LadysSolo 7,360 Views
Joined Dec 17, '06.
Posts: 355 (70% Liked)
I have had to explain to PCPs in the past that a LTC facility is the resident's home, and just like a home in the community, if the resident wants ice cream, pancakes with maple syrup, whatever, they can have it and we have no right to stop them (unlike the hospital where if it is not ordered they cannot have it.)
No, you are never supposed to be busy with another patient, you are supposed to make your patients think you have all the time in the world for just them. Some of my nursing homes that I go to DO post the number of nurses and STNAs on per shift. I think that's a good idea.
Revisiting a tired old thread, but as widespread and widely acknowledged as this issue, why are boards of nursing doing nothing about this?
I love the idea of old IV poles for watering plants (I have a collection of some orchids that would appreciate drip watering.) Maybe I will see if I can get a few at a reasonable price (better than them ending up in a landfill.)
I am very sympathetic - I have two home care patients that use a home physician service that recently stopped their pain medications and told them to go to pain management. One is 750+ pounds and the other is 350+ pounds, both minimally ambulatory (hence need of home visits.) How are they to GET to pain management? What are these people to do? No one wants the responsibility any more.
Nurses are always expendable in the name of CEO bonuses for cutting "expenses." We are not necessary, we are an "expense." I have heard an MD state that "trained monkeys can do the job of a nurse." (yes he is an a**.) But some CEOS seem to think this way also.
I am sad to see it hasn't gotten any better since I left the floor after becoming an NP. I worked oncology, giving chemotherapy and blood every night. 5 patients was best, 6 was doable, and if I was day 4 of my 4 day stretch and had already had the 6 patient for 3 days I could usually add a 7th (but it was REALLY hard) if I was already used to the 6. I was usually charge, and if someone had to be screwed, I preferred it to be me. We had one nursing assistant for the whole floor, thankfully they were excellent. They wanted to cut our staff more, I went to the hospital board and asked for someone to come follow us for a shift before cutting our staff. One board member came, and made it for 4 hours and left, saying no cuts would be made as he didn't see how we could do it with the staff we had. Success! (in a way)
State of Ohio says 1:50 is safe in LTC, I disagree. I did some agency for awhile, it was me and 2 STNAs for 48 residents, there was a 3rd STNA in the building doing laundry so they were allowed to count her. I believe 1:24 is safe if you know the residents, with adequate STNA staff.
Re: patient deaths, I had a medical resident tell me one time confidentially that hospitals have panels that decide based on usual lawsuit payouts how many nurses they can cut and save salary versus what they would have to pay out in a lawsuit. It is a cost/benefit ratio. All well and good unless yours is the family member who is expendable due to desire to cut nursing salaries. I believe it is the truth.
Being a nurse and now a NP, I will say I like the patient care/contact and the intellectual challenge of helping people, but I detest the paperwork (which only gets more and more ridiculous,) and the constant pressure from TPTB to do more and more with no increase in compensation.
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