Never ending frustration in LTC.....

Nurses General Nursing

Published

Specializes in Geriatrics.

I will try to make this short and to the point. I work LTC on 2:30 to 11:00 shift. As with every place there is friction between the shifts (days and evenings). I have gone to my nurse manager SEVERAL times about the problems we are having, from trash and linen carts not being taken down to rounds not being done and all the resident's needing to use the restroom at 3:00 because they haven't been there since before lunch time. I requested to have a meeting with the dayshift and discuss the situations and try to come up with a solution. Well, the NM decided to have the meeting on my day off, with only 1 CNA from my shift confronting the ENTIRE dayshift. Basically she was chewed apart and there was no one there to defend her. The outcome of the meeting????? Pick up after the shift before you and keep your mouth shut. :angryfire

I didn't know any of this when i first walked on the floor and the NM was sitting at the nursing station and didn't even look at me, which is very unusual cause she always says "HI", NO EYE CONTACT whatsoever!! As soon as i heard what happened i went to her office to find out why she did that and she had gone for the day (about an our earlier than usual).

I am just so frustrated because I have tried soooooo hard to get things running better, the girls that work with me (CNA's) are just super, and I let them know that. I feel like I am letting them down because no matter how many times i meet with the NM about my concerns nothing gets done.

I don't want to give up because it is not fair to the residents, when there is so much left over from the shift before it takes away time that should be spent taking care of the residents.

I also said that the dayshift nurse needs to step up and take charge and make sure the CNA's are getting things done. The aides on dayshift are extremely rude to the LPNs and walk all over them and none of the nurses have the backbone to take charge.

I could go on forever. I just need to vent and know that there are others out there in my situation. I have seriously considered quiting and finding a job in someother specialty. I have an interview with a private duty co. next week, i think i am getting burnt out of the LTC environment and maybe i need a change?!?!?!?

Thanks for letting me vent.

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Your CNAs are lucky to have you!! It will be their loss if you leave but you have to do whatever necessary for your sanity.

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Specializes in Med Surg, Hospice.

That's why I don't want to work in LTC. My roomie had the same situation at the LTC place where she worked. She hated it. They'd call her in on her days and weekends off and called at all hours of the day and night to get her to come in. This is one area I do not want to specialize in, even though I adore older people.

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Specializes in LTC, med-surg, critial care.

Something like this was going on where I work (I also work 3-11) and I basically bugged the DON with notes "Where's all my linen?" " AM's is leaving a mess every day when I get here." and so on. Then I also encouraged my CNA's to come in early enough to do walking rounds with the AM CNA's so they had to do last rounds. Anytime that didn't work I just started writing everyone up. Now they know I don't take crap from any of them and when I'm there they do their dang job. :devil:

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Specializes in LTC.

Hmm sounds like typical LTC place. I agree with not now. Leave notes for the DON and NM. Be as specific as possible on the note .Make sure to keep copies for yourself in case their copies get"lost"

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The trouble with all of it is that without backing and enforcement from the top, nothing will change. Once again, poor management by incompetent managers. It is a pity.

I guess, OP, you should put your concerns in writing and send them to your boss and every other boss over her and definitely keep a copy somewhere off the premises. Don't tell your coworkers where.

Best if you can get your staff to sign with you. Be specific - dates, patient names, the exact offense. State a solution, too, so none of them have to tax themselves to come up with one. Be totally professional and unemotional. Your concern is for the good of the employer (avoiding legal troubles and fines) and patients, not for staff convenience, although an appeal for reasonable sharing of the workload and improved staff morale is probably ok to mention. Maybe you will catch the attention of the high-up's if you mention which JCAHO and CMS rules are being violated.

Sorry for sarcasm, I just am so sick of hearing how this behavior seems to absolutely pervade LTC, maybe acute care, too. What is wrong with these lazy, heartless Day aides and these terribly incompetent managers? What are they thinking?

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The trouble with all of it is that without backing and enforcement from the top, nothing will change. Once again, poor management by incompetent managers. It is a pity.

I guess, OP, you should put your concerns in writing and send them to your boss and every other boss over her and definitely keep a copy somewhere off the premises. Don't tell your coworkers where.

Best if you can get your staff to sign with you. Be specific - dates, patient names, the exact offense. State a solution, too, so none of them have to tax themselves to come up with one. Be totally professional and unemotional. Your concern is for the good of the employer (avoiding legal troubles and fines) and patients, not for staff convenience, although an appeal for reasonable sharing of the workload and improved staff morale is probably ok to mention. Maybe you will catch the attention of the high-up's if you mention which JCAHO and CMS rules are being violated.

Sorry for sarcasm, I just am so sick of hearing how this behavior seems to absolutely pervade LTC, maybe acute care, too. What is wrong with these lazy, heartless Day aides and these terribly incompetent managers? What are they thinking?

That's just it....they're NOT thinking.

The OP should call Office of LTC, or whatever office in her state governs the nursing homes. It is STATE law that people are supposed to be toileted and position changed q2hrs.

That is disgusting that the NM is letting the dayshift aides get away with that. I hope SHE doesn't ever have to end up staying in a nursing home under those aides care. What goes around usually comes around.

Someone should have the guts to advocate for those elderly people.

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That is something that happens here at times as well. I work the night shift, and there are different groups of NAs on Evenings, and you can really tell whose been on because our 2 am rounds will either be very quick, with everyone in dry briefs and we just have to turn them, or every bed soaked needing a linen change. I always help the NAs on their rounds, but they tell me I am the only nurse that does.

I also find it frustrating being the only nurse, because we are so short staffed, and if someone is sick in the summer it is inevitable that your 8 hr shift will turn into a 12 or 16hr shift and you will be called on your weekend off at least once a month. If you don't answer the phone, the other nurses will lay it on you the next time they see you. Last weekend I was stuck on a double E/N and they wanted me to come back and do it again on the next day, I told them no, and they got rid of my E and the person who worked it ended up staying for both. The weekend before that I was stuck doing a 12 but it was all OT because they changed my shift from an E to a D. We have no Prn staff, our manager convinces us to come in sick and stay if we get sick on shift.

No wonder there is a shortage, who would do this on purpose?

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