After working as an RN in a variety of roles in LTC for over 20 years, I switched to working as the full time RN in 2 separate Assisted Living facilities (under the same company). Both of these Assisted Living facilities had a memory care unit attached so these residents required heavy care. Many were 2 staff transfers which was not a problem as staffing was adequate (in numbers only, not training). What was not adequate was that aides were being hired "off the street" & they were expected to pass meds after a crash course in med passing, even administering predrawn insulins. The ALA staff weren't even CNA certified. After being employed there for 7 months & doing what I thought was a decent job, I was unexpectedly fired. I was reminded on several occasions that I had to get my LTC thinking mode out of my head & to start thinking Assisted Living mode instead, but with the type of residents they had in the memory care units it was very difficult for me to do so. For example, I had to get orders for bowel programs due to impactions, wound care for decubitis ulcers, etc. The administrator was an LPN & she would go behind my back & tell the staff to do things differently after I had given instructions for something specific (such as giving someone a pain med before bedtime to prevent nighttime wandering, etc). The reason for them firing me, according to this LPN/administator & the VP, was due to my mind being supposedly in LTC mode & faxing MD's too often for orders. I really loved that job & I'm still in shock! Anyone ever heard of this before? I have been an RN for 28 years & was an LPN prior to that; I've never had so much as a written warning until this happened! Thanks in advance & I aplogize for a long post!
Specializes in ER, Cardiac, Hospice, Hyperbaric, Float.
After reading these posts, I have to make a few comments.
1. It is VERY sad that things in "assisted living" are this way not just where I am but it seems to be widespread.
2. Someone said that Med Techs had to be CNA's first and then get 6 weeks of training? Um, no. I know FOR A FACT that Med Techs are people hired as "caregivers" (and I use that term VERY loosely) who receive a TWO WEEK training course (and rumor has it that sometimes this doesn't happen as it should).
3. Someone mentioned that these type of patients need to be in SNF and not assisted living - YES! You are "preaching to the choir"! But let me tell you this - if a resident is in a facility that owns both AL and SNF, they LIKE keeping people in AL - that is where the mucho money is made. They can charge exorbitant amounts of money to the residents and pay bare minimum for bare minimum care. There is more regulation in SNF's, so you gotta spend money on licensed people and stuff - not as much profitablity there. The money-mongering in the AL business makes me absolutely SICK, but it seems to be widespread and a simple fact. (Trust me, I have never heard as much BS as what I have heard lately from administration while trying to get a patient of mine transferred from AL to SNF. They are like politicians - they talk AROUND the issue and never really answer the question about WHY they won't transfer the person. But, as I said, I smell money - or lack of it in this patient's case).
4. I think the public needs to be educated/warned/told the truth about "assisted living" facilities. I never really knew the difference between SNF and AL until I started working in them. I, like a lot of people (I believe) was under the VERY mistaken notion that AL's were kind of like "stepdown" SNF's or something. I had NO IDEA the realities regarding the lack of regulation and the substandard "requirements" (essentially none) regarding staffing. And I am SURE the marketers do their best to facilitate that misconception, or at the very least they do their best to avoid correcting it.
5. I am slowly resigning myself to the sad fact that although I will continue to advocate for my patients and do my best to see that they get the care they need, the AL situation is what it is. (I may, on my "own time" - off the clock - look more into the legislation and investigate what can be done to change it. Unfortunately, I live in a state that is usually NOT in the "top 49" when it comes to many things.)
After reading these posts, I have to make a few comments.
1. It is VERY sad that things in "assisted living" are this way not just where I am but it seems to be widespread.
2. Someone said that Med Techs had to be CNA's first and then get 6 weeks of training? Um, no. I know FOR A FACT that Med Techs are people hired as "caregivers" (and I use that term VERY loosely) who receive a TWO WEEK training course (and rumor has it that sometimes this doesn't happen as it should).
3. Someone mentioned that these type of patients need to be in SNF and not assisted living - YES! You are "preaching to the choir"! But let me tell you this - if a resident is in a facility that owns both AL and SNF, they LIKE keeping people in AL - that is where the mucho money is made. They can charge exorbitant amounts of money to the residents and pay bare minimum for bare minimum care. There is more regulation in SNF's, so you gotta spend money on licensed people and stuff - not as much profitablity there. The money-mongering in the AL business makes me absolutely SICK, but it seems to be widespread and a simple fact. (Trust me, I have never heard as much BS as what I have heard lately from administration while trying to get a patient of mine transferred from AL to SNF. They are like politicians - they talk AROUND the issue and never really answer the question about WHY they won't transfer the person. But, as I said, I smell money - or lack of it in this patient's case).
4. I think the public needs to be educated/warned/told the truth about "assisted living" facilities. I never really knew the difference between SNF and AL until I started working in them. I, like a lot of people (I believe) was under the VERY mistaken notion that AL's were kind of like "stepdown" SNF's or something. I had NO IDEA the realities regarding the lack of regulation and the substandard "requirements" (essentially none) regarding staffing. And I am SURE the marketers do their best to facilitate that misconception, or at the very least they do their best to avoid correcting it.
5. I am slowly resigning myself to the sad fact that although I will continue to advocate for my patients and do my best to see that they get the care they need, the AL situation is what it is. (I may, on my "own time" - off the clock - look more into the legislation and investigate what can be done to change it. Unfortunately, I live in a state that is usually NOT in the "top 49" when it comes to many things.)
I work in assisted living and our administrator will take just about anyone. She tells everyone who will listen that she is very choosy but really, she's isn't.
I don't know about all ALF's but at the one where I work, you must be a CNA or an MA and you have to have your medication certification.
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Leda1st
50 Posts
After reading these posts, I have to make a few comments.
1. It is VERY sad that things in "assisted living" are this way not just where I am but it seems to be widespread.
2. Someone said that Med Techs had to be CNA's first and then get 6 weeks of training? Um, no. I know FOR A FACT that Med Techs are people hired as "caregivers" (and I use that term VERY loosely) who receive a TWO WEEK training course (and rumor has it that sometimes this doesn't happen as it should).
3. Someone mentioned that these type of patients need to be in SNF and not assisted living - YES! You are "preaching to the choir"! But let me tell you this - if a resident is in a facility that owns both AL and SNF, they LIKE keeping people in AL - that is where the mucho money is made. They can charge exorbitant amounts of money to the residents and pay bare minimum for bare minimum care. There is more regulation in SNF's, so you gotta spend money on licensed people and stuff - not as much profitablity there. The money-mongering in the AL business makes me absolutely SICK, but it seems to be widespread and a simple fact. (Trust me, I have never heard as much BS as what I have heard lately from administration while trying to get a patient of mine transferred from AL to SNF. They are like politicians - they talk AROUND the issue and never really answer the question about WHY they won't transfer the person. But, as I said, I smell money - or lack of it in this patient's case).
4. I think the public needs to be educated/warned/told the truth about "assisted living" facilities. I never really knew the difference between SNF and AL until I started working in them. I, like a lot of people (I believe) was under the VERY mistaken notion that AL's were kind of like "stepdown" SNF's or something. I had NO IDEA the realities regarding the lack of regulation and the substandard "requirements" (essentially none) regarding staffing. And I am SURE the marketers do their best to facilitate that misconception, or at the very least they do their best to avoid correcting it.
5. I am slowly resigning myself to the sad fact that although I will continue to advocate for my patients and do my best to see that they get the care they need, the AL situation is what it is. (I may, on my "own time" - off the clock - look more into the legislation and investigate what can be done to change it. Unfortunately, I live in a state that is usually NOT in the "top 49" when it comes to many things.)