Assisted Living nurses - how do you protect your license?

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Am not sure where to post this...for nurses working in an ALF (NOT LTC)....I have a dilemma..I accepted a position at an ALF..in the past month since I've been there pretty much everything I was told in the interview has either changed or just not been true. One of the biggest issues I have is the aides are not certified, there is no other licensed nurse in the facility AT ALL unless I am there and the aides are the ones who administer ALL medication - including narcotics AND count the drugs. Almost everyday there is something wrong w/the count or a drug (usually xanax or Lortab) is missing..or a resident states they didn't get their meds when it's documented they did. There are also incident reports multiple times/week for various things...I won't go on but I have decided to leave this job. It's close, the hours work well for me, the pay it's great and it's only part time but...it was nice not to have to get up at 0400 for a 12 hr shift...however, there are not enough safety stops in place and I am really concerned about my license or getting pulled into something - especially knowing the state is already looking at other issues (before me) and some people are facing legal actions. I mainly want to know if all ALF are like this - no nurse other than a few hours/day with aides that are not certified aides counting drugs etc.

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Oh my goodness! I'm glad you've decided to leave. ...don't just walk away, RUN!!!

Not ALL assisted living facilities are like that, but some are. If you want to work at an ALF, try looking at some of the bigger ones that may have more RN's. You could also consider looking at some of the facilities that are assisted living, CBRF, and LTC all in one -- they will definitely have more regulations in place and many more RN's on staff.

I wish you luck in your job search!!

Amanda

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Specializes in LTC.

I work in LTC , If I had a dollar for all of the people saying that they did not get their vicodin at 1400 I would not have a mortgage. :)))))

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Specializes in Assisted Living Nurse Manager.

Not all ALF's are like that. I am the nurse manager and I have three LPN's and the rest are CNA's trained as med aides. We have very few med errors. I take the time to teach the importance of med administration and what the meds are for and so on. My aides also give narcs and count, but we do not have a problem with missing meds or residents complaining they did not receive them.

As far as protecting your license, you do the right thing, practice safely, train appropriately and pray for the best!

Doesn't sound like you are at a good place to work, I would move on but that is me. I wish you the best.

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Specializes in Cardiac.

I think ALFs work differently than other LTCF and obviously hospitals. I think there is a loophole for using unlicensed personnel for meds because it's not technically a "nursing facility." I could be wrong but I heard that somewhere...

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Thanks for the replies...yes, it seems there is a loop hole for the ALF's re: aides not having to be certified nursing assistants but I did find out those that pass meds and count them are required to go through an 8 hr med class before being allowed to provide/count meds/sign for meds when they are delivered by the pharmacy. Just really surprised by this.

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Wanted to update anyone who may be reading this...I have decided to resign this week. This facility, for my limited experience in this type of nursing, is too...disorganized. The head person never comes in when she says she will and there has been literally NO orientation of any kind - from paperwork to the computer - all of it I'm either "winged" or figured out myself. Meds are missing on an almost daily basis...I am just too concerned about my license to stay and knowing what the company is facing with the legal issues that happened before I started...I think more patients families will pull them and there are already wings closing because the census is so low. There is NO support in place - the people are nice but that doesn't run a business or provide quality care. I was so hoping this would work - it could be a great little place. :(

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I had wrongly assumed that all ALFs were State regulated.

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Gloria - I did too and after this experience I will not work another ALF in the state I currently reside. I'm sure they are all not run like this one but I am appalled and amazed. I was going to give 2 weeks notice but after yesterday and today...more meds missing, a patient missing, then found then more issues on top of that...I am no newbie to healthcare...I know there are bad days, good days and days in between but this facility REALLY has some issues and I am not willing to hang in there any longer. This place is a big fat lawsuit waiting to happen.

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Okay, I work in a assisted living...we have aids and caregivers too. I make sure my counts are correct at the beginning and end of my shift. I am covering my own butt here! I cannot worry about others, there is too much to be done when i am there for that. I cover my own butt though!

Documentation is a necesary thing to for this....I keep records when something is not right of my own so it does not come back to bite me on me that is.

Watch your back.....I have found my being a newly hired nurse at this facility that I don't have the aids' or caregivers watching my back....as I have theirs....but this I hope to change. They resent me being there and being their supervisor while there, but hey, if they would work, not sit on the rear ends I would not be so hard on them! Anyways, cya as usual!

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