Are most LTC's always low on supplies?

Specialties Geriatric

Published

I have been gone from LTC for 3 years. I remember there were always a shortage of B/P cuffs, oximeters, and other needed supplies. I had to bring my own B/P cuff because I could never find one available on the floor. The problem with that was that the CNA's would catch me using a B/P cuff and would ask to borrow mine. So I would feel sorry for them and loan them my B/P cuff but then when I would need it I couldn't use it because the CNA's had it.

Are LTC's still out or low on supplies these days? If you bring your own supplies, what supplies do you usually have to bring to work? Thanks.

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Specializes in Geriatrics, Telemetry, Med-Surg.

I think that's pretty typical. I started off in LTC, and had to supply my own BP cuff and thermometer. I didn't have my own pulse oximeter, but I wish I did, because they were hard to come by. We were always running short on all sorts of supplies; gloves, adult diapers, dressing supplies, etc. It was also next to impossible to get applesauce or pudding to mix with medications, so there were days when I brought my own pudding. I also brought snacks for the residents, because the dietary staff never remembered to bring them up for us. I can definitely understand your frustration.

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The one I work at is extremely cheap.. Private owned. 10 min of overtime is like committing a felony lol. I have my own stethoscope cause theirs suck. We have bp cuffs but a couple are broken so we have 2 or 3 for the whole facility, we do have our own pulse ox in each Carr which is good. We get snarky comments when we say we are out of tunes of calmo and dressing stuff like calcium alginate and firbrocol. A lot of Ltc places are in the same boat. I make due with what I have.

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Specializes in retired LTC.

I, too, have worked in LTC facilities that at times, had shortages of equip/supplies also. But I'm going to go against the grain and comment that many times I have witnessed gross abuses by the staff.

Yellow isolation gowns being worn by staff just because pt was incont. WAS NOT ISOLATION, just pooped.

Isolation face masks used just because of stinky BMs.

Disposable diapers and briefs squirreled away (ie stockpiled) in pt closets. Towels, washcloths and hosp gowns, esp too, with other bed linens.

Cans and cans of shaving creme and deodorants in pts' drawers (and the shower rooms!). Also incont care oints so there's none in supply. Etc Etc Etc. And what about -

Glucometer strips that DO NOT MATCH the programmed calibration chip; can't find any other supplies to match, so I have to waste the jar of $trip$.

Cracked gauges on BP cuffs (dropped on their own?) - not pulled aside for maint to replace the little glass faces.

Thermometers left at the bedside and then they take feet. Pulse oximeters too.

Boxes of dressing gauzes and tape rolls overflowing at bedsides.

Extra foley caths and insertion sets left at the bedside, not to mention duplicates & duplicates of specimen cups/tubes/'hats'.

Bottles of unopened enteral feedings, and cans of Ensures and Glucernas left unconsummed (not even opened) at the bedside. And when they are opened but still full, I wonder what the MAR and I&O's record.

'Waste not, want not" is for everybody else.... I could go on & on, but I feel like a voice in the wilderness...

I've had problems with edibles unavailable but I think the units' community pantries allow for supplies to be taken by visitors. esp peanut butter, crackers, SUGAR, teabags, coffeee packs, breakfast cereals, etc. I finally resorted to keeping a big box of cheerios and instant oatmeals as reserves for my early morning transportation appts and dialysis pts, clearly marked & bagged in the medroom.

On behalf of management, they can only buy just so much before it disappears because of waste and/or theft. Why do you think so much stuff is kept under lock & key, like in the kitchen and laundry??? They DO have a budget to follow !!!

A couple times a month, I'd have my 11-7 staff do a 'scavenger hunt', and I'd leave it for daytime mgt to see (with a private memo telling them where stuff was found). Next nite, we'd do a 'hunt' again, and I could better track the wastes.

So, I'm basically unsympathetic when staff c/o shortages. It's not just nsg and it occurs 24/7.

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Yes, that's not good to be wasteful either. That's for sure. I am wondering about there being no calmoseptine, calcium alginate and firbrocol.

Let's pretend that the state inspector arrives unannounced and follows the treatment nurse around the LTC facility. The state quickly discovers that there is no calmoseptine, no calcium alginate etc. etc. etc. Who would get into trouble in this case? Who gets the blame? The nurse or the LTC facility? Or let's pretend that the patient's decubitus ulcer gets much worse due to there being no calmoseptine, calcium alginate, etc etc etc. The family gets a lawyer and sues. Who would get sued? Who would be blamed? The nurse or the LTC facility?

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Specializes in retired LTC.
Yes, that's not good to be wasteful either. That's for sure. I am wondering about there being no calmoseptine, calcium alginate and firbrocol.

Let's pretend that the state inspector arrives unannounced and follows the treatment nurse around the LTC facility. The state quickly discovers that there is no calmoseptine, no calcium alginate etc. etc. etc. Who would get into trouble in this case? Who gets the blame? The nurse or the LTC facility? Or let's pretend that the patient's decubitus ulcer gets much worse due to there being no calmoseptine, calcium alginate, etc etc etc. The family gets a lawyer and sues. Who would get sued? Who would be blamed? The nurse or the LTC facility?

Think about your question ... if the State were to find nurse Abby on A wing was short tx supplies, and nurse Betty on B wing, and nurse Cathy on C wing, it is not an individual nurse issue. This is a facility wide problem and the facility would be at fault.

A Plan of Correction would need to be done. But first an investigation is needed to determine why the shortage. Has the number of wound tx using Ca alginate significantly increased so that now the supply hasn't kept up demand??? Who does the ordering? Has this info been communicated to him/her? Whose job is it to commun that info? A tx nurse? A nite nurse? Infection Control? Unit Mgr?

Nurses A, B and C just commiserating into the air to everybody, anybody, somebody and nobody just doesn't commun the problem to the right person. Now if the person responsible to monitor supplies (or to order supplies) has goofed, then that's a discipline issue. But if the facility deliberately didn't put the order in, that's where the problem is (uh, did they pay their last bill? LOL) What if the mfr has temporarily held up shipment - I remember one of our oints being on backorder. (Happens to meds too.) All those orders needed to be changed temporarily with a POS/TAR change. That's Problem Solving 101 from point A to point Z. And that's the burden of the facility.

And if there's wound deterioration, again the facility has to answer. But did everyone do what they should have? It is time consuming to investigate but that's the only way to achieve remedy while CYA. If the facility chooses NOT to use certain tx supplies, then why are tx orders still being written for something not to be used??? Most facilities use supply providers by contract or thru corporate approval, and these providers may or may not supply XYZ. Again like if I need a recipe ingredient Q and my local ACME doesn't carry it, I either substitute or I don't do the recipe. I can't do what I don't have from the sources I have!!!

I had freq problems with my diabetics bottoming out on 11-7. Turns out kitchen freq missed sending up HS snacks. CNAs couldn't give anything out if there wasn't anything sent up. So we kept detailed lists of dates and 3-11 would make phone calls as nec. I went so far as to write up disciplinary actions and left the names blank for the dietary mgr to fill out because his staff failed to complete their duties. Don't know if he ever used them but the situation got better. One time, I used our CNAs' union as leverage to solve a major on-going problem that violated their contract - luckily contract negotiations were coming up, so it worked!

I could continue .. but the point made is that you need to know WHY you haven't the needed resources. And you need to address it to the right people with the right information in the right way. (And I always kept copies.) If you've done this and the facility still doesn't provide, check the orders with the MDs; go to Plan C or plan D; or you may just have to move on. (I should tell you how a got one CHEAP CHEAP CHEAP employer to supply me GT equip that I wanted, but that's a whole other story about one really C-H-E-A-P place and this is enough for now!!)

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Specializes in Geriatrics.

In my facility, which is a county nursing home, nurses supply their own pens, highlighters, sharpie markers, penlights, and bandage scissors, although there is one resident with his own designated bandage scissors kept in his designated wound care bin. There are no flashlights on the unit because, the nursing supervisor told me, whenever they are provided, they "walk." I use my own stethoscope by preference. Fortunately our two Dynamaps each have a handheld thermometer on them as well, and we have one handheld o2 sat monitor for our unit. We have 50 residents on my unit, but about 300 in the whole facility. Sometimes it is difficult to find the handheld thermometers but we don't have a problem with theft of those.

We sometimes run out of washcloths by the end of the night but on other days there is a plethora. Large briefs are kept locked in the med room to make sure only residents who need them get them.

amoLucia, I appreciated your post about waste.

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We are also short on supplies, and short on people who will put them in proper place. We have all new cabinets and drawers for storing supplies. Whenever we request gloves or sterile water,etc. it is always brought to unit. It is never put away. I always find boxes of supplies that we are pulling supplies out of, even though there is plenty of storage space. Looks like abomb exploded in clean utility room. Things are just tossed everywhere. We used to have a staff person who monitored our supplies and knew what we needed and brought supplies to us before we needed them and took the time to put supplies away. That position was eliminated, and now it has been tacked onto another person responsibilities. We have a newly redecorated facility, but we are short on staff, short on supplies and short on organization.

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only thing i will bring is a stethoscope. if they want blood pressures, temps, cbgs.. on their patients, then they will get the equipment. I'll be damned if im going to absorb the cost of taking care of their patients when those costs are figured in to what they charge the insurance. that is downright trashy and greedy of them because they get bonuses for keeping their costs down.

im pretty sure there are rules and regulations that require them to have equipment that is in good working order.

and they are responsible for the cleaning and infection control of those items.....and in order to do that, they need to have possession of it.

i would drop an anonymous complaint to your state agency and see if that gets them up to speed.

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Specializes in ICU, CM, Geriatrics, Management.

Short Answer to the Question Posed: YES!

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Specializes in kids.

One would think that the $$ to buy supplies came straight from the purchasers OWN bank account....frustrating on both ends I am sure.

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Specializes in ICU, CM, Geriatrics, Management.

Agree, NH! :)

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