After reading week 5 scenario, it seems like at my current facility staff argue with one another and gossip about other staff members all the time. It actually seems like every other night discussion on our unit. I work at a LTACH facility and we still do paper charting, however, we use Epic for lab orders and reviewing diagnostic results. Our DON was changed approximately four times in the past two years. Management is very inconsistent, and staff does not have a set structure to follow. To note, I did intra-facility transfer approximately a year ago and I still do not have a badge to open the rooms including the medication room where the pyxis is stationed. Most of the gossips and arguing between coworkers are usually night shift verses day shift. Night shift is more team oriented, we share the entire floor, all the call bells, and do final rounds including restocking rooms and emptying the trash. On the other hand, day shift is more independent and stick to their section and they typically don’t help each other unless there is a rapid or a code. As a result, day shift leaves the rooms unstocked, patients incontinent and wet, tasks not completed and passed to night shift. During report and after creates a lot of tension and gossiping in-regards to different staff members. In addition, staff wants to retaliate by not restocking the rooms for day shift, especially if the same aide or RN is back again. This decreases patient quality of care, creates more tension, and job dissatisfaction between staff members. I usually either stay out of it because it gets old due to management never taking charge or taking an initiative to make any changes. There is rarely any consequence if any done by management. Moreover, I try to stick to my own morals or what my mother taught me growing up to just respect other and be forgiving. I tend to try to do the right thing or contribute negative behaviors if it is a reoccurring issue. The downfall is the patients suffer in the middle of this. For example, if a patient keeps ringing every 20-40 minutes all night long, staff just stops answering the bell and keeps ignoring it while just sitting at the nursing station messing around on their cell phones. I tell myself if it was my family or myself, I would want someone to answer the bell, so I answer the bell. However, it takes away from my section and I tend to over work twice the amount and I never sit down to take a break. As a result, I feel overwhelm and over worked by the end of my shift and it gets old when you know it is the same staff over and over again.

Another example is the daily arguments I have with pharmacy. Usually no one as a badge or if any only one other nurse if we lucky, so we leave all the doors propped open so we can all have access. Pharmacy comes restocks the medication room and closes the door usually at 0600 when we are doing our final rounds before end of shift. This is usually when things go wrong, we need to call a rapid or hypoglycemic event from 0600 blood sugar check. I go to run into the med room or clean utility room to grab supplies and the door is lock. I got into a big argument with pharmacy telling them stop unpropping the door and it is becoming a safety issue with no one having access. They still close the door. This morning I waited until they walked out and grabbed the door and propped it open again with the trash can and they yelled and said you cannot do that I told pharmacy, I do not care leave it open no one has access and explained my rationale. She did not listen and insisted to close the door, I replied no. Finally, I just stayed in the medication room until she left and then propped it open and continued with my rounds. Remind you, this been going on for over a year now and apparently Lehigh Valley Hospital is aware as well as our DON here for Good Shepherd. The problem is Good Shepherd is dependent on LVH to print our badges out since we rent two floors from LVH. However, Good Shepherd employees never get badges made and they take forever, hence why it has been one year now and I still cannot get anyone to give me a badge.