Appalled at LTC standards of nursing care

Specialties Geriatric

Published

Hi. I have never worked in an LTC before. Just hospital acute care. Orienting, I noticed there is not assessment going on, there is not proper documentation going on, nor infection control. There are not even readily used anti-microbial wipes nor proper sized gloves in the rooms. Patients have MRSA and there are not infection control measures being enacted. The system is completely askew, and the charts are completely disorganized. There is not system for lab retrieval, and I wonder what the clerk is actually doing? When the physicians come, it seems like the LPNs don't know what to discuss with them re: SBAR. How can you discourse about the patient if you have not even physically assessed! I am an RN. Is this the difference? Are LPNs educated to such a less degree about the thouroughness? Or is this place uncommon. Much prefer the nitpicking hospital environment. Please tell me what the heck is going on here?

Specializes in LTC.
In so many LTC/SNF, the LPN's are considered "warm bodies" not taken as having any good ideas. What we need is someone who management will actually take seriously. As an LPN, I have restructured the filing system, updated paperwork to include information that is useful, organized the Med- Room. What it got me was more work, leaving me no time to continue "fixing" problems. Suggestion I made were sidelined, at a few places I was told I was not allowed to organize because someone else did it years ago and thier all used to it. But, I keep plugging along, I make what changes I can. I am glad you chose to stay with that company, the patients need you as much as the staff does.

Seriously? Well my response would be.. "this place looks like a pig pen.. and it needs to be cleaned.. if that person doesn't like it .. then they can fix it themselves. get them in here to clean.. i work here too and i can't work in a mess"

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I assess every morrning. I manage a skilled unit, 38 beds, and examine every resident during breakfast. I don't necessarily do much more than say good morning and see if they're at baseline, but if anything seems off we are right on it.

There's a difference within the facility, between units. Mine is now the one everyone wants their loved one to get and I'm very proud of that. My charge is an LPN with 15 years more experience than I have and is my right arm. The aides, once they learn that you respect them and listen to them, will reward you and, more importantly, the residents, with quality care.

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Good for you ---- my place is such a mess I am seriously considering a career change. Chart to CYA -- but - hmmmm - that will get you too!

Forget it - I will go back to loving my freinds and family and advocating for them and this litigous culture can move on with out me!

LOVE what I do for my patient ------- HATE the nurses who feel compelled to eat their young ---- and then have the brass to tell you they only do it because they love you?!?!?!?!

Talk about an abusive relationship. My dad used to tell my mom the same same!

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Specializes in ER, L&D, ICU, LTC, HH.

Well encountered my first night on new job. Was first night of orientation and I ended up with 40 patients with 2 aids. The preceptor would have had 80 patients alone with 4 aids had I not been there. She usually works days and goes to school to get her RN also. She had been in school and not slept all day. They made her stay over another 8 hours at 7 am because they had 2 call ins. It was nuts. She was so sleepy she could barely read the narcotic count. I quit the job first time ever after only one day. It is not a safe place for the patients and I refuse to be treated like she was this morning. I felt so sorry for her. What has happened to LTC? The rooms are dingy and I could deal with that if I had to. I can not deal with the medication room the floor being filthy and supplies stacked directly on it. I decided I would rather be unemployed than support a horrible place I would not put someone I cared about and that should be shut down.

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Specializes in ER, L&D, ICU, LTC, HH.

Trying a different LTC facility on Wednesday. I found one with a high Medicare rating. Was shown all the rooms even the medication and storage rooms; they were all clean. The food looked good in the eating room. The nursing director introduced me to everyone including the kitchen and house keeping staff. I was impressed with his interaction. Maybe this job will be better. I love caring for patients and I am just praying for a better situation than the last place.

~Willow

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Specializes in ER, L&D, ICU, LTC, HH.

Ok started new job today and they staff nights with 1 nurse to 30 patients a much better ratio than 60 to 80 per nurse for sure. =)

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Just started a new job in LTC facility, and my mind is blown. Set thru orientation where I was told such things as absolutely No cell phones allowed period, no artificial fingernails, no facial piercings, strict color-coded dress only-absolutely no gum allowed-all things I considered very appropriate for this setting. The Resident Rights were thoroughly gone over, with the fact that we are working in their home and that absolutely no form of abuse or disrespect would ever be allowed EVER. An hour later I am on the floor-the first thing my supervisor did was pull out her cellphone, CNAs are using them at the nurses station, Long bright artificial nails were everywhere! Facial piercings on the noses, eyebrows and lips very visible. AND the unit manager and charge nurse were having a good laugh about pouring water on an elderly lady as she lay in bed refusing her bath!!! Yep. This was all in my first hour, so needless to say I wont be going back. Again.:crying2:

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Specializes in Clinical Research, Outpt Women's Health.

So how is it going a month later Original Poster?

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Specializes in Gerontology, Med surg, Home Health.
Just started a new job in LTC facility, and my mind is blown. Set thru orientation where I was told such things as absolutely No cell phones allowed period, no artificial fingernails, no facial piercings, strict color-coded dress only-absolutely no gum allowed-all things I considered very appropriate for this setting. The Resident Rights were thoroughly gone over, with the fact that we are working in their home and that absolutely no form of abuse or disrespect would ever be allowed EVER. An hour later I am on the floor-the first thing my supervisor did was pull out her cellphone, CNAs are using them at the nurses station, Long bright artificial nails were everywhere! Facial piercings on the noses, eyebrows and lips very visible. AND the unit manager and charge nurse were having a good laugh about pouring water on an elderly lady as she lay in bed refusing her bath!!! Yep. This was all in my first hour, so needless to say I wont be going back. Again.:crying2:

You need to report them for abuse. Call the DON or the DPH.

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Specializes in LTC, Hospice, Case Management.
AND the unit manager and charge nurse were having a good laugh about pouring water on an elderly lady as she lay in bed refusing her bath!!! Yep. This was all in my first hour, so needless to say I wont be going back. Again.:crying2:

This is absolute abuse and should NEVER be tolerated. This needs to be reported. I can assure you that this is not normal in every facility. If I knew this had happened in my facility people would be immediately suspended pending investigation with termination once investigation complete.

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Call the hotline. I would have sent anyone doing such a thing home STAT and then informed the DNS and admin. After I was pulled off the offender and Mirandized for battery.

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