The Elderly Are Devalued - page 4
by TheCommuter 9,142 Views | 44 Comments Senior Moderator
During the many years that I have spent browsing these forums, I have noticed a common theme regarding the preconceived notions that many people in healthcare have expressed about long term care (LTC) and the elderly population... Read More
- 8Aug 15, '12 by PMFB-RNFor starters, I have observed that LTC is sometimes viewed as the specialty of last resort for newly graduated nurses who cannot seem to secure employment anywhere else.
*** Exactly as it should be IMO. I just hate to hear when a new grad is unable to find employment in acute care and must seek work in LTC. Not cause I devalue the elderly, but cause I value the grads. LTC nurses usually work alone. The grad misses the chance to spend her first year or two learning the ropes from her more experienced co-workers. She also misses the chance to rapidly gain experience dealing with conditions and situations she will face throughout her career.
I would rather see the grad move on the LTC after spending 2-3 years working in a supportive acute care envirment.
- 3Aug 15, '12 by RH-CC2011The elederly may be devalued, but we all-too-often see the elderly with chronic conditions as having "done it to themselves." Other at-risk populations like children and special needs are viewed as "innocents."
(In the Hospital) I see all sorts of seniors in renal failure, chirrosis from a lifetime of drinking; diabetics who eat like crap and ususally have sugars @200 that wonder why thier leg wound won't heal; 40-pack-year smokers w/ COPD that can't get to a bedside commode w/o desatting; stroke victims that quit taking BP meds years ago because it fixed them. I could go on and on, but I'm sure I'm also guilty of not taking care of myself too.
I would be much more afraid of the patient ratios in LTC than I would be the "stigma" of becoming labeled a LTC nurse.
- 4Aug 15, '12 by not.done.yet GuideI will not consider working LTC but it has nothing to do with undervaluing the elderly and everything to do with how much care they need and how the corporate, profit driven nature of nursing homes leads to being understaffed. I don't think I could stand the stress.
- 3Aug 15, '12 by IowaKarenAnother barrier to the "they are just old" mentality is when the ER doc's, on-call doc, and even their own Doctor has that mantra and it takes biting bullets to get them to listen to you over the phone. DNR does not mean do not treat and I just hate to use the famous quote "but the family wants them to go the ER," and after repeating that 3 or 4 times when they aren't giving me a viable order for someone that does have some quality of life left, they will finally give me the order to transfer. Our ER kits don't have everything we need in them and suffering is just not an option while I am in charge. I wish there was an easy answer to keep facilities staffed better and I do think if reimbursement better, it may not go to increasing staff. It may just line the owners pockets more. Not every place is like that but I would bet more than most are.
- 2Aug 16, '12 by ElSeaQuote from PMFB-RNGreat points! Thank you, I'll keep that in my mindFor starters, I have observed that LTC is sometimes viewed as the specialty of last resort for newly graduated nurses who cannot seem to secure employment anywhere else.*** Exactly as it should be IMO. I just hate to hear when a new grad is unable to find employment in acute care and must seek work in LTC. Not cause I devalue the elderly, but cause I value the grads. LTC nurses usually work alone. The grad misses the chance to spend her first year or two learning the ropes from her more experienced co-workers. She also misses the chance to rapidly gain experience dealing with conditions and situations she will face throughout her career. I would rather see the grad move on the LTC after spending 2-3 years working in a supportive acute care envirment.
- 6Aug 16, '12 by cienurseI couldn't agree more!! As a Director of Nurses in a SKILLED NURSING FACILITY, the job of orienting and providing clinical experience to new graduate nurses has fallen upon us. Every new grad, with no exceptions, has spent exactly one year in my facility, learning time management skills, medication pass, complex treatments, IV's, tube feedings, central and portacath line maintainence, etc. Then off they go, with a year of experience under their belt, to work in a hospital where "real nurses" work! I have been in long term care for most of my 36 years in nursing. I have seen nursing homes go from places where people went to die to places where people come to LIVE, get well, go home, be active-all the things that used to be part of hospital med-surg units. Health care has mandated that doctors can no longer decide how long their patient stays in the hospital, that patients with the same diagnosis are allowed the same recovery time, for insurance purposes. Thus, the advent of 'Skilled Nursing Facility" as an adjunct to the hospital med-surg unit, where patients can go to continue their recovery and to receive SKILLED NURSING and rehab services. Long Term Care is a legitimate nursing specialty, and not on the low end of the spectrum, particularly with the baby boomers now heading into the ranks of elderly, the need for more nurses who are "specialized" in long term care will be needed!
- 2Aug 16, '12 by cienurseUnfortunately, the media has painted a picture of long term care as always neglectful, terrible places where the elderly are abused and mistreated. Not every nursing home is like that. You can make a decision on which nursing home to apply to by going on the CMS website "Nursing Home Compare." There you will see the results of the nursing home's annual Department of Public Health survey (yes, they come unannouced every year!) There is also a 5 star rating report, which will tell you how the facility ranks, by its survey results and quality measures that are assessed the the facility on a quarterly basis. Do yourself a favor, take a random tour of one or two of these nursing homes, after reading about them on the nursing home compare site. You can do this without an appointment, just walk in and ask for a tour. And don't be afraid to ask about survey results, quality measures, and 5 star ranking should you decide to go for an interview. Good luck in your search and don't let the horror stories in the media poison your mind to long term care!
- 5Aug 16, '12 by TXregisteredninjaI agree wth this entire post 100%!! I was a LTC nurse for 1.5yrs and I know all about the attitudes/views from other nurses that we get.....However, recently I applied for several jobs in the hospital setting (due to management not my pts ) and soooo many Nursing Directors, during the interviews, would say "Now I have to warn you, there is a large elderly population in this facility. So you will have a geriatric pt load at times..." All I can say is....Thats where I came from, and thats what I'm good at! At least geriatric pts come from a time when you appreciate things ppl do for you.
I recently went from an LVN and transitioned to an RN and let me tell you, all of the students there are like, "Oh I want to work with the babies or something to do with kids, they're so cute!" You know, when children are neglected/abused they are strongly advocated for and something always gets done, but what about my geri pts with no family, who become wards of the state....what happens to them?? People like me step in and get things done....we have to take care of our elderly because what we do is viewed by OUR children as the right thing to do!! And I personally want my kids to look back and say, it was an honor to take care of my mom in her time of need.
- 3Aug 17, '12 by aknottedyarnOne thing I have not seen, but may have missed while skimming this thread, is the fact that nurses who care for the elderly have frail patients, quickly changing situations similar to peds. Dehydration is so common and yet under reported. Nurses have to have great assessment skills and know what is normal for this person who has survived the ravages of time. They may have a chronic CHF that if listened to once and not looking at the whole picture will send the patient to the ER. I have seen this happen.
Many of our elders need a bit more time to tell their histories. They have some confusion, or lots of brain damage, or perhaps they are used to stoically facing physical problems of the aged. It may be hard to tell their stories.
In many cases the ability to think clearly or speak clearly is impaired or gone. At that point the nurse becomes even more of a detective and I often thought of myself as smilar to a vet. Not that I compared the elders to animals, I compared the need to understand non-verbal communications more clearly.
I wish elders here were more valued. It really is up to those of us who love geriatrics to call people on their attitudes and behaviors. I have seen many unnecessary heel breakdowns coming from acute care because they did not think about how sensitive the skin of an elder is or use booties, etc. When nurses start talking about "GOMERS" we need to speak up and address the wisdom coming through the doors, not just the problems of skin tears and rollling veins.
Great thought provoking writing from all.