And, on the 5th day, "Behold, the mighty gods of state!"

[guest042302019, BSN, RN]

Wait, don't do that, because if state finds out. Okay, so we're going to double pad normally but don't when State comes. State doesn't allow that. You're not following state's rules. I hope state doesn't come this week. You'll probably be questioned by state. Here's a review sheet of what to say and not to say to state. Get residents up early but when state comes. It's okay to do this, that, or the other, but when state comes.

Ad nauseum...

Our facility is awaiting the dreaded review of state. The above examples are extreme but sometimes, the harsh reality of LTC nursing? I'm not referring to my facility per se but I have heard of such circumstances. I'm fresh out of school as I have been working in LTC for about 5 months now. Our facility encounters similar problems that you all seem to have. Staffing. Pericare. Employee dissatisfaction. Gossip. Likely unnecessary infections. Turning. Skin issues. Among others. Take your pick.

However, I'm constantly being reminded of state. The almighty. Firstly, I didn't get much of an orientation when I first started. I was given a few days and then thrown into it. I told the DON that I could handle it. And, for the most part, it's been okay.

I didn't, however, get much of a primer on state regulations. Now that I've been flooded with the continuous fears of state showing up, I'd simply like to know more about them. I started to research my state's rules and it's dense, super boring, and very confusing.

I would like to think that rules and regulations would be more accessible. I also know that the previous thought is seemingly too logical for regulatory bodies to grasp (Not just health care bodies). Any suggestions out there?

I guess I'm thinking out loud but I'm slightly tired of the paranoia. If one does there job, there shouldn't be anything to worry about. However, that's where the pickle is. Under-staffing=burned out, short-cut taking, tired employees=poor care=resident suffering=State fines. Again, I know this to be an extreme but it seems to be the harsh reality.

Money seems to be of greater importance than giving a busy shift an extra nurse or god forbid, an extra aide. I've learned very quickly that nursing homes are no picnic nor an environment to be able to practice textbook, quality nursing care. But, I haven't given up. I'm still hanging strong.

I thought I was writing about the big brother state. I've found myself rambling. I

Ultimately, I try my very hardest to work with what I've got. I try to rally my employees, care for my residents (compassionately, morally, ethically, legally), and follow the rules. But, it seems there isn't enough time in the day so what will I have to sacrifice. Inevitably, something. Unfortunately.

P.S. A majority of my job is enjoyable. I love my residents. It's the financial, regulatory, and bureaucratic garbage that is something I've yet to come to terms with. Maybe I should pray to the almighty gods of state?

[NurseNightOwl, BSN, RN]

I feel the same way. All I hear is "This place will get your license," etc. I'd like to know examples of nurses losing their licenses for things other than narc diversion, specifically in the nursing home environment...