Be thankful you're in a position to be able to retire!!! Good Luck to you and Congrats!. I'm 60, been an LPN for 17 years, and most recently lost my job because I forgot to give a patient's meds. This patient was asleep, had various problems with aggression, acting out, and insomnia. During the last medpass, I elected not to wake them, and decided I'd give the meds an hour later (permissable to give an hour before scheduled time or one hour after scheduled time). I forgot to give the med, oncoming nurse found the meds and called the DON to report the offense.
Yes, we've all found pills not given at some point, and usually we have the professional courtesy to ask the nurse that worked before us, suffice it to say... this nurse was quick to "be the judge and jury" and report me, rather than come and ask me. (As soon as I got home I remembered the meds, called work to tell her... she had ALREADY called the DON.) That night, I had an admission, a patient with no bowel sounds, a patient actively dying that needed a physician's order for pain meds, and I was the senior nurse working with two "new" nurses that had less than a year's nursing experience. Overwhelmed is an understatement.
I work in Tennessee, and yes the acuity level is getting more complicated. In LTC the average nurse to patient ratio is one nurse to 30/35 (on 3-11 shift). For the 11p-7a shift there are 50 patients to one nurse). Of this group, there can be patients that are: Total Hip replacements, Post CVA, ESRD, CHF, Alzheimer's, Post MI, etc. There were patients there that weighed over 300 pounds. It was myself and two CNA's to look after these patients. Most had to be fed by staff, and assisted to the bathroom, or were incontinent.
Where I was employed was also for PROFIT. The frontline staff was stressed to the max, forced to work overtime, and still having more, more, more added to the "to do" list. No, it's not safe, no....patients don't get the quality care they need and deserve. As long as healthcare is "for profit" there will continue to be this conflict. Managers are given bonus pay for keeping their respective departments under budget. The food served is portioned by the spoonful, and needed supplies go unordered. DON's and ADON's along with the rest of Administrative staff get promotions, bonus pay, and incentives to keep frontline staff to a minimum, while adding more and more work and responsibility to us.
Since Tennessee is a "work at will" state, you can be fired for something as silly as not smiling at the right time, or for no reason at all. We have no collective bargaining power, no representation, and no voice. Yet we are supposedly the "patient advocate".
As far as "ratio" when talking about nurse/patients, the "powers that be" have figured out how to get around that one long ago. The law is based on "nursing hours" to patients, not actual nurses per shift to patients. Thus, all those "management" nurses that "work" day shift have their hours counted. This includes the ADON, DON, Nurse managers, MDS nurses, Restorative Nurses, TX Nurses, Skilled Care Coordinator, etc. The hours they work, PLUS the nurses that are actually working the floor are added together. This amount is then averaged among the shifts and patients. Looks good on paper! No one seems to notice that most of these "nursing hours" include nurses that never touch or see a patient.
This is almost across the board for every LTC facility. I'm ashamed to say that the largest "for profit" LTC corporation has it's Headquarters in my hometown. Hundreds of office and administrative staff work in several of the largest buildings in town. Suffice it to say millions of dollars are made, while the frontline staff are left begging for equipment, supplies, all the while being paid an income far below what the Administrative staff makes.
Fair? Not in any way, shape, or form. The families that think their loved ones are receiving care based on what adornments the facility may have are being deluded. All those smiling faces in the front offices see prospective admissions as another dollar, NOT as someone needing nursing care.
While I'm expressing my frustration here, anyone got any comments on how Physical and Occupational Therapy Departments are operating on the "legal edge"? By that I mean charging for therapy given to medicare patients that could not possibly benefit from the therapy. I've seen therapy employees whisk patients with kidney infections, pnuemonia, to "therapy" and have them sit in the corner, or toss a ball. I've seen patients with contractures in both upper and lower extremities (that have been present for years) be rolled from one side of the bed to the other, and medicare is billed for "therapy".
It's all justified by using the correct coding, and taxpayers are footing the bill. Reporting does no good, all the "correct" paperwork is there. Physical Therapy assistants, (the one's tossing the ball) make more than frontline nurses with 17 years experience. PT Department heads have even made the statement...."WE are the one's that bring in the money to this facility".
This is what it's become, MONEY.. FOR PROFIT, not healthcare!