A nursing home with no nurses.

[Thechilldude]

Hi, I'm new here and I just wanted to get your imput on my situation. I'm a cma, or med-aid. If you've never had the pleasure of working with one of us before I'll give you a quick rundown on what most med-aids do. We generally pass medication, do treatments, check blood-sugars and all those other little time suckers. Generally we try and make a nurses life easier.

I work in a very small facility with 5 full time residents and up to 7 respite patients. As you might imagine our turnover rate is a nightmare, and I'm responsible for the paperwork and everything that comes with it on up to 7 addmissions and discharges a week, and I work nights! We only have 3 Nurses on staff and those aren't going to be replaced when they leave.

Essentially the managment is attempting to run a nursing home without actually having any nurses, now we do have access to nurses from another building on site, but actually getting ahold of one to come over is very hit and miss.

any thoughts or suggestions?

[OCNRN63, RN]

And so it begins! The beginning of the end of the nursing profession. Doomed to go the way of high button shoes.

And nursing is caving in without even firing a shot.

Again, I will say, go to the people who will be impacted by, "make believe nurses". Get this out to the public and the news.

Has anyone even mentioning replacing teachers in our public schools, with inlicensed teachers aides? Why not? Because teachers have always belonged to strong unions, and stick together. And they go righ to the parents when they are being bullied by their administration to shortchange the kids .

Yet, no one ever died because they could not do long division, diagram a sentence, or recite the Gettysburg Address. But patients all over are hurting by having unlicensed, uneducated, individuals, taking over the professional practice of RNs. This is a no brainer. Get out there and make a big stink. Make the facility cringe with the embarrassment of what they are trying to pull on the patients/residents, that they are legally required to provide the appropriate professional staff. It is a non negotiable item. Period.

Call the papers and the news stations. Give em hell!

JMHO and my NY $0.02

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

I agree, although without teachers we wouldn't have nurses.

[DoGoodThenGo]

Hi, I'm new here and I just wanted to get your imput on my situation. I'm a cma, or med-aid. If you've never had the pleasure of working with one of us before I'll give you a quick rundown on what most med-aids do. We generally pass medication, do treatments, check blood-sugars and all those other little time suckers. Generally we try and make a nurses life easier.

I work in a very small facility with 5 full time residents and up to 7 respite patients. As you might imagine our turnover rate is a nightmare, and I'm responsible for the paperwork and everything that comes with it on up to 7 addmissions and discharges a week, and I work nights! We only have 3 Nurses on staff and those aren't going to be replaced when they leave.

Essentially the managment is attempting to run a nursing home without actually having any nurses, now we do have access to nurses from another building on site, but actually getting ahold of one to come over is very hit and miss.

any thoughts or suggestions?

Just to be clear do you work in a skilled nursing (nursing home), LTC or assisted living facility.

One asks because federal and local laws regarding staffing of skilled nursing homes (especially those that are reimbursed by Medicare and or Medicaid) are pretty clear. Even the worse nursing home owner under such circumstances wouldn't have a place totally without RNs and LPNS. How they staff them is another story.

You say your facility has three nurses currently and there aren't plans to replace them when/if they leave. Again depending upon how your employer is organized that may not be legally possible. What can (and often does) happen is a RN will be there but very high up the food chain. You might not ever clap eyes on her especially if you work nights, but look at the roster of management/administration.

Just finished watching the PBS/Pro-Publica program on Frontline about Emeritus Senior Living and strongly urge you to do the same. Emeritus Assisted Living Asks Employees To Do Damage Control After Frontline Exposé, Accidentally CCs Reporters â€" Consumerist

In short what is being asked of you is not only unique but a growing problem. A medication aide covered in the PBS piece was doing everything from direct patient care to being responsible for giving meds for a large population of seniors (who often had several Rx each) on an impossible time schedule and worse often with limited supplies.

She did complain both to her direct supervisors and corporate and responses varied from silence to "don't get caught". Finally they turned around and discharged the girl, who is now suing for wrongful termination IIRC.

As one state regulator for "senior facilities" put if off camera in the program; they don't lift up the rocks and look at what is going on with these places because they are terrified at what they will find.

Emeritus is not alone in being part of the really big money that is being made today from senior/assisted living facilities and they like current lax to nil regulations in place. Such companies also have deep pockets to lobby federal, state and local governments to keep things in their favor.

[jadelpn, LPN, EMT-B]

There is a huge difference between assisted living (where clients are independent, but just need some minor assistance here and there)and are usually private pay, and skilled care (which to be reimbursed the facility needs licensed personnell) and LTC (which usually divided into sections due to the needs of the residents).

Respite care is big business. However, you could get a respite care client who needs practically nothing, and one that needs full care. If we are talking a client needing a "companion" then a CNA could (and does) generally "journal" for the family as far as how the day went. If however, a client is total care, then it involves care beyond the scope of UAP's, can turn pretty bad pretty quick unless you have a plan of care--and unfortunetely, for profit organizations see dollars, but are short on sense.

[DoGoodThenGo]

There is a huge difference between assisted living (where clients are independent, but just need some minor assistance here and there)and are usually private pay, and skilled care (which to be reimbursed the facility needs licensed personnell) and LTC (which usually divided into sections due to the needs of the residents).

Respite care is big business. However, you could get a respite care client who needs practically nothing, and one that needs full care. If we are talking a client needing a "companion" then a CNA could (and does) generally "journal" for the family as far as how the day went. If however, a client is total care, then it involves care beyond the scope of UAP's, can turn pretty bad pretty quick unless you have a plan of care--and unfortunetely, for profit organizations see dollars, but are short on sense.

There you have it! Most of us here know the differences but the general public at large seems to be in need of education.

Many "assisted living" or "memory care" places will say on paper or to the media they screen applicants to those whom do not required skilled nursing facilities, but as the PBS program on Emeritus proved that is not always true.

Prime motive seems for many places to get butts in beds and keep them there at all costs. This makes sense when you consider many if not all these places are run as for profit ventures. Empty beds translates into lost revenue or the potential thereof. Emeritus's stock has been taking a hit lately as investors try to square what that company and others promise in performance, versus real conditions on the ground.

[Havin' A Party!, ASN, RN]

... any thoughts or suggestions?

Putting scope of practice and regulatory issues aside, I see great potential danger for residents, and huge liability concerns for you and the management. (I'll leave it there.)

[Havin' A Party!, ASN, RN]

I think it is very possible to run a nursing home with minimal nurses

Sure can... if you're not adverse to shouldering huge levels of risk / liability.

One significant event, and your life ...as you now know it... may no longer exist.

[Art_Vandelay]

...

Just finished watching the PBS/Pro-Publica program on Frontline about Emeritus Senior Living and strongly urge you to do the same. Emeritus Assisted Living Asks Employees To Do Damage Control After Frontline Exposé, Accidentally CCs Reporters – Consumerist

In short what is being asked of you is not only unique but a growing problem. A medication aide covered in the PBS piece was doing everything from direct patient care to being responsible for giving meds for a large population of seniors (who often had several Rx each) on an impossible time schedule and worse often with limited supplies.

She did complain both to her direct supervisors and corporate and responses varied from silence to "don't get caught". Finally they turned around and discharged the girl, who is now suing for wrongful termination IIRC.

As one state regulator for "senior facilities" put if off camera in the program; they don't lift up the rocks and look at what is going on with these places because they are terrified at what they will find.

Emeritus is not alone in being part of the really big money that is being made today from senior/assisted living facilities and they like current lax to nil regulations in place. Such companies also have deep pockets to lobby federal, state and local governments to keep things in their favor.

Just watched it...1.6 billion in profit/year. This is disgusting. I wouldn't be so appalled if the worker conditions weren't so awful. The reference to skilled nursing makes skilled seem better. Yeah right.

[thenursemandy]

And so it begins! The beginning of the end of the nursing profession. Doomed to go the way of high button shoes.

And nursing is caving in without even firing a shot.

Again, I will say, go to the people who will be impacted by, "make believe nurses". Get this out to the public and the news.

Has anyone even mentioning replacing teachers in our public schools, with inlicensed teachers aides? Why not? Because teachers have always belonged to strong unions, and stick together. And they go righ to the parents when they are being bullied by their administration to shortchange the kids .

Yet, no one ever died because they could not do long division, diagram a sentence, or recite the Gettysburg Address. But patients all over are hurting by having unlicensed, uneducated, individuals, taking over the professional practice of RNs. This is a no brainer. Get out there and make a big stink. Make the facility cringe with the embarrassment of what they are trying to pull on the patients/residents, that they are legally required to provide the appropriate professional staff. It is a non negotiable item. Period.

Call the papers and the news stations. Give em hell!

JMHO and my NY $0.02

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

Lindarn,

I happen to looove your $0.02

:)

[Gamboa411]

This is a sad situation that seems to be happening everywhere. This is being done by the doctors and non-nursing administrators that seek to increase profits for their organizations. I have gone to doctor appointments (for myself) and discovered that there are no nurses employed there. I had an issue with on of the MA s (medical assistant) care (he did not seem to know how to take a manual blood pressure and had to call in a fellow MA) Also he recorded a temperature of 98.1 when no temperature was taken. I was referred to "the supervisor" who turned out to be a "clinic manager" with a physical education degree. I eventually made it to the Director who turned out to be an EMT. I asked do you not have a nurse on staff?!! His response: "we don't need one". Ridiculous--in Texas, if there is no nurse present, the doctor takes the responsibility for medical/nursing practice. I was never able to talk to the doctor--he sent me the phone number of the "corporate office" who employed the MAs. Needless to say, I don't go to this clinic anymore.