Dirty little secrets to managing LTC

Specialties Geriatric

Published

I am mostly acute care experienced but working through agency and there are a lot of LTC shifts coming my way.

I have worked at facilities that staff from 15:1 to 40:1.

This weekend I worked at a 40:1.

First time at this facility.

Unbelievable. There is no way a nurse can safely and legally give all meds to all patients!!

I had to ask for help and had another nurse take part of my team.

The oncoming (staff) nurse gave me one of her tips.

She signs the narc sheets at beginning of shift! All of them!

Signs she took out the medication, the time, the remaining number!

Unbelievable.

In California and maybe elsewhere facilities are getting tighter and increasing number of patients

on each team. So in my mind, I now understand , there are many nurses that need a job so badly they

are willing- and DO- things like above. Just to cope. Just to manage. Because we all need to work.

(Well almost all of us here)

So illegal practice and compromising patient safety are probably more common than is ever spoken.

Hence I call it the dirty little secrets of LTC nursing.

How many of you do the above? Or skip routine meds like vitamins or minerals and just sign the mar?

Chart something you did not do? What are all the dirty little secrets kept by LTC nurses?

Is this the way of the world now? Why aren't nurses coming together and demanding legislature to change

these unsafe ratios? Because until we do it will never get better and will only, as it is now, become much worse.

Specializes in Gerontology, Med surg, Home Health.
Especially if that resident is a fingerstick or GT...

This weekend we had 5 empty beds. 5!!! I was finished with my medpass at 6am.

I'm sure you didn't mean this the way it reads. The resident is NOT a fingerstick nor a GT. They are a person who needs/has those skills.

We had a celebration today when one of the peskier residents finally found living arrangements elsewhere so I get where all y'all are coming from.

Specializes in LTC.
I'm sure you didn't mean this the way it reads. The resident is NOT a fingerstick nor a GT. They are a person who needs/has those skills.

We had a celebration today when one of the peskier residents finally found living arrangements elsewhere so I get where all y'all are coming from.

I meant that a resident with a fingerstick or GT takes more time than a resident who doesn't. Its hard to phrase it and even say it right without it sounding wrong. One hallway has at least 10 6am fingersticks. Another hallway a couple months ago had 5 residents with GT's . That can take up a good chunk of time in the morning.

On a side story.. our 5 empty beds at the end of the night were 4 empty beds at the start of the night. One of our favorite residents passed. I knew she was on her way out so I checked on her at change of shift, 12:30am when I tried to get something for pain in her, and again at 2am when I saw that she passed. As soon as I turned the light on I knew. She was my first resident that passed on that I found. I'll never forget her. she was a sweetheart and I'm having a glass of wine tonight in memory of her. She drank wine with dinner and some nights thats all she wanted lol. Lived to 101.

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