Nurses Working Conditions

Nurses General Nursing

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I've been taking nursing school prereqs to get into a BSN program for a few years. I recently took on a job as a C.N.A. in an SNF and I'd really appreciate some feedback as to whether my experience here is typical of the nursing field, or whether it is typical of SNF or if my experience is not to be expected as a general working condition of being a nurse.

People sleep at work, in the hallways and all over the facility, both nurses and C.N.A.'s. I do work the noc shift.

We are short of supplies. I understand being low on things like briefs (as long as another size is available), special soaps, or bed sheets but we have been short on gloves!

Some patient care tasks must be pushed aside. Examples are not changing all of their briefs more than 1 time per shift. Another example occurs when certain patients call for help due to pain from bleeding wounds. I was told by a colleague to ignore her so I can get my other tasks done and I was told by a nurse to never ignore anyone.

We are told not to wear gloves all of the time to respect the patient's dignity, but I just contracted scabies.

No-one on my shift appears to wash hands between residents, nor change gloves between residents. New gloves aren't put on even after removing a soiled brief.

Briefs with feces and urine in them are tossed on the floor and picked up later on.

I don't know if the management knows or cares about any of this. I kind of think that some of them do know.

I want to know if this is typical of the nursing profession and I will need to develop a higher tolerance in order to work in the field or if these are indeed unusual behaviors.

Sooooo true!!

After having worked in several SNFs/nursing homes over the years, they're all still operating. They all pass their state full book surveys because they increase staffing, purchase abundant supplies, and do everything by the book the very moment a state surveyor walks into the facility. Once the state surveyors exit, many of the shady facilities go back to their corner-cutting ways. I've personally seen this game played many times.

When a complaint or accusation is called into the state regulatory body that handles SNFs/nursing homes, facility management tends to be on their best behavior while the state surveyor is in the building conducting the investigation. Again, management beefs up the staffing and purchases plenty of supplies while the investigation is occurring. Employees are doing everything by the book while being watched by the state surveyor. Guess what happens? The complaint or accusation cannot be substantiated without hardcore proof.

If the facility happens to be 'tagged' after a complaint or accusation, they'll usually pay any fines, come up with a generic plan of correction, and continue operating in the same shady manner to save time, cut corners, minimize costs, and maximize costs. It's wrong, but it happens all the time.

Sooooo true!!

Specializes in LTC, Hospice, Case Management.

All facilities are not alike. Had the night nurses calling me at 7:00am Saturday morning. They were fed up with a CNA that was sleeping on the job. They admitted they had been having problems with her and had not told me hoping they could resolve it themselves and cut the aide a break but they reached their breaking point and called me. I went into the building, called the aide back in (who came in with major attitude). She admitted sleeping and I fired her on the spot. Not tolerated in my building!

Keep in mind this was New Years Eve and I just shot myself in the foot with staffing on a major party holiday. Luckily I have a broke college student begging for hours. Good kid - food more important than booze! :)

Too often it is part of the money making situation of 'caring places'. They only listen to family and patients, not nurses. When everything is based on making a profit, guess what goes out the window????

I don't work SNF type due to a lot of things such as described.

There are MANY more issues besides what is being described. It is a shame how much dishonesty is going on everywhere in USA. At times as bad as the 3rd world countries we go out to 'improve'.

Specializes in med surg ltc psych.

Correct me if I'm way off base here. Regarding: nothing can get done if there is no substantiated hardcore proof, and is always the case when there is any law enforcement or legal actions taken now a days. So this being true, does anyone know if it is entirely and completely illegal for a soon to be resigning out employee to take any photos of the poor conditions (no resident identification by photo or otherwise) to visually document the soiled briefs on the floor or other unsafe conditions and submit to authorities? The reason I mention this is because I was visiting my mother a yr ago and was looking at her local news online, and low and behold an employee took some photos from her cell phone and a short video of a resident being severely manhandled, (and did submit to authorities, they of course pixelated the images) and the filth and soiled briefs laying on the floor at the feet of her wheelchair. It was a big story there and resulted in the administrative owners and the SNF being shut down. Completely. Completely and immediately. I am fully aware of HIPPA laws, but yall know you've seen media evidence of wrongdoing in healthcare in the past.

Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

Thank you everyone for your comments and suggestions. I'm very glad to know that these conditions, while not unusual, do not exist in every work setting that nurses work in.

Oh my Gosh. Report this! I agree! Quit and report. I worked a small period of time in a SNF. I was appalled. Things were similar to the one you mentioned. And NO GLOVES! To protect WHAT? Dignity? Uhhh......I thought we were in the business of healthcare. It should be easy enough to explain why you are always wearing a fresh pair of gloves for each patient and each soiling. If the patient is too demented to understand your explanation, I doubt that they will care whether you are wearing gloves when you hold their hand. That sounds like an excuse to understock your facility.

The SNF I worked in had no contact isolation. I enacted it on my patients and the staff thought I was nuts until I told them about all the junk they were exposing their children to. And they all had to agree....."oh yeh, the one patient had the yucky diarrhea, and then she died. Then the whole floor had the diarrhea." They started wearing the gowns and gloves and setting up iso carts and putting signs up outside the rooms. I was disciplined by my boss because I was spreading "discontent" and because I was overusing supplies in the contact rooms. "We don't have contact precautions here because there are no people who are so contagious", she said. So my patients with MRSA, VRE, and C-Diff are not contagious, huh? I quit very soon after that.

Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

Thanks for the feedback, nightengalegoddess. You made several excellent points. I'm so glad to know that I'm not way off base with my line of reasoning. Grrrrr.

Oh, and re: "The SNF I worked in had no contact isolation. I enacted it on my patients and the staff thought I was nuts" - this has happened to me, too at this place. A nurse laughed at me for wearing PPE when doing a brief change on a resident on contact precautions for MRSA or C-DIFF (no-one knows which one....) but she is on contact precautions.

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