Dissention in the Ranks

Today marked my first day in the long-term care department at the VAC. I went into today with high expectations - a sure sign that shit was going to head down hill fast. Allow me to say first that TK is a very friendly person and has a good repoire with the patients and the staff (after the IDT meeting it became more clear to my why this is...but that's going to be elaborated upon here shortly). First thing we did this morning was deliver IVs to the med rooms in Unit A and Unit B. When we placed the Primaxin IV in the Unit A refrigerator, I noticed a case of Schlitz sitting on the shelf. I thought it would odd for a detox patient to be in the long-term care unit, so I asked why the beer was there. TK told me that since the goal of the long-term care unit was pallative care, the guys (and gals) were allowed a beer if they wanted one. I think that's just plain awesome. I've never been to a nursing home that served beer before! The rest of the day paled in comparison to the beer discovery. This feeling was culminated at the IDT meeting. IDT stands for Interdisciplinary Team - which is a crock. It should be called the Nursing and Dietician team, because the physicians' and the pharmacists' input counted for very little. The dietician was extremely rude and very unprofessional. She made off-collar comments about patients and when medication suggestions were made, she actually laughed at the pharmacy staff. I came this close to saying - "You are a dietician. You deal with food and nutrition. I don't tell you what to feed your patients - don't tell me what medications are best for the patients!!!" I have worked with wonderful dieticians before...this woman was a bitch. Then there was the nurse manager that makes Freddie Kruger appear to have a good bedside manner. We were discussing a patient with a Stage II pressure ulcer, and I recommended an Akton pad for accelerated healing. You thought I would've suggested removing her right arm! She informed me that those pads are not for pressure sores and my idea would never work. I wanted to inform her that obviously her nursing techniques do not work because a patient should NEVER have a stage II pressure ulcer. Skin break down occurs because of neglect. Instead, I bit my tongue and replied that my sister is vice president of the company and would be more than willing to re-educate them on this misconception. She shut up and noted to NOT take my recommendation. The IDT meeting drug on for 2 and 1/2 hours...the resident and I spent the last 30 minutes playing "doodle duel." We competed for the most aw-inspiring doodle. The activities director awarded co-first places. I finally trudged out of the VAC at 4:45 - 15 minutes past my normal quitting time. I say "boooooo" to long-term care!!!