It's The Grim Reaper, Charlie Brown

Because you're a good nurse and you care, that's why you feel guilty. Don't. We can't help anyone if we run ourselves into the ground. My biggest fear as a nurse is that I'm going to be so tired after doing "fill in" shifts that I make a mistake -- miss a lab, don't check behind a CNA who wouldn't tell you if someone's BP was 4/2. So when I start feeling all guiltridden, I just remind myself how much worse I'd feel if something went wrong because I was too tired to notice it.

So just do this when they call you to come in:

No need to feel guilty. Don't get me wrong, I love my job [usually] and I love my residents - but I also realize that I can't be there 24/7. You are a fantastic nurse and you will be even better if you enjoy your time off and return to work refreshed and ready to go!

Good for you!

It's important to reinvent ourselves many times throughout our lives and careers. Necessity often spurs that, and looking back I know that I've developed other skills when changes in employment (and the times) happened for me. Flexibility is a great asset, and survival skills and attitudes help, too. There will be more opportunities opening to us with the changes that will be made with Universal care. It's essential that costs are conserved, and less recovery time will be spent in hospitals, utilizing more home health services.

Making a guess, I imagine the families of prospective residents have decided that staying at home is less expensive than paying LTC facilities' rates. They can have home health care which may be sufficient to prevent conditions from occurring or to worsen. Certainly it's easier on elderly patients' minds, to stay in familiar surroundings, having friends, relatives and neighbors visit them. Home cooked meals arer usually appreciated.

It is especially important that families realize, especially those who live in large cities (and not so large ones) that
having sturdy locks to pevent criminals from entering homes of elderly people, who could do them harm. If an elderly family member lived with me (I don't have any)I'd place the monitor used to listen to babies, in their rooms at night. Fluids for them are very important, as you know, especially in hot weather. That teaching needs and many other topics must be addressed when residents leave LTC facilities, to live in their homes.

One of the first things home health nurses do, upon starting their home visits, is to assess possible sources of injury there, and recommend changes such as removing scatter rugs, etc. Enterprising nurses might want to start their own businesses to assist with needs of these patients, such as cooking and feeding them meals when their
family and friends are at work, or otherwise unavailable.