Office chairs cleaned of resident urine twice.
  • Cellphone located in resident’s shoe.

1855 heading for home. Day 19 in a row without a day off. My cellphone rings before I even leave the driveway.