How do VA and state nursing homes differ from "for profit" nursing homes?

heron, ASN, RN · Jul 8, 2011

Be aware that by working off the clock, you and your employer are violating federal labor law.

Hard to answer your questions ... so much is facility-specific and depends on local management and staff.

RHIA, RN · Jul 8, 2011

When I worked in a private LTC facility we had to beg for supplies and unlicensed staff. We used paper charts and what I felt like was out dated equipment (lifts, beds). When I went to work at the VA they had just switched to electronic records (2006). Supplies and staff are always available. I really enjoyed working at the VA until my family situation changed and I couldn't handle working 3 weekends a month anymore. As far as I know, my local VA LTC does not have COWs. I know that the VA hospital does.

happyinillinois · Jul 8, 2011

Never clock out and work for free! It is not volunteer work, so you should be paid. What if something happens to someone and you have to respond? Being "off the clock" you might not be covered! Things will never change if you aree to do 10 hours of work for 8 hours of pay. Work hard, smart, but on the clock while you are working.

SitcomNurse, BSN, MSN, EdD, RN · Jul 8, 2011

Paper MAR, Paper Treatment sheets, paper care records for CNA staff.

Paper pharmacy orders, paper incident reoprts, paper weight list, diet roster, dnr forms, ..paper any part of a chart, as well as pill poppin med pass with blister packs.

Computer MDS, forms created on computer to use on paper.

No time clocks, but if the boss says go home, you are off the clock at that point, and you need to go home or be subject to personal liabilites if anything goes wrong.

30 patients, plus wives/husbands of same. Mostly cohesive units, althouth calling them sister units is only because they are next to eachother, not because they cooperate.

Trade it? No. Not at all.

mazy · Jul 8, 2011

I agree with the PP who said to never ever clock out and come back in to do charting. If anything were to happen to a patient you so much as touched, or if you were to fall and injure yourself, the facility would be completely off the hook, you would be liable. Anywhere you go you are going to deal with administrators demanding you clock out on time, everyone has that problem, just do your job the best you can.

I work in a public facility and I think it's great. I know a lot of my co-workers might not agree with me, but I came in to this sector having put a lot of time into some of the worst facilities in the state -- literally, they were known everywhere as the "worst facilities in the state." So I'm a little starry-eyed.

I think that it does depend on the facility, but where I work, nurse patient ratios are much more manageable, support staff is plentiful, there are constant trainings, we never run out of supplies, and I actually feel like I'm doing something good for my patients. I still run around like a lunatic and a lot of times I don't get out on time, and sometimes I just want to stop and scream, and I rarely get breaks, but it's nice to go home and actually feel like I've accomplished something.

The politics is the same as anywhere else, the politics of nursing never changes.

The pay is not great -- we haven't gotten raises in several years -- I earn a lot less than my colleagues in the for-profit sector. But I would never want to back to that, more $$ is not worth the anguish of trying to be a nurse in a corrupt facility that doesn't give a crap.

The benefits are good, but they are also expensive.

The paperwork is insane...well, actually I don't think it's different from any other facility, but there is a lot of pressure to do it and do it right, which is fine with me. Wherever you go stuff is going to fall through the cracks, but it happens less when there are staff members who do nothing but chase paper trails.

So, good and bad. The good I guess is that I know my patients are getting quality care, the bad is that we're nurses and it's the same old song for nurses no matter where you go.

nurse955 · Jul 8, 2011

I've worked for both the VA and private sector nursing homes and there are differences. In my opinion, staffing is an issue regard less of what sector you are working in. I enjoy my stint at VA, it has lots to offer including tuition reimbursement, vacation/sick leave(not PTO), 11 federal holiday pay, unionized, no going home if census is low.

Keep in mind that VA is federal and Veterans are entitled to veteran benefits, therefore some of the medicare regulations one encounters in the private setting does not apply at the VA. However, VA does have JCAHO and its own regulatory VA directives either at the VISN or central level that it must comply with. The one I worked at was also Magnet accreditated, paperless, everything was computerized and takes patience and an excellent preceptor to teach and explain. Lot of the bedside nurses complaints centered around the paperwork, it seem like more time was spent completing paperwork than actual patient care. VA LTC units are called community living centers, and each VA facility may have 3-4 units, 30bed each and staffing is determined at the local VA level. NO 2 VA facilities are alike, so it would be hard for me to talk about staffing level. But staffing at the one I worked at was : (1) RN- charge nurse, 1-2 LPN, 1-2 PCA

Hope I answered your question.