Re: Warning to New Grads

Just like any other industry, when there is an abundance of workers, if you leave there's always someone to take your place. In my area, when there aren't enough "home grown" nurses, or the "home grown" nurses won't work under the conditions present--the facilities import from other countries (does great things for our working conditions [sic])
Not all facilities are run this way, but it tends to be the rule rather than the exception for skilled facilities. There are some places that are nice to work.
of note: JCAHO visits are not without warning

Re: Warning to New Grads

Originally Posted by Spartacvs

The first thing that comes to mind is that all Ive heard have been horror stories except for one DON who sounds like she does the right thing for her staff and patients. Where are the other good stories? Is the system that broken? Why isn't the working popualtion in these facilities shouting out at the top of their lungs? What are the whistleblower protections, if any? Where are the unions in all of this? Aren't unions supposed to protect the worker from these very issues that are being described? When JCAHO comes through are they blind to the understaffing? Are they acting just like the Fed not seeing Madoff right under their noses? Why do you jepordize your license? Why do you jepordize the patient by not doing required V/S before passing meds. Work off the clock to finish your work *boggle* don't call me naive but that is wrong in so many ways. You are ENABLING the institution to get away with it.

If you are being abused and don't stand up to it you are allowing the abuser to do it to someone else.
Thats wrong!

Who is standing up for your rights as workers? Where is the nursing loby in Washigton? Who's calling JCAHO to tell them about the deplorable conditions? Does anyone from JCAHO subscribe to this website?

You know, there are some who might read your comments and call you naive. I don't. I like and admire your passion and I hope you never lose it.

Sometimes the system can break even the best of us. Many people do blow the whistle only to find that nothing gets done. They feel broken and that their efforts to change things are futile. Others are intimidated and become so afraid of retaliation that they say nothing, even putting their licenses in jeopardy because, by their inactions, they are colluding with the abuse. Some find that they, too, have to cut corners at times and feel guilty because they know they aren't delivering the best care they can. Being chronically understaffed---or improperly staffed due to acuity---can wear a nurse down. Not delivering good care can make nurses distrust themselves or their gut instincts. They begin to think they're bad nurses and not worthy of working in a better facility. They become burned out and part of the problem.

Sometimes, when you take a stand, you run the risk of losing your job. You can even run the risk of becoming unemployable if you're thought of as a "troublemaker". I have seen people who will shut up and put up with workplace abuse---like the practice of making nurses work off the clock---or the whole CYA mentality of covering up mistakes so the department of health won't find out. All because they've been sufficiently threatened and are worried about losing their jobs. Whistle-blower protection should be a given but often it is not, partly because the state agencies are also underfunded and understaffed---or they have to wade through so much bureaucracy that nothing gets done.

Then again, I have asked myself, what kind of person would I rather be? Would I rather stick to my principles and risk unemployment or would I rather put up, shut up and work in an environment that causes me tremendous moral conflict? Having no money is no fun, but I'd rather be poor and principled than be part of a system that perpetuates workplace abuse and cuts corners on the delivery of safe, adequate nursing care.

If you continue to stick to your principles and try to make a difference, you may often feel like Don Quixote, chasing windmills and pursuing an impossible dream. Then again, you could end up becoming a nurse leader someday, in a position in which you can make positive change. You can be like the good ones here on AN. Noc4senuf is one; CapeCodMermaid is another. I'd work for either of these effective, conscientious nurse leaders in a heartbeat.

Trying to be an agent of change is hard work---it's especially hard when one is trying to deal with the stresses and rigors of being a nurse in any setting, not just LTC. I think many nurses don't bother to join their state nursing associations or the ANA, not only because of cost but because they don't have the time. And then they become frustrated because ANA does not represent their interests. It's a self-perpetuating cycle and the only way I see to make change is to become active in nursing organizations. If you don't like their politics, try to be a voice for the opposition. At least you will have made yourself heard, even if you don't change things right away. You can also look at legislation that affects nurses, particularly those that affect nurseatient ratios. If you agree with it, write to your legislators. If you don't, write to your legislators. Know what's going on so you can be part of the solution rather than the problem.

Now, the current job market is tight, particularly for new grads, and it seems to be worse for many AD grads and LPNs. Many ADNs and LPNs find themselves working in LTC, even if that wasn't their first choice, simply because they're having trouble getting hired by hospitals. That can put you in a bind; unfortunately you will find more abusive practices in LTC than in acute care settings, though crap happens in the hospital as well. Should you find that you need to work LTC as a new grad, make sure to check the previous state surveys of the institution at which you are considering applying for a job. The state surveys will tell you a LOT. What kind of deficiencies did the institution get? Have any resulted in actual harm to residents? If there are repeated deficiencies related to bedsores, for example, you might steer clear because that might indicate poor staffing; same for repeated falls. If there are deficiencies related to dignity issues, again steer clear. If a facility is not respecting resident rights, you do not want to work there. Talk to people who are employed at a facility---not just the nurses, the CNAs and other staff as well. If they consistently report feeling burdened or give you a strange look when you ask if the facility is a good place to work----it isn't. Run. If a facility has had such serious deficiencies that it has lost its ability to admit Medicare patients---even temporarily---run. If you are told upon interviewing that, as a new graduate, you will be in charge, doing staff development, management or MDS, run. You will not have time to just become used to being a nurse before being expected to take on a role that really does require more expertise.

Spartacvs, some folks who read your post and my answer are going to write us both off as idealistic. I don't think being idealistic is necessarily a bad thing and I hope to remain idealistic until the day I die. Continue to stand up for yourself. Ask questions. Be involved. You are doing the right thing and I'd be thrilled to have you as a co-worker, a student or my nurse.

Re: Warning to New Grads

Originally Posted by zebsmom2002

Just like any other industry, when there is an abundance of workers, if you leave there's always someone to take your place. In my area, when there aren't enough "home grown" nurses, or the "home grown" nurses won't work under the conditions present--the facilities import from other countries (does great things for our working conditions [sic])
Not all facilities are run this way, but it tends to be the rule rather than the exception for skilled facilities. There are some places that are nice to work.
of note: JCAHO visits are not without warning

Curious, just wondering which part of the country are you in that are still importing nurses from other countries nowadays? Maybe Texas or Okaloma? Most places used to import foreign nurses 4, 5 years ago, but not any more. The bills that are trying to give foreign RNs more visa numbers have failed a couple of times. I guess had there been a real shortage of nurses, that bill would had been passed already.

Where I'm, lots of LTC are not hiring new RNS either, they want experiences.

Re: Warning to New Grads

California

Re: Warning to New Grads

Maura:
Once I read your last sentence, it made more sense; AGE DISCRIMINATION. I have no doubt that it is real and restricts choice, at the onset.
Good luck.
Genie

Re: Warning to New Grads

Originally Posted by Moogie

You know, there are some who might read your comments and call you naive. I don't. I like and admire your passion and I hope you never lose it.

Sometimes the system can break even the best of us. Many people do blow the whistle only to find that nothing gets done. They feel broken and that their efforts to change things are futile. Others are intimidated and become so afraid of retaliation that they say nothing, even putting their licenses in jeopardy because, by their inactions, they are colluding with the abuse. Some find that they, too, have to cut corners at times and feel guilty because they know they aren't delivering the best care they can. Being chronically understaffed---or improperly staffed due to acuity---can wear a nurse down. Not delivering good care can make nurses distrust themselves or their gut instincts. They begin to think they're bad nurses and not worthy of working in a better facility. They become burned out and part of the problem.

Sometimes, when you take a stand, you run the risk of losing your job. You can even run the risk of becoming unemployable if you're thought of as a "troublemaker". I have seen people who will shut up and put up with workplace abuse---like the practice of making nurses work off the clock---or the whole CYA mentality of covering up mistakes so the department of health won't find out. All because they've been sufficiently threatened and are worried about losing their jobs. Whistle-blower protection should be a given but often it is not, partly because the state agencies are also underfunded and understaffed---or they have to wade through so much bureaucracy that nothing gets done.

Then again, I have asked myself, what kind of person would I rather be? Would I rather stick to my principles and risk unemployment or would I rather put up, shut up and work in an environment that causes me tremendous moral conflict? Having no money is no fun, but I'd rather be poor and principled than be part of a system that perpetuates workplace abuse and cuts corners on the delivery of safe, adequate nursing care.

If you continue to stick to your principles and try to make a difference, you may often feel like Don Quixote, chasing windmills and pursuing an impossible dream. Then again, you could end up becoming a nurse leader someday, in a position in which you can make positive change. You can be like the good ones here on AN. Noc4senuf is one; CapeCodMermaid is another. I'd work for either of these effective, conscientious nurse leaders in a heartbeat.

Trying to be an agent of change is hard work---it's especially hard when one is trying to deal with the stresses and rigors of being a nurse in any setting, not just LTC. I think many nurses don't bother to join their state nursing associations or the ANA, not only because of cost but because they don't have the time. And then they become frustrated because ANA does not represent their interests. It's a self-perpetuating cycle and the only way I see to make change is to become active in nursing organizations. If you don't like their politics, try to be a voice for the opposition. At least you will have made yourself heard, even if you don't change things right away. You can also look at legislation that affects nurses, particularly those that affect nurseatient ratios. If you agree with it, write to your legislators. If you don't, write to your legislators. Know what's going on so you can be part of the solution rather than the problem.

Now, the current job market is tight, particularly for new grads, and it seems to be worse for many AD grads and LPNs. Many ADNs and LPNs find themselves working in LTC, even if that wasn't their first choice, simply because they're having trouble getting hired by hospitals. That can put you in a bind; unfortunately you will find more abusive practices in LTC than in acute care settings, though crap happens in the hospital as well. Should you find that you need to work LTC as a new grad, make sure to check the previous state surveys of the institution at which you are considering applying for a job. The state surveys will tell you a LOT. What kind of deficiencies did the institution get? Have any resulted in actual harm to residents? If there are repeated deficiencies related to bedsores, for example, you might steer clear because that might indicate poor staffing; same for repeated falls. If there are deficiencies related to dignity issues, again steer clear. If a facility is not respecting resident rights, you do not want to work there. Talk to people who are employed at a facility---not just the nurses, the CNAs and other staff as well. If they consistently report feeling burdened or give you a strange look when you ask if the facility is a good place to work----it isn't. Run. If a facility has had such serious deficiencies that it has lost its ability to admit Medicare patients---even temporarily---run. If you are told upon interviewing that, as a new graduate, you will be in charge, doing staff development, management or MDS, run. You will not have time to just become used to being a nurse before being expected to take on a role that really does require more expertise.

Spartacvs, some folks who read your post and my answer are going to write us both off as idealistic. I don't think being idealistic is necessarily a bad thing and I hope to remain idealistic until the day I die. Continue to stand up for yourself. Ask questions. Be involved. You are doing the right thing and I'd be thrilled to have you as a co-worker, a student or my nurse.

Amen. You wrote exactly how I was/have been feeling. Since I quit my job at SNF, I've been looking for other places to work with no leads so far. I've also been feeling like maybe it was a bad idea that I quit, but as you said here:

Would I rather stick to my principles and risk unemployment or would I rather put up, shut up and work in an environment that causes me tremendous moral conflict? Having no money is no fun, but I'd rather be poor and principled than be part of a system that perpetuates workplace abuse and cuts corners on the delivery of safe, adequate nursing care.

That pretty much summed up everything for me. And that's why I left. Before I did so, I informed the DON of all the issues and concerns I had during my experience, but as she said, the blame is on Administration...
It's hard trying to keep your head up when right now it just feels hopeless...

Re: Warning to New Grads

Originally Posted by Little_Mouse

Amen. You wrote exactly how I was/have been feeling. Since I quit my job at SNF, I've been looking for other places to work with no leads so far. I've also been feeling like maybe it was a bad idea that I quit, but as you said here: That pretty much summed up everything for me. And that's why I left. Before I did so, I informed the DON of all the issues and concerns I had during my experience, but as she said, the blame is on Administration...
It's hard trying to keep your head up when right now it just feels hopeless...

You are not alone. Remember that. I have found so much support here and it's truly helped.

I think I would have given up on nursing had it not been for AllNurses.

Re: Warning to New Grads

All of the poor conditions described on this thread happen to "seasoned" nurses, too- not just new grads.
That's the way nursing is. Now you know the real reasons for what was formely known as "the nursing shortage"- poor working condtions and not enough time to properly care for human beings- and nurses getting out.

Re: Warning to New Grads

i just want to share this line
"don't let anyone make you feel that you don't deserve what you want" .
stay strong guys!*

Re: Warning to New Grads

Well said Valerie