Let's be frank, some LTC facilities are ran well, some are average and some are poor.
I had the opportunity to work at two facilities during the past year that I would consider average or above. I never felt once that we did not have the best interest of our patients at all times. What I am challenged with, is that most family members of these patients have very little clue to the care that we provide or they are in denial of the patients condition.
First, we do have a lot of patients with dementia that we treat. As anyone knows that works with these patients, it is a progressive disease and these patients' reality is much different than the norm. I am surprised that family members expect that these patients will improve when in our facility. Again, as I point out that dementia is a progressive disease, family members find it easier to blame the facility of mismanaged care or improper medication. Obviously the prescription of medication is left to the doctor and not the facility. Second, as other nurses know, getting patients to take their medication can be quite the challenge. Believe me, we try numerous ways to get these patients to take their meds. Sure they will take them when family is around in most cases, but other times we exhaust every possibility before we have to document the patient refused.
Fall incidents....Oh my that is a big challenge! Like a lot of LTC facilities, we have 30 patients in a unit that one nurse oversees. Additionally, we have 3 CNAs. That means at any one time up to 26 or more patients are not being supervised one on one at a time. I cannot tell you how many patients that have not walked in years wake up in the middle of the night and try to walk to the bathroom. I am not sure what goes through their mind that they think they can simply "walk" after not doing it for such a long time. The end result is usually a fall. Again, the family members feels that we are to blame because we were not watching them.
The reality is, is that a lot of families come see their grandmother and grandfather for about 30 - 45 minutes once a week. (This is average. Some family members come longer, others don't come at all.) For that 30-45 minutes family members see the "best" behavior of patients. They rarely see the patients refusing meds, spitting medication back out, pooping all over themselves after the CNA just give a complete bed bath 5 minutes earlier or patients attempt to get out of their beds to go to the bathroom or better yet, get dressed to go home because their car is parked in back of the facility.
Family members need to get a true reality of what takes place in a long term facility. Yes we try to treat our patients with dignity. Unfortunately, we care givers are not given the same dignity in return.
