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