I hate LTC. I hate it with an undying passion. I truly feel if it were my only resort I'd just leave nursing altogether.
In my experience, my patients were not "stable".
I never had proper supplies let alone hand sanitizers.
Orientation was pointless ( 2 eight hour shifts and ur on ur own)
The charting was redundant to the point of sheer ludicrous.
Everything was on paper and then expected to be transcribed to the computer.
Hours were watched like a hawk for fear u go over.
You never left the med cart.
The MARs are illegible.
The meds are disorganized and u are encouraged to steal from other resident's supply to fill an empty med slot for another resident.
Med pass should be but a medium chunk of the day, not all of it. If I were actually at my computer and not in my iPhone I would write very precisely every thing, in detail, that is wrong with many LTC settings.
The environment is toxic and leads to... No, encourages poor nursing care.
On a side note, this has only been my overall impression of LTC from observation and experience.
I look at LTC centers where LPNs are few to none and the staffing seems much better. Get this.... In a pediatric LTC center for rehab (and some hospice) there were no LPNs, but instead an all RN staff and QMA's who passed meds. The RN approved PRN meds for the QMA, she did all the charting, VS's, assessments, and treatments. The RN never had more than 8 patients at a time.
Now why are the RNs making more and doing less? Why are her patient ratios so much smaller? Why does she have someone dedicated to med pass so she can do the appropriate work required of her position.
I, an LPN, had to deal with brand new strokes straight from the hospital who were total care pts. Ppl in recovery for post op open heart, ppl who would regularly be placed on bipap (srsly), and ppl with god awful infections of varying kinds and at least half are on IV vanc and merripenem (!!!) thru their PICC lines. How am I supposed to deal with meds, new admits, treatments, ADLs, blood draws, daily weights, accuchecks, more meds, and spontaneous colostomy seepage when I, an LPN am responsible for 16 patients and btw, WHERE is the foresaken handwashing station!!!!!????
That's not even that bad. My friend went to a diff LTC center for her LPN to RN critical care clinicals and some dude was on Levophed- and he was awake!!! Seriously, the same "levophed leave 'em dead" stuff. This is the kind of stuff LPNs have to deal with in LTC.
Yes yes- someone is going to say that isn't the typical LTC experience. That is correct. Many LTC facilities hold are not SNF's, or rehab, etc. it's just an elderly, frail, person who needs a little guidance and reminder to take all their meds- but that has not been my experience.
And working in the ER, when I get report from a LTC nurse, it generally results in a lot of eye rolling. Seriously who continues to give Norco's for a fever to a dialysis pt and then wonder why she's become lethargic. /facepalm
I hate LTC. I feel very strongly on this subject and believe "hate" is sufficient to convey the amount of contempt I have for LTC.
God bless all the nurses who work there because I cannot.
Sorry this tangent kept going on and on