Questionable practices at a LTC home

Specialties Geriatric

Published

I have taken a job as an "RN" at a LTC home. When I interviewed, I threw out there that I was willing to work as a CNA to cover in case of emergencies. They took it as I would fill every hole in their CNA schedule. What's the point of having your RN if you don't get to use it, right? Well, last night was my first night of CNA "orientation," and it was awful. They have the care home diveded into two sides, and side two (which I was on) has about 60 residents and there were three of us. Two really, because I was just supposed to follow the guy orienting me. There is a 300 lb lady that has to go to the bathroom every 15 min on the dot, and it takes a long time to get her from her wheelchair to the bathroom and back. There were two male roommates, one mostly demented, and the demented one tried to beat up the non-demented one because he was yelling at him to shut up and stop babbling. Two residents were in the middle stages of Alzheimer's (the point where they get agitated and wander but still as you the same questions every five seconds). And there were several residents who put on their call light every five seconds for picky little things "Are my legs completely covered? Move my arm 1/4 inch to the left." There were three people that required a full lift and four people who required a sit-to-stand lift. :eek:

Now, they said 2-10 shift was horrible, but I've noticed every 2-10 shift is a little horrible because there is never enough people when everyone goes to bed at the same time. However, last night was seriously understaffed. There should be at least 4-5 people on that side on a regular basis. Last night there was only 4 CNAs in the entire long-term care home. And despite what they tried to tell me when I interviewed, I am seeing there is only 2 CNAs on this side on a regular basis. So, what I did may have been cowardly, but I pulled some punches. I told the ADON I did not want to work as a CNA except in absolute emergencies, and questioned whether me having a job there rested on me working as a CNA when I was an RN. She claimed she just wanted to have me work as a CNA on both sides once to get to know the residents and see "just how bad things really are."

Now, the CNA-to-patient ratio (I think) is dangerous. But, I talked with the scheduler and I will be charge nurse on each shift after only one day of orientation for each. I can understand doing that for night shift, but days??? I just graduated in December, and I have no real-life nursing experience. All these people's lives are going to be in my very inexperienced hands. Is this normal for LTC? I have only worked at a couple of nursing homes (as a CNA) for a couple of months each.:crying2:

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You have no one to blame but yourself.I hope you get paid as an RN for your CNA shifts.

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Thanks so much for your ever-so-helpful comment. I hope people are just as supportive to you when you have a problem.

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Specializes in LTC Family Practice.

It sounds like a really bad environment, I certainly would consider turning in my resignation stating thanks but no thanks, it's your license on the line.

I know there are other facilities that are run much better so good luck.

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Specializes in LTC.

I think in your interview when you mentioned that you were willing to work as a CNA in emergencies just lends credit to your dedication and the fact that you are a team player. I also work in LTC and they know that I too will work as an aid in emergencies (though they rarely use me bc I'm an RN, and they would rather pay an LPN to do it for a lesser rate). Your intentions were good, but I really hope you are not taken advantage of because of this. The staffing your are describing is horrible and UNSAFE, and one day of orientation on each shift is also unsafe- especially with this being your first nursing job, if your DON is telling you she wants you to see "just how bad things really are"......well that is just a horrible way to represent a facilily and lets you know right there that she has no belief in the place, I would RUN RUN RUN. IF your gut is telling you this is a bad place to be, you are probably right, and I can tell you no matter how supportive management might seem when it goes down, they will throw you under the bus like nothing flat, and your license will be on the line, so please listen to your insticts..

Wishing you the best of luck

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You have no one to blame but yourself.I hope you get paid as an RN for your CNA shifts.

Seriously??? The OP came here asking for advice and this is all you can come up with??? WOW.

To the OP, this environment doesn't sound very healthy to a new grad. If i was you, i think i'd look at other employment op's.

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I would not accept this position. It is dangerous, to the residents and your license.

Good luck. And hang tough for a decent spot. And they do exist in LTC, but clearly, not in this facility.

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You have no one to blame but yourself.I hope you get paid as an RN for your CNA shifts.

I feel very sorry for the people that depend on your care. Leigh's story/problem isn't uncommon, you of all people should know this. Why is Leigh to blame? Your response makes no sense.

There is such a thing called, "constructive criticism", but you were just plain rude.

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I feel very sorry for the people that depend on your care. Leigh's story/problem isn't uncommon, you of all people should know this. Why is Leigh to blame? Your response makes no sense.

There is such a thing called, "constructive criticism", but you were just plain rude.

Exactly that. And it is for this reason that it galls me. I have a friend, an RN who does more CNA job than she does RN. She hates it but WILL NOT speak up. I hate it for her and I hate it for Leigh!

There is nothing wrong, helping out once in a while and offering too, but it becomes upsetting when it becomes when you do that more than the job you were originally hired on to do.

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Did the ADON really say "so you could see how bad things are?" If so isn't she admitting that they need more staff? WOW How many nurses for 60 pts? Usually that's a worse ratio.

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You probably should leave this job, either immediately, or after you have found another job. But beware that this scenario may not be too far off from what is offered at the other LTC facilities in your area. At some point, you will need to balance your need for a job with what is available out there. Hold the DON to her statement that you will only work as a CNA a couple of times in each section to see how it is. I believe you already know how it is. Good luck getting a better job.

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Exactly that. And it is for this reason that it galls me. I have a friend, an RN who does more CNA job than she does RN. She hates it but WILL NOT speak up. I hate it for her and I hate it for Leigh!

There is nothing wrong, helping out once in a while and offering too, but it becomes upsetting when it becomes when you do that more than the job you were originally hired on to do.

Does the facility your friend works at schedule her for CNA shifts instead of hiring more aides? If so, that isn't right. Or is she an RN lending a hand to her fellow aides? If so, she is awesome and there should be more RN's like her. When she works as a CNA does she get paid her RN wage? If so, be happy for the hours and pay. Performing the duties of a CNA will keep her humble, well rounded, and overall a better nurse.

I don't know your friend's nursing history or experience, but if her employer is actually scheduling her as a CNA, maybe there is another reason.

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