Will I ever get out of LTC or am I doomed?

iceprincess492 · May 31, 2012

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.

JZ_RN · May 31, 2012

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.

newrnltc · May 31, 2012

lol regarding decorations.. our place serves beverages in long stem wine glasses! O_o

hotflashion, BSN, RN · Jun 2, 2012

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.

CapeCodMermaid, RN · Jun 2, 2012

It's the business. If you think the hospital is any better go read the post that compares hospital nursing to slavery.

dtroia22 · Jun 11, 2012

Not all LTC centers are equal. I love my job. I love my residents. Yes it is stressful at times. Yes families drive me crazy sometimes. Yes med pass gets mundane at times. Yes the paperwork sucks. But those same problems exist in a hospital setting. Instead of passing the same meds to a greater number of people, you will possibly see the same type of patient over and over again. Instead of state inspectors breathing down our necks, it will be the Joint Commission.
I believe attitude is everything. I love that I can see the sunshine out the window at work, and open the window for some fresh air. I love that I can take residents outside and enjoy the sunshine (weather permitting, I DO live in northern MI. lol) I like seeing some of the same people all the time. On the other hand, I wouldn't mind if some of my patients moved to a different part of the building! I love that its more of a home environment and not so sterile.
I live for, and cherish, the shifts were I get everything done on time, can help my CNA's out, document everything that I should and have a chance to spend more time with my residents; more than just "here are your dinnertime meds." Mostly the good shifts outweigh the bad shifts. I think we tend to remember the bad ones.
Maybe LTC really is not for you, and that's fine. I just hate that it gets such a bad rap constantly and hospitals are made out to look like heaven. The grass may not always be greener.

I am so glad someone thinks like I do! I graduated a year ago and wanted to work in the hospital, or so I thought. Got a job at a LTC center to "get some experience first" and have not, and do not intend on leaving! I love my residents and their families! They have become sort of an extended family! My kids love to go visit my residents on my days off and as much as I like days off, I miss my residents when I'm not there! Not all people are cut out for LTC. Of course there are the difficult residents (i still strongly believe its all in how you approach them, talk to them, and your attitude) and the annoying family members (who can be your greatest advocates if you keep them informed), but overall, I can't picture myself anywhere other than LTC! My mom tells me all the time this is what I was meant to do because since I was very young I have always loved the elderly. If LTC is not for you, please, for you, and most importantly, the residents, find something else! Your residents can sense your attitude, stress, and frustration, even when you think you hide it well, and this greatly affects their moods, behaviors, and mental well-being! Not all LTCs are like the nightmares and horror stories you hear about!

hotflashion, BSN, RN · Jun 11, 2012

The OP would rather work in a hospital; or she thinks she would. As a new grad, I too, thought I would rather work in a hospital. I was certainly educated to think of hospital nursing as the goal. The unfortunate part of this story, from my perspective, is that the OP may never find out that LTC nursing can be rewarding because she's having such a bad first experience.

It may not be possible for the OP to find another job. Nursing jobs for new grads are very scarce in the 50 mile radius I call home and from which I will not be moving. Appalling working conditions seem to be the norm for nursing. I hope the OP learns from her experience such that she makes improving working conditions a lifetime career goal.

Do your best, treat the new nurses you work with the way you wished to have been treated, and never become complacent about actual working conditions.

JZ_RN · Jun 12, 2012

I am not saying the hospital job is what I want, I really just would like to do something where I can care for patients in a SAFE manner. That is all.

litbitblack, ASN, RN · Jun 16, 2012

Rather than feel like you are doomed look for oppurtunities to obtain the experience you are looking for in an acute care facility. Nursing is nursing and you WILL find those same type of patients where ever you go. Maybe try applying for some type of prn job at your local hospital. See if they have an internship you could participate in. You certainly do not need to stay where you are not happy.

JZ_RN · Jun 18, 2012

lilbitblack- I appreciate the honest and non-rude response. I actually have just resigned from my LTC job since I got a clinic position. I could not take the unsafe staff-patient and nurse-patient ratios, lack of supplies, unhelpful and abusive management, rude MDs who couldn't care less, senseless rules, and felt that safe patient care was more important. I am so excited to leave a care area where patients are not being given the care that they could be receiving because of budgets and lack of staff and supplies. We were overworked and treated with disrespect and no one deserves that. I hope that place improves for the safety of the patients and the sanity of the nurses who are stuck there still. But I was not going to risk my health, well-being, mental state, license, and livelihood to continue working there.

MySonIsAdorable · Jun 19, 2012

I hear this a lot from my friends who work in LTC, I personally feel like if that's where I end up while I continue my education then I will take it and smile...because regardless of where you go outside of pediatrics you will be dealing with geri patients... I hate to say it but I agree I wouldn't want a nurse thinking about my Grandmother like that.

Maybe you just have too much to handle, sounds like you are overwhelmed and need to find a job where you will have less patients, have you tried looking at smaller nursing homes in your area? If you really want to be in a hospital then keep trying, keep learning, know what you are talking about. A mentor told me a few days ago actually that "if you end up in a nursing home then keep up to date with whats going on in the hospitals" continue to learn outside of what is going on with your patients you see everyday...Good luck.

JZ_RN · Jun 19, 2012

These people become upset when their elderly parent or grandparent declines as is what happens with age. They hardly visit. Some of the people with the worst behaviors are because they don't want to be there. They could live at home if they had a caregiver but their families dumped them there. They don't get the meds they need cause their families won't pay for them. They're upset. I don't have anything against the residents. I just had too many to deal with and not enough help. Which is why I left LTC and got a different job.