Advocacy for Elderly

Nurses Safety


I have been a hospital nurse for seven years

and recently took a weekend charge position

for a long-term/skilled facility. I have

47 patients, and 3, sometimes 2 CNA's and a

Med-Tech for four of the twelve hour night


I am apalled at this situation. If one issue

of great concern occurs with one patient, my

whole night and routine is rocked! The main

concern is for these folks' safety and our

responibility to provide quality and digni-

fied care. I am researching the legis-

lative and regulatory bodies in my state,

however would appreciate any feedback from

others in this situation. It is truly sad

when we really think of those who suffer the

most....not us over-stressed nurses, but those who are supposed to be recieving the

care that their facility markets as being of

high quality. These folks pay $3000-$5000

dollars a month for their well-being. Little

staff and scarce supplies only reinforce us as to where the money is going. There have

been nights when I haven't even been able to see all of my residents in one shift. I can stop here as everyone has heard the story.

Appreciate your feedbacks and experiences.

Hi Cameron. I just read yesterday that some US legislators are presenting a bill that would provide for LTC funding. We both know that LTC needed money yesterday. The problem, as you pointed out, is that the people who need the funding will never see a dime of it if the bill passes.

Take comfort, if you can, in knowing that LTC is not the only area in industrial chaos although LTC has been overwhelmingly problematic for years. There is no setting that I know of today that is immune to the vicious cycle of exploiting illness (patients and their families) and making a killing in profits which greatly interferes with safe, quality patient care. Most LTC facilities that I'm familiar with are run by large management companies with alot of overhead. This creates havoc on staff and especially patients. I would be curious to know if the conglomerate owned LTC facilities are better run than the smaller ones. I know government managed LTC facilities are the worse.

I believe that there is alot of ignorance and even apathy on what to do with older people who are not able to stay in the mainstream of things. LTC facilities unfortunately are like jails, in that they are not set up to truly rehab people or at least help in giving an older or disabled person the highest quality of life possible. This would require a change of mentality and even more funding.

I work in a long term care facility in Florida. On the 11-7 shift there are two nurses in the facility. One has 60 patients and the other has 40-60 patients. There are 6 CNAs for these 100-120 patients. You are right...One incident throws the entire night off... At least Florida has passed new legislation requiring increased staffing in LTC January both CNA and nurse staffing ratios will be increased.... But on the 11-7 shift, this will just mean 1 more nurse. No increase in CNAs. CNA staffing ratios are scheduled to increase at intervals over the next 18 months...but it is only the one time increase for nurses....people love to talk about poor staffing and yet don't want the money allocated to improve staffing...I work for a not for profit organization...and truthfully staffing is worse now than when we were managed by management company...


I just got home from work. Some time in the wee hours of the morning, I sat outside and cried. Like you, I have almost 50 patients and two aides. I had two patients last night, on opposite ends of the building, who were reported to me as "dying, checking out, on their way." Thats been my "report" all week. - and every night this week there has been one portion or another or several of their care not being done on the shift prior to mine. - Continuity of care, provision of comfort measures..I think administering meds and i.v. fluids per d/o's fall under that, doesn't it? Except I come in to find pain meds not given, pumps shut off or i.v.'s never started. Upon reporting this I have been informed that I LOOK too hard for something to complain about, always trying to get someone in trouble. - It really isn't that difficult to "look" to see an i.v. pole at a person's bedside and wonder a.) why its there, because you weren't told about it in report, and b.) if its there, why isn't it running, and c.) if it isn't running, why does the chart say it is and has been for sometime? - and if I don't report it, then doesn't that make me an accomplise after the fact? But if I do report it then I'm a trouble maker.

THIS is the cause/affect relation to the nursing shortage, the decline of the nurse's stature, and the pathetic pay rate we receive. Suddenly the job requirement for caring for the elderly and infirm is no more than a warm body with licensure. No need to embelish on that one to answer the frequent question of "why are so many choosing to put away their nursing licenses?".

As for my two patients, they were still alive when I left. For their sakes, I hope they don't wait for me to come in tonight.

If you go over to calnurse you will see an article about this very problem. The journalist writting the article advocates that an RN be on duty every shift in every nursing home. That puzzles me because it makes me wonder what he expects one RN to do with 100 to 120 patients. About 4 years ago a very idealist new grad that I knew stayed at a nursing home where conditions were bad. She fought management daily for better staffing and patient care. When the facility was sited for the bad conditions they served her up as a human sacrifice and suspended her. They hid behind her license. A practice I have mentioned here several times. Lucky there was no action taken before the board. Which brings me back to the question of what the writer of the article expects from one RN.

The nursing care for long term leaves little to be desired as A RN 19 years in practice, Med Surg, Ortho-neuro, Closed Head Rehab, Some Peds, and Long term care! I have seen the profession slowly deteriorate. The staffing issues will never be what they should until the nursing profession speaks up for these poor lost individuals and changes the rules. We can only do this in numbers united and no one wants to take a chance on losing their jobs or be discredited in front of their peers. The care that the elderly are getting today is shameful! and our Govt. should be ashamed for enforcing the rules and guide lines by which we must preform our duties leaving no time for the reason we all became Nurses to begin with. I will never give up my license , or give in . If I can bring comfort, or a smile to just one poor for forgotten soul a day I feel I have at least accomplished something I have encountered all of the problems mentioned in this thread and then some! It is our responsibility to speak-up and speak out against the people that are making the ridiculous rules that are leaving these poor souls to survive on their own, only the strong survive. We need more hands to give the proper care these people deserve, and we need them now not five years from now! Aniela

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