Will I ever get out of LTC or am I doomed? - page 4

by JZ_RN

11,145 Views | 53 Comments

I am a newer grad. Graduated last summer. Only job that even gave me a chance is LTC/sub-acute rehab. I hate it. I want a hospital job, desperately. Even a clinic, anything but this kind of nursing. All I do is pass meds, do... Read More


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    Iceprincess492- I love each and every one of my residents, it's the work environment I despise, so get off your high horse and stick your judgment where the sun doesn't shine.
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    To the OP.....
    It seriously sounds like you're suffering from burn out. I hope you get time off soon so you can take care of yourself as well. If we don't take care of ourselves, we can't take care of others. Our pt/residents DO sense the stress and frustrations that we all have when we get burnt out (and we've ALL been there at one time or another no matter what setting we work in) whether we feel we are hiding it well or not. Dementia pts pick up on this VERY well and they will act out because of it!
    I love working LTC and wouldn't change my setting! However, I understand you're frustrations all too well!!! Unfortunately with the economy all healthcare facilities, including both LTC and hospitals, are cutting back on staff. I left my last job because they not only were cutting back on staff, but were admitting the most acute pts and expecting us to do medicare assessments, change of condition assessments (there were many days that I had literally 15 full assessments), 2 admissions, a discharge or two, 6 different IVs, a tube feeding or two, 15 treatments/dressing changes, 2 med passes, new MD orders and taking care of the crashing resident, the fall, the low BGT, the new skin tear, etc all in 8hrs. I think you get my point. Its places like these that you need to do your best while your there and look for something new.
    One thing I encourage you to do is really concentrate on your assessments. You actually can gather a lot of info in a short amount of time. It is in LTC that you will really learn to hone into those assessment skills as you are literally the eyes and ears for the MD. It is YOUR assessment that gets the residents the care they need. There is no MD in house to come check out a resident when things start going wrong. I also find that in LTC you do learn a lot about many different disorders/illness. And you get to see the disease in progress. many times start to finish - You can learn A LOT from this.

    I wish the best of luck to you! I hope you find your niche. Don't count LTC completely out - there are good facilities out there!
    Pat2012 likes this.
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    Quote from JZ_RN
    Iceprincess492- I love each and every one of my residents, it's the work environment I despise, so get off your high horse and stick your judgment where the sun doesn't shine.
    JZ-RN Thanks for the advice but I prefer to keep my judgement where it is. As long as I am able I will continue to make sure SNF residents are treated with the dignity and respect they deserve. If that means that I'm on a high horse then I hope my horse only continues to get higher. Some day you will realize that the way you really feel about your job is quite clear to the residents you supposedly care for and again I say they do not deserve someone who feels as though they are a "glorified babysitter" caring for them. They deserve a nurse who enjoys caring for them and sees them as something more than a way to pay their bills until something better comes along...
    NoonieRN, CapeCodMermaid, and egglady like this.
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    As a New Grad I know you are full of the pee and vinegar to get out there and cure the world, I dont mean that viciously, but the trend of Baby Boomers coming into full swing into the Nursing homes in coming years is going to be a major Job demand in this area for nurses of all ages and backgrounds. The aged are difficult. however if you are finding yourself impatient on this job, what are you going to do when you hit the other field you are interested in. LTC takes MAJOR patience, self control, and the ability to NOT get annoyed with the people because they are old, have dementia and very sick. Afterall, think of it this way. I know you are young now and believe me enjoy every minute of it, but your own aging process will catch up to you one day and you will realize how vital and necessary you as a nurse is needed for these people. We are all getting older. If you feel that deeply about being in the backseat(LTC) dont be. IT is a steppingstone. The elderly in the US are not looked up and respected like they should be....they are the reason we are all here today living in a free country. But, if you honeslty hate the LTC scene by all means go to another field. Being Happy in nursing is vital to your peace of mind and contentment for the profession.
    iceprincess492 and Elsie20 like this.
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    I am not annoyed with the patients, though their behaviors can be frustrating. I am annoyed that I have 50 patients and no assistance and am always the whipping post for the doctor who refuses to return phone calls and the managers who want us to spend 3 hours checking carts for expired tylenol instead of patient care. I love my residents. I hate my work environment. if you cared so much about your residents, you'd be angry at the situation as well, so seriously, your judgment is unwarranted. If you want to be on a high horse, get on the same one as me and expect decent ratios and levels of care for these residents, not more abuse for nurses and higher profits for nursing homes at the nurse and patient's expense!
    hotflashion likes this.
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    If anything, I feel guilty that I cannot spend time with them because I do care about them, but with 50 people and constant med pass, angry families who don't know what's going on, and admissions who scream, kick, punch, spit, pull hair, throw poop, etc., when can you spend any time with a patient besides a few pills or a dressing? My original post was from a point of rage after a horrible night. Maybe you work in an ideal nursing home but I've found that the nurses who are content with sub-par care are really the ones the patients do not deserve. Please think about the fact that you are okay with this ridiculous assignment, what does that say?
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    Quote from JZ_RN
    I am not annoyed with the patients, though their behaviors can be frustrating. I am annoyed that I have 50 patients and no assistance and am always the whipping post for the doctor who refuses to return phone calls and the managers who want us to spend 3 hours checking carts for expired tylenol instead of patient care. I love my residents. I hate my work environment. if you cared so much about your residents, you'd be angry at the situation as well, so seriously, your judgment is unwarranted. If you want to be on a high horse, get on the same one as me and expect decent ratios and levels of care for these residents, not more abuse for nurses and higher profits for nursing homes at the nurse and patient's expense!
    You are apparently not well informed if you think that nursing homes are making any profit right now. The government has cut the funding so much that many nursing homes will be out of business within a couple of years. If the nursing home industry didn't care about their residents they would not try to run them as financially responsible as possible. If they are out of business then they are unable to care for their residents at all.

    Your managers want you to look for expired tylenol in the med cart because the surveyors who come to your facility from the State that you live in will look for expired Tylenol. Any citation you receive from your state agency is public information. When people are looking for a nursing home for a loved one they will research on line and choose a nursing home with good surveys. If you have poor surveys you will not get residents which will lead to not getting any reimbursement from the government which will lead to nursing home closing which will lead to residents not getting taken care of. So, as you can see it is all a vicious cycle and you should not assume that your managers do not care about the residents, they are probably acting as responsibly as possible to assure that your residents continue to have a home. Again the managers are more than likely doing what they have to do have a successful Nursing home. The fact that they are still there shows that they do indeed care about their residents because believe me they could could find easier less stressful jobs than they currently have.
    CapeCodMermaid likes this.
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    Where I work they are making profit, and they spend money on frivolous things like it is going out of style. And I know expired meds are bad for state surveys and can harm patients, I'm not an idiot, but why should we spend hours doing that instead of patient care. We actually had a perfect survey last time, but managers are still adding additional tasks and pointless rules onto the nurses that take away from patient care. For the staff, the work environment is miserable, and even our PRNS never want to take shifts. Then managers end up working and making mistakes and they struggle worse than any of the regular staff, but still have no care for us and how hard they are making us work when they add extra senseless things on, like, make sure the wheelchair footplates are scrubbed underneath, and, make sure you spend time putting in all the doctor's orders when he/she could do it themselves and save transcription errors, especially since some get mad when you call EVER to clarify or ask a question or even worse, just don't answer the phone whenever you call. The ratios- staff to patient are dangerous and if our managers cared about the residents they would push for more nurses on the floor and less for decorations and other unnecessary things like they do.
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    lol regarding decorations.. our place serves beverages in long stem wine glasses! O_o
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    If a facility is run for profit, then they are making a profit, regardless who is paying the bill, or they would not be in business. It's my opinion that there is a serious, inherent, conflict of interest when healthcare is provided by a for-profit enterprise. The bean counters should be watching out for costs but the focus should be on care, not cost. In a for profit structure, the focus is on cost.

    I work in assisted living and while my working conditions are not as bad as the OPs, we are staffed to a minimal level, such that any call out is a catastrophe. People get fed up and don't stay long, so every other employee is a new employee. We cannot give the residents the care they deserve and for which they pay. There is no time for thoughtfulness, it's just do it as fast as you can and hope you do not make a serious mistake. The working conditions stink. I looked up the book mentioned by one of the writiers (Reality Shock: Why Nurses Leave Nursing) and it's not available, not even at the library. Sounds like a good read.

    To the OP, just keep looking for a better job. Perhaps you can find a job in a hospital transitional care unit, and from there move into the hospital proper. Perhaps you have surgical centers in your area? Perhaps a job at a rehab hospital. Or, a specialty hospital? What about a specialty area, e.g., wound care?

    Good luck, and never become complacent about the working environment you find yourself in.


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