LTC is getting the best of me! - page 3

i went on vacation and came back with about <10% of my work done by someone else....the rest was waiting for me, plus work becoming due for the current week. plus troubleshooting and wanting to pull... Read More

  1. by   ktwlpn
    Quote from NursesRmofun
    I am sorry, but those are terribly broad generalizations and one person's experience. I worked as a hospital nurse for many years and rarely had those problems (in general) with nursing home patients. I work in a NH now and I do not see the kind of things you are talking about go on in relation to my facility.
    I started to respond to this and then decided that I just did NOT have the strength.....Thanks for taking care of it.....
  2. by   NursesRmofun
    Quote from ktwlpn
    I started to respond to this and then decided that I just did NOT have the strength.....Thanks for taking care of it.....
    LOL. You are welcome.
  3. by   bubbacat
    I hear you all, I just started this May as a unit manager on a unit that is now subacute/living assist & I am about to pull my hair out. Everyday someone is chewing my butt. The paperwork is unbelievable & having to micromanage everyone is stupid. Why can't people do what they need to do and shut up about it. I hear complaints all the time, & sometimes I just want to turn to them and ask "your point"? Any suggestions on managing a unit would be most appreciative!!!!
  4. by   leslie :-D
    Quote from bubbacat
    Any suggestions on managing a unit would be most appreciative!!!!

    yes i do have a suggestion: don't do it. it truly is NOT worth being a middle man. no one could ever pay me enough to put up with the garbage that you have to and to top it off, you don't get support from anyone!!! talk about a thankless job.
  5. by   NursesRmofun
    Quote from bubbacat
    I hear you all, I just started this May as a unit manager on a unit that is now subacute/living assist & I am about to pull my hair out. Everyday someone is chewing my butt. The paperwork is unbelievable & having to micromanage everyone is stupid. Why can't people do what they need to do and shut up about it. I hear complaints all the time, & sometimes I just want to turn to them and ask "your point"? Any suggestions on managing a unit would be most appreciative!!!!
    Well, I am pulling my hair out a good deal of the time too! I empathize! I am trying to get out of this management position and out of the facility myself. It's a lot to take. But if you really want to stick it out, my best advice is to do what you have to do and try not to worry what anyone thinks. My crew don't complain much....in front of my face, that is....behind my back, I am sure they do lots! LOL! It isn't a great feeling,...but as a manager, I think you have to expect it. As has been said before,...managers are kind of stuck in the middle, taking heat from both those we manage and those that tell us what to do from above. Not easy.
  6. by   teeituptom
    Quote from NursesRmofun
    I am sorry, but those are terribly broad generalizations and one person's experience. I worked as a hospital nurse for many years and rarely had those problems (in general) with nursing home patients. I work in a NH now and I do not see the kind of things you are talking about go on in relation to my facility.


    Ive called Adult Protective Servicxes so often, Im almost on a first name basis with some of them. And its not just one nsg home in the area either
  7. by   donmomofnine
    Quote from earle58
    wow. if that's the case, i'd be pretty aggravated too. gee tom, i'm glad you don't stereotype. maybe you should relax and have a cigar.
    hmmmmmm, Tom....not REAL sure about your hospital, but we send our residents to the hospital, and ......never mind. It works both ways, ya know!
  8. by   nurseduck
    So when was the last time you worked in a nursing home? I have never worked in an ER because that isn't my cup of tea but I would not dog every ER nurse. I happen to love being a nurse and respect any nurse that works in any field. Sure there are bad nurses but they are few, there are a few bad ER and a few bad LTC nurses but is it becasue they are bad or because of circumstance out of their control like Medicare reimbursement and nursing shortage.

    :imbar

    Quote from teeituptom
    ER Nurses hate nursing homes

    they send them to us to replace foley catheters

    they send them over at 2 am and want us to call the GI lab in to reinsert a PEG tube and then call us back and yell at us for sending the pt back with a foley catheter as a gtube instead.
    They code their patients and call 911 and send them to us to either pronounce or save, usually they all have DNRs on their charts.
    They send the lil ole pt who had fallen 3 days ago at 2 am, after they finally got the xray report back saying the hip was broken.

    thats just a start of a long laundry list against nursing homes in general
  9. by   leslie :-D
    Quote from teeituptom
    Ive called Adult Protective Servicxes so often, Im almost on a first name basis with some of them. And its not just one nsg home in the area either
    as i am just as certain that it's not all nursing homes either.
  10. by   ktwlpn
    Quote from teeituptom
    Ive called Adult Protective Servicxes so often, Im almost on a first name basis with some of them. And its not just one nsg home in the area either
    I am quite certain that if your concerns were found to be justified by the investigators the homes in question would be fined or closed-at the very least it would be front page news in your community..........


    <they send them to us to replace foley catheters>>>>>>>>>>>>>> Yes-I have had to do this in my nursing career-those big old prostates,ya know? The UROLOGIST gives the order to send the patient in.......

    <they send them over at 2 am and want us to call the GI lab in to reinsert a PEG tube and then call us back and yell at us for sending the pt back with a foley catheter as a g-tube instead.>>>>>>>>>>>>>>>>>>>Can't say I have ever done this in the middle of the night but have had to send pts out-and was thrilled when they came back with g-tubes that we can then replace as needed....
    <They code their patients and call 911 and send them to us to either pronounce or save, usually they all have DNRs on their charts.>>>>>>>>>> I find it hard to believe that full codes are run on DNR's often-but we DO have to code them as long as the advance directive and the loved ones tell us to.....
    >They send the lil ole pt who had fallen 3 days ago at 2 am, after they finally got the xray report back saying the hip was broken.>>>>>>>>>>>Having no in-house radiology dept does make for delay in treatment...If the xray report comes back at 2am and the resident is in pain that the home can not relieve,shouldn't they come to the er?We have a limited supply of meds in our emergency boxes...

    <thats just a start of a long laundry list against nursing homes in general>
    Now it's my turn-things that happen to my dependent and helpless residents when they are in the hospital......#1 Pet Peeve Pressure ulcers and raw excoriated peri-areas...Or-foley caths and a resulting UTI....Weight loss from nurses dropping the tray off and never coming back to feed them.....Numerous skin tears from restraints....Increased confusion from the massive doeses of haldol given to sedate them into submission....Back to the pressure ulcers---I have lost count of the number of residents that have suffered and DIED from the sacral or heel ulcers they obtained in the hospital...You have to remeber that the nursing home is the person's home and they have the right to refuse treatment.That includes a bath...It's assault and battery if we try to throw them in the tub....or brush their teeth against their wishes..Remember there are 2 sides to every story
  11. by   TELEpathicRN
    I feel your pain!! I am a unit manager for a 58 bed unit with usually 10+ Medicare residents. Everything falls on me! I am responsible 24/7 for the operations of the unit. I was supposed to be M-F 8-4:30, but our admin has decided that we need nursing mgmt in the building on the weekends. Just to enlighten you, this facility only has 1 RN supervisor!!! and that position has only been in effect for about 3 or 4 months!! So, now we are going to have to start doing weekends too. When I first started, I was doing at least 60 hrs/week, but now I just say "screw it" as long as nothing is going on with a resident that needs my attention, I go home on time. I don't worry about the paperwork, it always can wait, residents cant. I do alot of my paperwork at home also. My DON/ADON are very realistic and don't get upset if the paperwork is late. I am very frustrated with my job and am about ready to go back to hospital work. I just want to be responsible for my own actions and that's it!!! Thanks for listening
  12. by   BHolliRNMS
    Er nurses dismiss nursing home patients instead of treating them in the same manner as other patients.
    1. Resident sent to ER during the afternoon after a fall. Report comes back "nothing's wrong." Resident dies during the night from a broken neck...undiagnosed.
    2. Resident sent to hospital for fever after a surgical revision of a wound. Go to check on resident in hospital and she is undergoing unnecessary vp for blood cultures, etc. The hospital staff cannot figure out why she has a temp. I ask about the wound and the response is "what wound" When I show it to them, it has MRSA from their OR and stool is in it.
    3. Yesterday at 4pm, send resident to ER when she returns from dialysis due to increased temp and mental status change. ER performs chest xray, blood cultures, u/a, CBC..etc. Return resident to the facility. DX: UTI. ER gave resident one dose of IV levaquin and said no further txment required til next dialysis day. This am, resident septic and sent back to ER, had to be intubated, O2 sat at 70%...oh yeah, the xray last pm, showed pneumonia.
    4. Resident falls at nursing home...sent to ER FIVE separate times due to severe pain. On the fifth visit, finally diagnosed with fractured vertabrae.
    I could go on and on with above incidences. Why do we need all the bad competition between nurses? We should all be working toward a common goal and support each other. People get sick. Accidents happen. Nurses and even Drs are human and make mistakes.
  13. by   NursesRmofun
    Quote from ktwlpn
    I am quite certain that if your concerns were found to be justified by the investigators the homes in question would be fined or closed-at the very least it would be front page news in your community..........


    <they send them to us to replace foley catheters>>>>>>>>>>>>>> Yes-I have had to do this in my nursing career-those big old prostates,ya know? The UROLOGIST gives the order to send the patient in.......

    <they send them over at 2 am and want us to call the GI lab in to reinsert a PEG tube and then call us back and yell at us for sending the pt back with a foley catheter as a g-tube instead.>>>>>>>>>>>>>>>>>>>Can't say I have ever done this in the middle of the night but have had to send pts out-and was thrilled when they came back with g-tubes that we can then replace as needed....
    <They code their patients and call 911 and send them to us to either pronounce or save, usually they all have DNRs on their charts.>>>>>>>>>> I find it hard to believe that full codes are run on DNR's often-but we DO have to code them as long as the advance directive and the loved ones tell us to.....
    >They send the lil ole pt who had fallen 3 days ago at 2 am, after they finally got the xray report back saying the hip was broken.>>>>>>>>>>>Having no in-house radiology dept does make for delay in treatment...If the xray report comes back at 2am and the resident is in pain that the home can not relieve,shouldn't they come to the er?We have a limited supply of meds in our emergency boxes...

    <thats just a start of a long laundry list against nursing homes in general>
    Now it's my turn-things that happen to my dependent and helpless residents when they are in the hospital......#1 Pet Peeve Pressure ulcers and raw excoriated peri-areas...Or-foley caths and a resulting UTI....Weight loss from nurses dropping the tray off and never coming back to feed them.....Numerous skin tears from restraints....Increased confusion from the massive doeses of haldol given to sedate them into submission....Back to the pressure ulcers---I have lost count of the number of residents that have suffered and DIED from the sacral or heel ulcers they obtained in the hospital...You have to remeber that the nursing home is the person's home and they have the right to refuse treatment.That includes a bath...It's assault and battery if we try to throw them in the tub....or brush their teeth against their wishes..Remember there are 2 sides to every story
    You made so many good points! Especially concur with the prostate problem that is beyond our control. Most LTC facilities don't have curved tipped caths due to the cost. I also agree with the fact that we cannot force people to shower in LTC....You can't legally in the hospital either. But when you are in the ER, you just don't have to face the same problems as nurses in LTC or the hospital Med/Surg units do.

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