Need advice from experienced LTC nurses.

minnib · Apr 21, 2009

:angryfire JUST MY 2 CENTS ON LTC FAICLITIES!!!

I worked at a LTC facility(as agency), I WAS THE ONLY NURSE FOR 30 RESIDENTS!!!, on the end stage alz. unit and I am a use to a big med passes, but I was responsible for all the tx, bloodsugars, vs, and whatever else!...I WILL NOT BE GOING BACK!!!!...and when I said something to the staffing nurse about how long it took and it being unsafe, she asked me if I was a new nurse????can you believe it?!..just terrible....I felt so bad, not feeling like I properly assessed my residents....even the regular staff nurses that I talked to, said they do this all of the time, understaff..it is a crime I tell you...I REFUSE to give substandard care..the staff was very helpful and I just love the residents.....I just felt so overwhelmed..and a nurse told me, they have nurses who will come in but they too refuse to work short, so that is why, only nurses who put up with this are called in!, WHY WE DO NURSES KEEP LETTING THIS HAPPEN????...

CapeCodMermaid, RN · Apr 21, 2009

Because most of these people don't need to be assessed every day...because many of them have better lives in the nursing home than they would if they were at home...because you perhaps have an antiquated view of what it means to be a nurse. I had 30 SUB ACUTE patients. They all got assessed...all got their meds on time...all got what they needed from me. Was it hard?? You bet. Was it safe...you bet.

achot chavi · Apr 21, 2009

:angryfire JUST MY 2 CENTS ON LTC FAICLITIES!!!

I worked at a LTC facility(as agency), I WAS THE ONLY NURSE FOR 30 RESIDENTS!!!, on the end stage alz. unit and I am a use to a big med passes, but I was responsible for all the tx, bloodsugars, vs, and whatever else!...I WILL NOT BE GOING BACK!!!!...and when I said something to the staffing nurse about how long it took and it being unsafe, she asked me if I was a new nurse????can you believe it?!..just terrible....I felt so bad, not feeling like I properly assessed my residents....even the regular staff nurses that I talked to, said they do this all of the time, understaff..it is a crime I tell you...I REFUSE to give substandard care..the staff was very helpful and I just love the residents.....I just felt so overwhelmed..and a nurse told me, they have nurses who will come in but they too refuse to work short, so that is why, only nurses who put up with this are called in!, WHY WE DO NURSES KEEP LETTING THIS HAPPEN????...

You sound very angry. I am sorry that LTC didn't work out for you. For many nurses it is the right place and for many it is not, You are obviously in the second category.

The beauty of nursing is that you can choose to work in so many different areas, If you dislike the busy unit, you can work in the OR or ER or whatever.

As a new nurse in LTC, it took me a month to get used to the priority setting and staff management of my 40 bed SNF unit but I stuck to it and am happy I did.

LTC is like that- either you love it or hate it.

My patients are not neglected or poorly cared for. I am proud of the work we LTC nurses do.

The sad fact is that if my patients could afford private duty nurses and have that 1 to 1 they would but they cant.

I wish you well in your chosen area of expertise.

Jo Dirt · Apr 21, 2009

Because most of these people don't need to be assessed every day...because many of them have better lives in the nursing home than they would if they were at home...because you perhaps have an antiquated view of what it means to be a nurse. I had 30 SUB ACUTE patients. They all got assessed...all got their meds on time...all got what they needed from me. Was it hard?? You bet. Was it safe...you bet.

THANK YOU! THANK YOU! THANK YOU!

I have never understood why people whine about the loads they are expected to carry at the nursing homes. Nursing homes are NOT acute care hospitals! They focus on MAINTENANCE. What do people expect? Really? There is a routine in a nursing home. You learn your routine and go with it. Not to say a lot of nursing homes don't have staffing issues, but I've never complained because I was responsible for a big med pass and blood sugars and charting--I've even managed to help with a shower or two in between. It's a hard day's work, but I used to care for more than 40 patients and was never so overwhelmed the patients were in unsafe situations.

johnst10 · Apr 21, 2009

thank you! thank you! thank you!

i have never understood why people whine about the loads they are expected to carry at the nursing homes. well, i guess that's why i quit today! i don't think whine is the word. it's a different perspective on nursing. i'd like time to read the chart and find out why the residents are there. what are their usual behaviors. who are their support systems... before i get blind sided! nursing homes are not acute care hospitals! i totally agree. this is why i'd like to have time to get to know the residents. this is their home. they focus on maintenance. we also do pd and iv infusions. what do people expect? to give the residents a proper, happy home. i don't expect residents to be told to "put up with" a roomate who yells all night. really? really. there is a routine in a nursing home. you learn your routine and go with it. not to say a lot of nursing homes don't have staffing issues, but i've never complained because i was responsible for a big med pass (when the meds have been restocked) and blood sugars (doesn't anyone know where the barreties are kept?) and charting the least of my worries--i've even managed to help with a shower or two in between. i salute you and others who are able to do this. i guess being floated between 3 differrent units did not allow me to establish a routine. it's a hard day's work, but i used to care for more than 40 patients and was never so overwhelmed the patients were in unsafe situations. i felt my patients were unsafe and not cared for in the manner they expected. i had several ask why their night time meds had not arrived by the time they went to bed at 8:30. i just couldn't do it. "suicide is painless" :crying2:

Jo Dirt · Apr 22, 2009

thank you! thank you! thank you!
i have never understood why people whine about the loads they are expected to carry at the nursing homes. well, i guess that's why i quit today! i don't think whine is the word. it's a different perspective on nursing. i'd like time to read the chart and find out why the residents are there. what are their usual behaviors. who are their support systems... before i get blind sided! nursing homes are not acute care hospitals! i totally agree. this is why i'd like to have time to get to know the residents. this is their home. they focus on maintenance. we also do pd and iv infusions. what do people expect? to give the residents a proper, happy home. i don't expect residents to be told to "put up with" a roomate who yells all night. really? really. there is a routine in a nursing home. you learn your routine and go with it. not to say a lot of nursing homes don't have staffing issues, but i've never complained because i was responsible for a big med pass (when the meds have been restocked) and blood sugars (doesn't anyone know where the barreties are kept?) and charting the least of my worries--i've even managed to help with a shower or two in between. i salute you and others who are able to do this. i guess being floated between 3 differrent units did not allow me to establish a routine. it's a hard day's work, but i used to care for more than 40 patients and was never so overwhelmed the patients were in unsafe situations. i felt my patients were unsafe and not cared for in the manner they expected. i had several ask why their night time meds had not arrived by the time they went to bed at 8:30. i just couldn't do it. "suicide is painless"

this is hard to sift through. let me run this through my little orphan annie secret decoder pin and i'll get back to you.

achot chavi · Apr 22, 2009

thank you! thank you! thank you!
i have never understood why people whine about the loads they are expected to carry at the nursing homes. well, i guess that's why i quit today! i don't think whine is the word. it's a different perspective on nursing. i'd like time to read the chart and find out why the residents are there. what are their usual behaviors. who are their support systems... before i get blind sided!
yeah right cause in the hospital setting or most others, you have all the time to do just that!!! and take into account that in the hospital setting you get different pt loads each day...
puhlease...
any good ltc nurse takes the time to read the chart and acquaint herself with all the nitty gritty details of the pts she cares for. i did so on the first night shift i worked.
really knowing your pt and his family is one of the advantages of ltc. we remember what antibiotic we used on that eye infection he had last year and when he is expecting his fifth great grandchild and how he likes his ensure etc..

i do respect your honesty in admitting that ltc is not for you, and wish you well in all future endeavors, but just dont dump on ltc...we work hard and do amazing work

nursing homes are not acute care hospitals! i totally agree. this is why i'd like to have time to get to know the residents. this is their home.
had you stuck around you would have done just that.

they focus on maintenance. we also do pd and iv infusions.

so? in ltc we do many skilled nursing functions and most under the umbrella of maintenance some just to help the pt avoid an er visit.

what do people expect? to give the residents a proper, happy home. i don't expect residents to be told to "put up with" a roomate who yells all night.

why would you let a pt yell all night? what did you do to helop the pt? is he in any discomfort or pain? does he need medication? i so disagree with you, you had the opportunity to alleviate two pts discomfort and didn't/ a good ltc nurse doesnt let her pt yell all night.

really? really. there is a routine in a nursing home. you learn your routine and go with it. not to say a lot of nursing homes don't have staffing issues, but i've never complained because i was responsible for a big med pass (when the meds have been restocked) and blood sugars (doesn't anyone know where the barreties are kept?) and charting the least of my worries--i've even managed to help with a shower or two in between. i salute you and others who are able to do this.
finally a good word and the truth at that.

i guess being floated between 3 differrent units did not allow me to establish a routine.

we never float a new nurse, that was a terrible thing to do to you and shows poor management skills on the part of the facility. i am sorry you had that experience. but please know that there are good and well run facilities that do honorable work.

it's a hard day's work, but i used to care for more than 40 patients and was never so overwhelmed the patients were in unsafe situations. i felt my patients were unsafe and not cared for in the manner they expected. i had several ask why their night time meds had not arrived by the time they went to bed at 8:30. i just couldn't do it. "suicide is painless"

so sorry it didn't work out for you, but dont dis all nursing homes, good luck in whatever you do

i will now return the orphan annie decoder ring to whoever i borrowed it from

johnst10 · Apr 22, 2009

So sorry it didn't work out for you, but dont dis all nursing homes, good luck in whatever you do

I will now return the Orphan Annie decoder ring to whoever I borrowed it from:)

I would never dis the LTC or the people who work in them. I, in that place, on the evening shift, floating between units, with little to no support besides "it will come to you", could not hack it. I have to believe that there are good places out there because me or my family may be in one. I could spend time defending why what happened did, I'll suffice to say I was out of my element!!!! (the problem with text is that the facial expressions can't be seen).

Give me a 2 day post CABG and I'll love looking for the bubbles in the chest tube. :specs:

Oh, the decoder ring, can I borrow it sometime?

Moogie · May 1, 2009

I would challenge you to come work where I work. Other than that, this kind of statement will only perpetuate the myth that all nursing homes are horrible. Nursing homes are a fact of life. People go there and that is usually their "last" address. They are at their worst in life, they need more than anyone can truly do for them and it's often not a pretty, romantic end. When nature fails to take its course, what else should should be done with these people?
A NH is a NH, a person can make what they want of it. I have the same patients and I've grown attached to them. I actually look forward to coming in every morning and seeing them. We laugh and talk and make the best out of a sad situation.
The patients stay clean and well-fed. They get a lot of stimulation and attention they wouldn't get anywhere else. We only have one in-house decubitus and it's very minor. We have a low turnover. I love where I work.
Not all Nhs are "bad."

You sound like an amazing LTC nurse and your facility sounds wonderful! In spite of my own negative experiences with LTC, stories like yours give me hope that there are good facilities out there. Thanks for an eloquent and uplifting post.

skinnurse66, LPN · May 2, 2009

I have worked in longterm care for over twenty years. There is alot I don't understand about the place you are working. They want you to clock out. Ok if you do I hope you are not working off the clock you would not be covered if something happened to you. Also how can they have you leave when there are meds due and no one to give them. I think I would protect my new license and run fast to the door. Not sure what state you are in but do they not have state surveys