Can you really change a bad LTC?

Specialties LTC Directors

Published

I worked in acute care and truly wanted to change to LTC, but for the last six months it has been crazy! I shed many tears shortly after taking my LTC job as I was not trained as promised and my corporate boss did not get along with the person training me at my LTC facility. The place was and still is chaotic with staff not caring about a darn thing! I was basically stuck in the middle of two people not wanting to train me - it was the "other one's job" so I ended up training myself. I've come to truly care about many of the residents so that has made me want to stay. My place is part.of a big LTC company. I had hoped to be able to move up the chain as I have my RN BSN MS, but to no avail. I think with all the garbage going on, and no one in Corporate truly knowing all the facts, I may appear to not be doing very well in my position when in fact it has more to do with the facility than my ability.

The last state survey was terrible; one of the worst in the state. No one seems to care and want change. There is a new DON. She is nearing retirement, just wanting to hang out until she does retire and has no interest in making change. Any problem she is confronted with is brushed off. The new administrator (probably about the 4th one in the past year) sits in his office all day talking to his girlfriend on the phone; never leaves the office to check things out, talk to staff or residents. There's tons of issues going on but if anyone speaks up they are viewed as a trouble maker.

I really feel like I want to speak with the VP about these issues, but know I will probably lose my job. I'm fed up with keeping my mouth shut. I want change and believe these residents deserve it. Does anyone have suggestions? I've only been in LTC for a short time; maybe this is more the norm than I expect, but I hope not! Thx.

Specializes in LTC, Hospice, Case Management.

What is your current position.. I assumed DON until I read your comments about the current DON.

Specializes in Gerontology, Med surg, Home Health.

It IS possible to change a 'bad' facility to a good one but you need a team. I've been the DNS is several facilities and they are always better when I leave then when I got there. You have to be consistent with all the staff. You have to empower the people who do a good job to do an even better job...you have to believe that what you are doing is the right thing and at the end of the day, you really have to know that it's not about you or the ED or the CNAs, it's about the residents.

I used to work at one of the LTC facilities that was a part of a huge corporate. Let me tell you, the crap will always stay crap. In my 1st nursing home (it was a combination of subacute and nursing home) we had no equipment to even start an IV. My patient was in a respiratory distress and we didnt even have any nonrebreather. I decided to leave this place for a better one (thinking that it cant be any worse). I always said I can afford losing a job but I cant afford losing license. The other job however was a lot worse! In the first NH i had 16 patients (subacute) in the other place i had 38 patients (if i was lucky, it could go up to 42+). At night u have 60 patients. My DON told me that i can request to have the preceptor changed if we dont get along well together. My preceptor was nice but i wanted to see the routine of other people as well, therefore i went to DON and requested to have the preceptor change. Here the horror started. The DON wanted to write me up for "causing drama". She didnt give any explanation, nothing, just said that im causing drama and she will write me up.

Thank God i got accepted to one of the hospitals, I left that nursing home without blinking. Now I am on the oncology unit, it is busy but i love it.

Good luck to you! With your Masters degree you should apply for a management position not a staff nurse.

I think it can be done. I have seen change for the better, but it does take work. We have had so many Directors and some just made everyone want to raise the standards. Others just let everyone fend for themselves. It is easy for staff to fall back to bad habits. The bigger problem to me, is unrealistic or uncaring administration. That is less likely to turn around.

Specializes in Gerontology, Med surg, Home Health.

It's commendable to have a Master's degree but it is NO substitute for experience.

I think that this is virtually impossible. I most recently worked for a LTC company. They were actually featured as one of the best companies to work for. The DON origninally hired me to work 11-7p, she then changed her mind when she was suddenly short of a treatment nurse. I agreed to try the position. She hatched a plot to get rid of me when I started to find pressure areas as this interferred with her BONUS. Mind you, my best friend was the ED. I got severely sick and was out of wirk for 2 weeks. The DON was aware that I was sick. Upon my return to work, I was allowed to work all day till 3:30 in the afternoon. She then had me meet her in the ED's office. She started out by telling the ED she hadn't heard from me in 2 weeks. I produced text messages that I saved from her. Then she changed her story and said she hadn't heard from me in a week, she thought that I had quit. She terminated me after 5 months on the job, I had not missed a day prior to becoming ill. Check this out. She fired me for no-call, no-show, when in fact the supervisors were reporting to her on a daily basis, after they called me at home every day or every other day. My friend was in a catch 22. She couldn't intervene because she did not want to look like she was showing favoritism. Eventually, the entire facility learned what she had done to me and were not happy about it. They actually complained to HR about how the DON can't be trusted and how she confabulates and deceitful. I say this to you..... GET OUT NOW! The DON will be intimidated by you because you speak your mind and want to do what is right. My girlfriend's problem is that because she is the ED, she thinks that the DON should handle nursing issues. It is her business to make sure that the facility as a whole is running smoothly as well as to make sure that the staff is getting what they need in the form of continuing education. If you don't have the supprt you need now, pack you bag and go where someone needs and wants and appreciates you.

I think that this is virtually impossible. I most recently worked for a LTC company. They were actually featured as one of the best companies to work for. The DON origninally hired me to work 11-7p, she then changed her mind when she was suddenly short of a treatment nurse. I agreed to try the position. She hatched a plot to get rid of me when I started to find pressure areas as this interferred with her BONUS. Mind you, my best friend was the ED. I got severely sick and was out of wirk for 2 weeks. The DON was aware that I was sick. Upon my return to work, I was allowed to work all day till 3:30 in the afternoon. She then had me meet her in the ED's office. She started out by telling the ED she hadn't heard from me in 2 weeks. I produced text messages that I saved from her. Then she changed her story and said she hadn't heard from me in a week, she thought that I had quit. She terminated me after 5 months on the job, I had not missed a day prior to becoming ill. Check this out. She fired me for no-call, no-show, when in fact the supervisors were reporting to her on a daily basis, after they called me at home every day or every other day. My friend was in a catch 22. She couldn't intervene because she did not want to look like she was showing favoritism. Eventually, the entire facility learned what she had done to me and were not happy about it. They actually complained to HR about how the DON can't be trusted and how she confabulates and deceitful. I say this to you..... GET OUT NOW! The DON will be intimidated by you because you speak your mind and want to do what is right. My girlfriend's problem is that because she is the ED, she thinks that the DON should handle nursing issues. It is her business to make sure that the facility as a whole is running smoothly as well as to make sure that the staff is getting what they need in the form of continuing education. If you don't have the supprt you need now, pack you bag and go where someone needs and wants and appreciates you.

That absolutely reminds me of LTC I worked for, Genesis Healthcare. Actually each time DON called me to the pffice for some weird reasons, she brought with her the entire team- HR person, 2 ADONs. She hired me full time, she was aware of the fact I have to have every Thursday off (cuz of school) and agreed to that. Then after 2 weeks of my orientation she changed her mind, she put me per diem. She said "we dont hire full time people that cant be totally committed to us". At this point I had no insurance and no benefits.

My orientation was supposed to be few weeks long but it was only 3 days, I was on my own but I had paid orientation rate. One time I asked her to pay me per diem rate since I am on my own anyway instead of orientation. Once i started speaking up my mind, she fired me saying "I can see on your face you dont like this job. I guess you have the resignation letter ready?" I left without even blinking.

Specializes in MDS/ UR.

You might want to edit out the name of the company. No matter what beef you have with them- naming them like this might buy you some grief.

Specializes in acute care and geriatric.
That absolutely reminds me of LTC I worked for, Genesis Healthcare. Actually each time DON called me to the pffice for some weird reasons, she brought with her the entire team- HR person, 2 ADONs. She hired me full time, she was aware of the fact I have to have every Thursday off (cuz of school) and agreed to that. Then after 2 weeks of my orientation she changed her mind, she put me per diem. She said "we dont hire full time people that cant be totally committed to us". At this point I had no insurance and no benefits.

My orientation was supposed to be few weeks long but it was only 3 days, I was on my own but I had paid orientation rate. One time I asked her to pay me per diem rate since I am on my own anyway instead of orientation. Once i started speaking up my mind, she fired me saying "I can see on your face you dont like this job. I guess you have the resignation letter ready?" I left without even blinking.

they dont deserve you, you did the right thing!

Thanks for the great responses. I did find one that said "It's commendable to have a Master's degree but it is NO substitute for experience. " I think you might be one of those I'm currently working with! I've worked hard for my degrees and have multiple years of nursing experience. Regardless, many with lesser degrees have made rotten comments to those with higher degrees where I work. I do not for a second believe a degree makes you a better nurse. Gosh, some of the CNAs could be better nurses than those with a nursing degree.

This comment shows the shallowness of what I've experienced in LTC by a few nurses. Those are the nurses who for whatever reason would rather belittle those for advancing themselves instead of getting their butts in school themselves. Certainly no one should go back to school if they don't want to - it doesn't make anyone a better person, but don't belittle anyone else who does. I welcomed LTC nurses with open arms to the acute environment when they wanted to try something new. Regardless thanks for all the great responses and sharing your experiences. I do believe all nurses to be supportive of one another and encourage advancement of any kind.

Specializes in Gerontology, Med surg, Home Health.

Sorry...my post wasn't meant as an insult. Perhaps I misread what you wrote...I thought you said you only had 6 months of experience in LTC. If I was wrong I apologize.

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