Am I Babysitting or Supervising?

Working in rural areas has its challenges, especially when working in a long term care facility in the middle of nowhere. Nurses General Nursing Article


  • Specializes in Public Health, Teaching, Geriatric, M/S.
Am I Babysitting or Supervising?

Working in rural areas has its challenges, especially when working in a long term care facility in the middle of nowhere.

I was a new RN grad and full of enthusiasm, even though I was in my late thirties. As I scanned the local job listings and word of mouth jobs, I came across an ad for a Unit Manager in a small nursing home 30 miles away from my home. I thought well, it couldn't hurt to apply even though my only experience was 14 years as an LPN at that point.

I made the call and was surprised to find out it that the DON was a person I had worked with years ago, she hired me on the spot! I hadn't even taken my board exam yet. Talk about pressure!

Well, I started out fine and oriented with a great BSN who taught me a lot. It was a busy little place with a memory care unit that was always full with a waiting list a lot of the time. The facility was known for taking the "tough" patients that other facilities would not take. Somehow, they did well and the staff worked well in that area. The general area was a different story.

One of my jobs was to make out assignments for the aides, 2 to a group. Sounds pretty straight forward right? At least I thought so. I was not told of the "rules" when I made out schedules for a week. It turned out that 2 aides only worked one wing together because separately, they were the meanest pair of women you could meet! They did good patient care though. So when I tried to put them on separate wings, you would have thought that the world ended. The tough part was they didn't just bring this to my attention; they screamed and hollered like children! I calmly adjusted the schedule and told them to relax, the world was not over. Lots of grumbling went on about that for a day or two.

Next, I found out that the PM schedule was not "expectable" either by the aides' standards because I had put a female aide and a male aide together that had slept together before and now they can't work together because he will ignore her all shift. What? I have to know who slept with whom before making out the schedule. Are you serious? This type of bologna went on and on because it was allowed. But it gets worse.

Some of the PM shifts I was working in my office and noticed that several of the teenage aides took many breaks, sometimes to the point where they were outside more than working with the patients. It turns out that there were a lot of "herbal" breaks going on. I couldn't believe it; even one of the LPN's on the med carts would join them from time to time. I was blown away.

I complained, I confronted, and I wrote people up, nothing changed. The administrator would get close to the young caregivers and they would talk her into letting them get away with it. The DON was completely disconnected and couldn't confront anyone. I was so frustrated!

The last straw came when one of our patients that was completely unable to move or speak was found on the floor with a large gash in his head. Luckily, I was on that evening and heard his feeding pump beeping. I found him on the floor beside his bed; tubing pulled to the limit, drenched in sweat, probably moments away from a heart attack, in a large pool of blood. I found out that they had just done rounds and it was obvious he had been repositioned so poorly that he fell out of bed. Thank God that feeding pump went off or he would have been found dead.

I reprimanded these aides after I gathered all the information, wrote them up and gave them a 1 day suspension; I wanted to impose a more severe suspension but the administration said no. The capper was when the union rep chewed me out for "embarrassing" them in front of the other staff, and I had no proof of their negligence. I am usually a pretty calm person, but I "freaked" out on this person, reminding her of the potential liability of the facility to give good competent care to all residents and how I was tired of the behaviors that were tolerated there. Are you kidding me? 1 day off for almost causing a man to lose his life because they were too busy rushing to go on break or take the time to make sure he was safe? Good lord! I resigned.

I know that the facility has improved greatly since then, and state has watched them very carefully. I feel I learned a lot in my nursing career from that experience, and will never allow myself to get in a position such as that again. It is no wonder that there is a nursing shortage; I had an ulcer from working there not to mention anxiety like I have never felt before. I even started smoking after quitting for 16 years. Talk about getting thrown into the fire! :smokin:

Public Health Nurse with 19 years of experience in Public Health, Teaching, Geriatric, and M/S.

7 Articles   35 Posts

Share this post

Share on other sites


68 Posts

Specializes in Mental Health, Emergency, Surgical.

Good for you for standing up for yourself and your patients. At least you had the strength to do that and to quit when the situation was untenable.

It would probably be you that lost your license before the DON did. That place sounds like a joke!

Specializes in School Nursing.

A 'herbal' break?? If that means what I think it does, that should have been grounds for immediate termination. The liablility that place was carrying letting that take place was ridiculous. This is peoples lives for crying out loud! :(

Doc Lori, R.N.

6 Articles; 135 Posts

Specializes in Dialysis,M/S,Home Care,LTC, Admin,Rehab.

I'm still trying to get over "expectable". Kudos to you, over and over again.

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

I can't believe these situations actually exist.


4 Posts

Specializes in ms,cardiothoracic & neurosurgery post op.

I can see why you took up smoking again. I've never smoked, and felt the urge to start after reading your story. Hope you find something more suitable. I suggest a med surg unit in a nice hospital. Good Luck!


53 Posts

Specializes in CHN, MH & Addictions, Acute Med, Neuro..

Wow. That is absolutely terrible.

I am glad to hear you have left.


129 Posts

I can see how that situation would be scary. But as an LPN with 14 yrs of exp.-you felt none of the those 14 yrs helped

you? I'm sorry any nurse would be in that position. I'm just surprised you would state it that way. When you meet people

do you count your 14 yrs as an LPN plus ur BSN as being a nurse,or just ur BSN.


14 Posts

I've seen too many places like this unfortunately.....


17 Posts

I have been nursing several years and have heard and seen more of the things you describe than I wish too at several places-------then on the other hand there are many caring people and facilities who do not tolerate this action and reactions-----as I get older and childern leave home or unable to care for aging parents this is what we (I) have to look forward to ----high price long term care facilities and the ones for less monies on the month-appears to make no difference in care when it comes to basic needs-------after a person reaches a cerain age bottom line is "Its a Me Generation---out of sight out of mind"----that's why the majority of people in the medical field mark themselves as DNR-------


11 Posts

Now U know why the DON was so eager to hire you! She could pass the buck to you, & obviously did not support U in the right decisions U made! This is happening everywhere, NH, hospitals & etc.


81 Posts

Welcome to the world of longterm care. At first glance we tend to blame the union but where I work there is no union and the same thing occurs. I blame higher up management who befriend the cna's and allow them to get away with almost anything. The bad thing is that their actions put residents at risk, gives us extra work, and put our licenses at risk. I have worked with good aids and that is because they were well trained, well paid, and higher management supported immediate authority above them. No matter what, one can't be in an authoritative position if one can't exercise the authority. Good luck.

Please sign in to comment

You will be able to leave a comment after signing in

Sign In

By using the site, you agree with our Policies. X