LTCangel 6,368 Views
Joined: Nov 8, '05;
Posts: 85 (49% Liked)
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Hang in there! Unfortunately Nursing seems to have a lot of this kind of thing. It is very unprofessional and when you start a new job you will learn who you can trust and who you can't. Just hang back and stay to yourself for a while and keep it professional. Good luck and God Bless. Focus on your residents and you'll be fine.
I began my Nursing career 16 yrs ago in LTC. I worked as an LPN in a Nursing Home for 1.5 yrs and have always been grateful for the experience I gained from my fellow Nurses and CNA's. I also fell in love with my Geriatric residents. I was offered an opportunity to work in a local hospital and because it meant more money and better insurance for my family I took the job. I started in Float Pool and learned so many skills but eventually ended up on an Orthopedic/Med-Surg unit. I worked on this unit for 14 yrs. We used the direct patient care model and I mastered time management and many other skills. During this time I went back to school and obtained my ASN and became an RN. I remained on my unit and became a Charge Nurse, a Preceptor, and a Clinician. I also went on to obtain my BSN. During all of these years the main patient population I cared for were the elderly or the baby boomers. My favorite! Give me a 65 y/o knee replacement over a 20y/o car accident patient any day lol! Long story short, I injured my back and just could not do direct patient care anymore. I interviewed at, ironically, the same Nursing Home I had started my career in. It is a challenge each day I walk in that building but I love it! It is hard, it is tiring, management expects too much, but I love my residents. I know them well. I know when they are sick, I know when they are in pain, I can quickly assess them when they are in respiratory distress. I was afraid I would lose my skills but actually I use them each and every shift I work. My residents are like my family. Many of them have no family or friends to visit them. It is up to us to hold their hands, to give hugs, to comfort when they are ready to leave this world. Yes, there are those Nurses who may turn their noses up when I say I work in LTC but I am sure they would be glad to know that I and my skills are there if one of their family members was admitted to my facility. I am proud to be a Geriatric Nurse. Lisa RN,BSN
I have a 91 y/o man on my unit who has had a stroke and it apparently affected the "filter" in his brain and he will say whatever comes into his head very loudly because he is also very HOH. Every morning when he gets up he say, "Got any food around here?" I walked up the hall and caught him at my med cart, he had my bowl of applesauce and had taken the plastic lid off and was using it like a scoop to eat every last bite of applesause, lol! Later that morning I was told that when he was in the dining room waiting on his breakfast tray, he had began to bang on the table and yell. "We want food, we want food!" he managed to get a handful of other residents to join in and they almost had a riot on their hands! I love it!
I am an RN who works in a Nursing Home and yes I love it too. I do have my share of frustrations overall but they don't have anything to do with the residents. I have a family member that just obtained her CNA certificate and will be starting in a Nursing Home and I hope she loves it as much as you do. Thank you for your hard work and enthusiasm, it is refreshing to see.
I love this story because it goes along with my feelings about working in LTC also. I "cut my teeth" so to speak as an LPN in LTC for the first 1 1/2 years of my career and then went on to work in a hospital for the next 14. I remember when I started working in the hospital it took me a long time to stop thinking and worrying about the residents that I had left behind. They had that much of an impact on my life and had taught me some valuable lessons about compassion and caring for others.
I went on to obtain my RN and then my BSN over the years I worked in the hospital and thought that I would always work there. I also implemented simple touch, kind words, smiles, and yes hugs into my patient care when and where it was appropriate. I have never had a patient complaint against me. Circumstances beyond my control brought me back to LTC last year and I have had many mixed emotions about it. It seems that Nursing ingrains in Nurses that working in LTC is somehow substandard and a step back or down. I worried I would lose my skills and or that I would be wasting all of the education that I had so rigourously obtained.
I was hired to work on one specific unit and that suits me because I am a homebody and like to get comfortable in one place. I take care of 26 residents from 7-11 pm and then pick up both halls at 11 until 7:30 am for a total of 46. I never should have worried about losing my skills, lol! I use them everyday and then some. I am assessing my residents while I am talking to them, giving them their meds, changing dressings and so on. I am starting IV's, drawing blood, using and replacing g-tubes, changing foleys, straight caths, wound vacs, trach care and management, respiratory treatments, and the list goes on and on. Not to mention, talking to doctors, writing and transcribing orders, dealing with Pharmacy, taking care of family issues, supervising my CNA's and charting, charting, charting.
In the midst of all of this, this past year I have grown to love each of my residents for who they are. I have listened to stories from their past, talked about current events, calmed their fears, held their hands, dried their tears, given hugs, made their rooms safe by running off the imaginary dogs and cats, fed them, laughed with them,showed them pictures of my family and looked at pictures of theirs, and very skillfully managed to get their minds off of that husband, wife, or mother they just can't seem to find.
I have also had the priviledge of holding a hand as a special person left this world for the next and made it a more comfortable passing. There can be no greater priviledge. So now when someone says "I can't believe you are working in a Nursing Home again", I just smile and say "Yes I am and I love it." There are actually many opportunities that I can eventually take advantage of, because of my experience and education, within the LTC system. I don't know about any of that right now, I am just enjoying the moment.
I hve never been a CNA but I was an LPN before becoming an RN. The hospital I worked in for 14 years used a direct patient care model. I was responsible for EVERYTHING that my patients needed. That included baths, toileting, exercising, filling water pitchers, turning and repositioning, and meds, dressing changes, charting, IV therapy...the list goes on and on. We did have CNA's available to assist but not nearly enough and trust me I did everything all day long that my patients required along with admissions, discharges, calling doctors, carrying out new orders, and right down to answering call lights. I now work in LTC and am responsible for 46 residents on 7p to 7a. I really appreciate the CNA's that I work with and make sure they know it and I am not afraid to "get my hands dirty". But it boils down to this, the role of a CNA is within my scope of practice but the role of an LPN or RN is not within the scope of practice of a CNA. A CNA cannot pass meds, do treatments, dressing changes, tube feedings, trach care, nebulizer treatments, accu checks, IV therapy, blood draws, physical assessments, call the doctor, transcribe and carry out those orders, pronounce death, determine changes that require a resident to be sent to the hospital, etc, etc. I am also ultimately responsible for the care that the CNA's provide. In healthcare, we need to think of each other as part of a team that is working together to provide the best outcome for the patients or residents in our care and appreciate each other while we do it. Just saying...
How much orientation do they provide a new grad? If it's anything less than 6 weeks, I would negotiate that or walk. LTC can be very overwhelming for any Nurse especially an new grad.
I also work in a union building, mandating is alive and well and happens ever single day. Some days to more than one nurse on a shift or one nurse on each shift. There is not a pool of casual nurses to call and no one else ever answers their phones because they are all tired from working so many long hours on their regular days. The facility does not allow Agency nurses to be called for last minute call ins, only to cover holes that they know about 24 hrs ahead of time. They do give a 50$ bonus for anyone who has been mandated for "Supplemental Staffing". It can make a long 12 hr shift turn into a 16 hr shift in the blink of an eye and they do not do a good job of backing up their attendence policies so the same people seem to call in over and over again without fail. I can look at the schedule and tell you who's going to call in.
I worked Orthopedics/Joint Replaement in the Hospital for 13 yrs and now am in LTC. Always roll to the UNaffected side for hips as the above poster said, preferrably with a pillow intact to keep the hip from crossing the body and possibly dislocating. For knees also, to the uaffected side and support the leg so that the knee does not roll. Hope this helps!
Whew!! Please say a prayer for me! I have an interview on April 13th with my local County Health Department and am excited and nervous! I worked in the hospital environment for 14 years and have been in the LTC setting the last year. Public Health is what made me want to be a Nurse to begin with and at the age of 42, I am so excited for the opportunity for the interview and am praying I am what they are looking for. I definitely have all of the experience in all of the skills that Nurses do and one of my passions as a Nurse is actually being able to teach patients and their family members about their illness, injury or disease process. I hope they find I am a good fit. All prayers and advice accepted!!
In all of the places I've worked in WV benzos, Ultram and Lyrica have always been locked up. I don't really understand a place that doesn't since they are all considered controlled substances.....hmmm. I have read all of these posts on FM and can relate and understand, since I have been a sufferer for several years now and had a hard time finding a diagnosis and treatment. I finally found a PM doctor who knew EXACTLY how I felt and I finally was put on a treatment regime that helped. He also diagnosed my Chronic Low Back Pain that I had taken for granted for years. I worked for 14 years on an Orthopedic Unit in a hospital and did a lot of heavy lifting, pulling, pushing....you get the picture. After I filed for FMLA for the FM, I began to be harrassed by my NM for being 1 minute late or anything else she could dig up. I started there as an LPN, got my RN, then my BSN and stayed loyal to the hospital and the unit. I was fired last March. I was denied unemployment benfits. I'm sure that when other employers call them for a reference that they don't give a good one since I cannot seem to get any other job except LTC.
Then to top it all off my PM doctor was raided by the DEA and brought up on Federal charges that he was responsible for the deaths of some of his patients. They were never able to prove it but the State pulled his license anyway. So now I am back to sqaure one on looking for a doctor who believes in FM in my area. I am not on the correct meds and I am suffering in silence. I am working 12 hr shifts in a LTC facility and making less money but I don't have to do much lifting and I can sit at times for a while since I am on night shift. I am halfway through my MSN with a concentration in Teaching but had put a hold on it when all of this transpired as I have been suffering with severe depression and anxiety. Some days I just want to give up and quit but I am the main breadwinner for my family and also have to provide health insurance. Even with a BSN and 15 yrs experience in Nursing I am having a hard time finding any other type of job, I think it's because most of that experience has been at the hospital that fired me. I have a hard time not feeling ashamed for losing that job even though I did every thing in my power to keep it.
I just filed a FAFSA so that I can try to get back in school and finsh my Master's. Please say a prayer that this works out. The Nursing Home has been a good place to hide out and still get a paycheck but it also has it's very stressful moments and they believe in mandating staff to stay over to cover call ins so there are many times that my 12 hr shift turns into 16 and then I am down for all of my days off trying to recover. Sorry if this was long, but it feels good to tell my story and ask for thoughts and prayers my way. I am only 42 and even with FM and back pain I believe I am still a viable member of the Nursing Community. It has been my passion and who I am for a long time now.
Good luck and God Bless to all of you out there who are living with Chronic Pain, whatever the reason. May God Bless and Keep You.
Just lost my job of 14 years on the same Unit in a Hospital d/t this type of Manager. for many years our unit was run by 2 experienced RN's who had worked that same floor as floor Nurses before continuing their education and moving up to Management and they were wonderful! As mentioned above, there was nothing they didn't know or couldn't relate to. They always tried to help us figure out solutions to all the extra work that Upper Management would sling at us and there was always plenty of praise and respect to go along with the times when we had to have "those Unit meetings." The hospital removed them from us so they could help build a new computer system, promising to give them back...didn't happen. The next Manager was younger but still had experience and was cool to work for. She was an Army Nurse at some point but she ran a tight ship and was fair minded. She got called to Active Duty and got a job she loves ...so that was the end of that! Next came a woman who had the degree, had the connections in the hospital politically, and had been working in Management for many years as ADON of the hospital but never as a Unit manager in which she had to manage individual people and schedules and all the things that go along with making sure your staff are not only giving quaility care, doing a good job, but are also happy doing their job. Her background as a staff nurse had been 2yrs on PICU. My unit was a busy Orthopedics/Joint Replacement/Med-surg Unit. You couldn't ask her a question because she would give you a blank stare and say, "I'll have to ask." We were constantly getting threatening e-mails that had come down from those above her to work faster, harder, get out on time, no overtime, no clocking in even one minute late, etc. etc. Staff meetings became blame games. I was considered one of the Senior "Expert" orthopedic nurses. I have become ill with fibromyalgia and had been advised by my previous Manager to file for FMLA to cover myself if I need to call in when ill. When this new Manager took over, I was in her sights so to speak. It was as if she was stalking every move I made. Then the write ups started for being one minute tardy, abscences (even if covered by FMLA), you name it. Every one knows that if "they" want to fire you they will find a way. Well I told my coworkers, She is going to fire me before it's over. So I started really watching myself, trying not to be late, or call in no matter how bad I felt. One evening as I was getting report, I was pulled from my unit by another ADON and said I was needed upstairs. She was waiting for me...with my last paycheck. My last tardy had been due to a sping thunderstorm that had slowed down traffic and caused me to be 5 minutes late. I had called to say I would be late and instead of clocking in had wrote in the sign in book and had the Charge Nurse sign it with me as to what time I arrived. The end of the quarter was only 3 days away. Then the count would have started all over. Too late. I was gone, they even fought me and denied my unemployment. I had to face her again when I challenged it. I am still trying to get over the indignity I suffered. The complete lack of compassion and respect not just from her but the Hospital in general. I am sure if I hadn't had FMLA, I would not have been on the radar. I found out after I was terminated, that it was happening to a lot of nurses who had FMLA, esp. for vague illnesses that were hard to prove. I am now working in a Nursing Home again. Every hospital in the area I have applied to has never called me back because I'm sure I'm considered a no rehire. I am still trying to regain my self esteem. The total lack of powerlessness I felt. That place was like a "family" to me. I had worked with the same people for many years, and I still miss them. I took a huge paycut because I had my salary built up there to the point that no one in the area could ever match it. Could be another reason to get rid of me...the bottom line. I am a good nurse. My file always had excellent reviews, no pt complaints, no personality problems, I was always told that I was an excellent charge nurse and an excellent team member. It was only in the last year when I became ill that I had any problems. I am trying to be thankful for what I do have. I have spent months now in severe depression, anger, hurt, loneliness. Slave away, yes I did for many years to the detriment of my health. I also have the back of a 60 y/o and I am 42. Still trying to figure out where I fit into this world of Nursing...not sure. Sorry so long, your article opened a large sore spot that still hasn't healed. Thanks for listening.
On Night Shift where I work if there is a 3rd aide on the other LTC hall or on ours then they do a split, where they divide the total of both halls by 5 and one of them takes care of some residents on each hall and the others have to help answer her call lights if she is not on a particular hall at that time. Make sense?
I work 7p-7a in the same type of facility. From 7-11 we have 2 nurses on my unit which holds about 46 when full and we have 4 aids. At 11, I take over both halls as the nurse and I have 2-3 aids. I am responsible then for tx's, prn meds, getting paperwork for appts in the AM, assessing those who are sick, on ABX, or get sick and need sent out, and then the 5-7 am med pass for both halls. It is doable, sometimes there unexpected things that come up such as a fall or the like and then paperwork and computer charting has to be done. Also, we chart about everything on the computer now. Good Luck! P.S. during the dayshift there is a nurse for each hall (21-24 residents) and 5 aids. This is the LTC side. On the rehab unit they have 18-22 residents who are in acute rehab and they do have alot more charting that needs done, but they have 2 nurses on dayshift and one at night with 2-3 aids at all times. We also have Unit Managers during the day and ususally an RN Supervisor at night.
My grandmother recently passed and she had been ill over a period of 2 yrs with different things, but this last time she went to the hospital it was found that her gut had shut down and she was going into DIC. She told the docs she was done and she wanted to be made comfortable and go home to be with Jesus. She was a very Godly woman and she said she was ready. For the next 4 days, all of her children, grandchildren, sister, brother, and friends came to see her and allow her to tell them how much she loved them. The night she died at 3 am she called everyone who was there and told them it was time to say goodbye. As everyone gathered at her bed, she kept looking over her oldest daughter's shoulder and smiling and waving. My Aunt said, "Mommy who are you looking at?" She said, "Jesus, can't you see him, he's standing right behind you?" Shortly after, she slipped into a deep sleep and began the death rattle and died a short time later very peacefully. I can't think of a better way to go
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