"Nursing homes" giving nurses a bad rap

  1. Hi,
    Im a nursing student and I'm putting my 2 cents in. I think if the public had a better idea of what nurses do, they would support us and not only insist upon but demand better patient care. Too many dont realize that the nurses are the ones on the front line and advocating for the patient. Too many people have only encountered nurses when they had their tonsills taken out or when someone in their family needed a C-Section. When my family or my friends families think of nurses, they think of "nursing" homes.
    You know, I'm sure each and every one of you know what I'm talking about. You walk in and are almost knocked over by the smell of urine. You walk down the hall to your loved one's room and try not to look at the pitifull old people lined up and down the hall with their heads hung over, waiting for their morning meds. "It will make them more comfortable" is the reason for this soon to be dead parade. You find your loved one totally incoherent and with unexplained bruises and you wonder what happend to your grandpa(ma) that was so full of life just a month ago.
    Your family may of put them there in good faith, believing that after a temporary family mishap, your loved one would come to live within the family once again or you may assume that this is the place for your loved one to live out his or her golden years (and give you a much needed rest). Unfortunately, your grandpa(ma) only lives a few months after being admitted and you can't understand why. Also your grandparents of your freinds that are in similar "homes" end up only living a few months as well. Soon the community begins to talk and you realize that, this is how nursing homes work. Once someone is admitted, they drug them untill they lose their will to live and just die. It's really a wharehouse for old people waiting to die to make room for the next wave of old people. They must make a half way decent profit as their turn around time is usually 3-4 months at most.
    So when most mid-westerners (at least the ones I have come into contact with) think about nurses, they think about "nurs"ing homes and how it only takes a minimal amount of effort to oversee a group of old people and give out meds.
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    About M2BchgoRN

    Joined: Jun '01; Posts: 1


  3. by   ComicRN
    Well....let me start by saying that I think you have a lot to learn.

    I have been a nurse for 9 years. My specialty is geriatrics and rehab. Yes, some nursing homes are horrible and have bad reputations. However, most are staffed by people with good hearts who want to do the best job they can, but are stifled by the lack of funding that nursing homes get.

    In your 2nd sentence you mentioned that if the public had a better idea of what nurses do, they would give us more support. When you graduate, you will be one of "us". Right now, I still see you as being one of "them", because of your attitude. Nurses in nursing homes DO advocate for their patients. We put up with not enough money for staff, or proper equipment, or supplies. Nursing home work is not "glamorous". The nurses are not there to SAVE lives. They are there to make lives more liveable. They aren't performing miracle surgeries or shocking someone back to life. It isn't high TECH. It's high TOUCH.

    Yes, the residents in nursing homes can look pitiful. And yes, they may be waiting for their morning meds. That can be for several reasons. It can be because their loved ones no longer come to see them, or because they no longer remeber who their loved ones are. They may be waiting for their morning meds because they no longer have the ability to medicate themselves. Or, because the nursing home is understaffed and one nurse has 20-30 patients to give medications to. But that same nurse also has to change dressings, talk to and comfort family members, comfort a resident who is confused and crying because he doesn't know why he is there, help feed a dementia patient because she no longer remembers how to feed herself. And yes, you find residents with unexplained bruises because elderly people fall more often, or bang their arms and legs against the side of the bed, or because their skin is thin and they bleed easily.

    Maybe grandma, who was so full of life a month ago had a stroke and can no longer care for herself. That would knock the wind out of anyone's sails. Or grandpa tripped outside while he was gradening and broke a hip and then developed penumonia while in the hospital. Perhaps he never saw himself in the position of needing help getting to the bathroom and it has depressed him, taken away his will to live.

    I have known people who lived in nursing homes for years, not just the 3 or 4 months you mention. I have known people who have independently made the decision to enter a nursing home because they do not want to be a "burden" to their families. They walk, they talk, the take their own meds, but maybe they just need little reminders every once-in-a-while. They are not sitting in the hallways with their heads hanging, just waiting for their medications.

    As far as how "it takes only a minimal amount of effort to oversee a group of old people and give them meds".........I really hope you will re-think that one. You said a lot in that statement about how you feel about the elderly. "Oversee a group of old people." No one is ever a GROUP of anything. Any patient you take care of will be an INDIVIDUAL. Yes, there may be similarities, as there are with patients who have COPD, or AIDS or cancer. BUT....EVERY ONE IS AN INDIVIDUAL, and should be treated as such. And cows and horses have someone to "oversee" them........people don't.

    I hope you have the opportunity do a lot of clinical time. I think it will help you to understand what nursing is all about. Good luck.
  4. by   lyndalous
    ComricRN I agree with everything you have said. I just graduated and worked as a CNA through college in a nursing home/alzeheimer's unit, and assisted living.
    I worked at the cleanest nursing home ever! We were ranked top in the state. I love the elderly. And maybe one day have a master's in Gerontology.
    I was hurt with the coment before about nursing homes and just a group of old people and giving meds. I agree that each one of those people have a heart, they were someone's mom, dad, bro, sis, etc.. and they are just like us but have more wisdom and wrinkles!! I love the elderly and yes they may have bad days and look a little bad, but the nurses in a nursing home are caring and have hearts to make is a happy place in their "home".
    My advice to you M2BchgoRN is to give nursing homes another look. Look in the hearts of these nurses and you will see they love their patients and not only do they hand out med's but they have fun activities with them, tuck them in bed and give them a kiss and let them know they are loved, dance with them, give them dinner, are ears to hear of all the sweat reminises of their lives, and most of all they are the real ones there when they have reached the end of the road.
    I wish you the best of luck and I pray your image of nursing homes changes, because they nursing home changed my life and showed me what nursing was all about.....
  5. by   sandigapeachlpn
    i am trying extremely hard not to take what your post said personally. when i was in nursing school my first quarter of clinicals was at the "nursing home". i hated every minute of it, i sweated my butt off giving showers, and walked around with a wet uniform half of the day. i could not carry on a meaninful conversation with most of my residents. i was appalled when it was time to go the diningroom and feed the residents. i freaked out over the bruises and skintears that they had. 3 yrs later quess what? i am now working in your so called nursing home. But after becoming a nurse with different experiences and understanding the total aspects of geriatric and rehab nursing i have a much different outlook than i did when i was a student. first of all, i do not work in a nursing home. i work at a health and rehabilitation facility. our residents are in two catagories one is long term that now need us for the duration, and the other is mr jones that fell while leading an independant life at home and broke a bone vital to performing adls independantly. the latter of the two i receive as an admission and nuture as their nurse while they go through grueling p.t. and watch them go from not being able to dress themself or transfer independantly, or perhaps toilet themself. then one day i have to tell them goodbye, as they have met their goals and are ready to be dc'd home or possibly to an assisted living. the long term residents are quite a different story, as i strive to make their last years or days at our facility as meaningful as possible. many of my residents know who i am and tell me they miss me when i am gone. some of my residents cannot communicate their needs because of alzheimers, dementia, or cva's.. and i try to put myself in their body.. what if i couldn't speak, smile, yell, feed myself, or even blow my nose; because those centers in my brain are not functional anymore. if i could hear still then i would know everything that was going on and i couldn't do one damn thing about. i am now totally dependant on people and am basically at their mercy. Because this is the way i chose to approach my resident's i know they are not neglected, abused, or mistreated. i am the charge nurse, and believe me my eyes and ears are everywhere in our facility, to ensure this never happens. as to your assumption that all the residents are drugged into oblivion, oh sometimes i wish i could do that so they wouldn't be so tortured at times. you see in the state where i work psychactive drugs are considered a RESTRAINT. THE LESS RESTRAINTS IN OUR FACILITY THE BETTER. just when we have ms. jones is calm, smiling and cooperative the state says we have to DECREASE her dose because she hasn't had behaviors for the last month, surprise! her drugs are therapeutic. then the drugs are decreased and she becomes dellusional, combative, re; we had a resident last night with alzheimers that believed she was on fire; you ought to try and explain to a resident with no cognitive reasoning that she is not on fire, when she totally in her mind iS!!!!!!!! it is heartbreaking. so what do you think the more humane intervention is hmmm, let her run up and down the halls, screaming and crying because she is experiencing possibly a past experience that won't stop or give her some ativan that will end the nightmare. and that is ONLY FOR A LITTLE WHILE. THERE IS ANOTHER NIGHTMARE FOR HER WAITING AROUND THE CORNER.
    the bruises and skin issues, well most of these people have no subcutaneous layer to speak of in their extremities; no collagen, and many are on medications that encourage bleeding and friability, such as lovenox, coumadin, and my personal favorite-- prednisone. so when they try to turn a corner in a doorway and reach with their arm to independantly pull themselves into the next room, they injure themselves. and usually it is quite humiliating for them because they were just trying to perform an adl. in response to the last and final insult, the creme de la creme, how it doesn't basically take a rocketscientist to do what i do. HA! i laugh in your face, because guess what, i was a med surg staff nurse neuro, peds, and ortho, i was an office nurse, before that i was a certified phlebotomist, before that i was an administrative secretary in the hospital. and let me know tell you i have never worked so hard physically, or mentally in my life. i never get a lunch, i am lucky if i get possibly two breaks in a 12 hour shift, and that includes going to the bathroom, and trying to get in a cigarette because my nerves are so shot at the moment. i chose cigarettes to relieve my stress, because i can't have a drink and then go back to the floor, management usually frowns upon it. the cool part of it all is that i wouldn't trade one minute of it. i love geriatric nursing. i love my residents. they are a part of my life and visa verca. i used to think like you, and maybe when you grow up you can be just like me. p.s. our facility does not smell like urine when you walk in the door; we use all diposable briefs, bag each and every incontinent episode, and then place them in a bin, that is then taken out to the trash, apprx 6-8 times a shift or as many as it takes. maybe you should visit our facility.
  6. by   MollyJ
    Hi there,

    This is an interesting thread because, like the previous poster said, you are in the nether world between consumer and nurse; perhaps you are more consumer than nurse at this point.

    I formerly did case management on tech dependent kids and here is the low down when you institutionalize or otherwise delegate the care of a loved one.

    *Not all nurses or institutions are created equally. In any community, there are going to be lesser quality institutions and they have challenges for reasons you and I can only guess at. If you are not happy with your institution, look around and find another. Any institution that constantly smells of urine may have a problem BUT an institution that takes care of the incontinent will sometimes smell of urine or stool. That's a fact.
    *No matter what the quality of the institution, your loved one will get better care if you make your presence felt. That doesn't mean coming in a bellering your displeasure. It means frequent visits (at least once or more per week) where you let them know what they're doing well so you have some capital when they make you unhappy. Develop a relationship with those folks that are caregivers. They are people and appreciate your recognition of what they bring to your loved one's life everyday. Liking you will make it easier to like your family member, who may not be able to tell them what an interesting person they really are/were. Good LTC caregivers recognize that they serve FAMILIES.
    *It is very challenging to provide long term care in a quality way because of the aforementioned reimbursement, staffing and lack of the "glamour" factor. If it was easy, we'd all be doing it for our families in our own homes.

    You will learn in school that it really is better for people to be up in a wheelchair, even if they droop to one side, than laying in bed. If you think it is hard for you to look at them that way, think how it would feel to have lost control over you body and to have no control over the fact that you slouched to one side. So become one of the people who, for the hundreth time, says, "Mrs. Smith, you're slip-slidin' away! Let's get you set back up," and then do it. Your caring and your touch will mean something to that person, even if they cannot necessarily tell you.

    Also, at the beginning all of us are taken aback at what can happen to the human body and what may likely happen to us. When we have relatives (once our lively and loving grandparents or aunts/uncles) who are experiencing those changes first hand, we can feel appalled, helpless, angry. Death and disability are as much a part of life as sunrise and new birth.

    Good luck in your growth. Become a partner to your family member's care staff, not an adversary. Give yourself some time to grow and expect some personal reaction and turmoil to the disability you see.
  7. by   NurseTami
    Just for your info, and I hope you are in your PRE- NURSING part of the curriculum right now, it is AGAINST the law to drug people up into oblivion. And I do not for one minute belive that this is what happens in even 5% of the nations nursing homes. The nursing home industry is the most highly regulated industry in the nation.
    I am an LPN/ new grad RN. I spent 12 years of my life taking care of "Grandmas" and "Grandpas" in at least threee different homes, one of which is a large corporation. I never witnessed the things you speak of. I saw love and tenderness, smiles and laughter for the folks who are depressed, (which by the way, hopefully your school teaches you that many older adults are depressed), hugs and kisses, gentle hands caring for fragile bodies, oh my list goes on.
    You cannot place judgement on a group based on an individual incident.
  8. by   catlady
    You really have a lot to learn. If that's how you see geriatric residents and geriatric nursing, perhaps you ought to rethink your career choice. You show a lot of contempt for the residents and for their caregivers, who are usually working their hearts out under oppressive circumstances. Did you know that the nursing home industry is the second most regulated industry in America?

    The earlier responders made their points well. Perhaps when and if you ever become a real nurse, you might understand what they're trying to tell you.
  9. by   nurse57
    Obviously you have alot to learn. I am a nursing home nurse. We can not and do not drug people! We do not oversee a group of old people. My coworkers and I, which consists of licensed nurses and licensed nurse aides care as best we can for the residents that are in our charge. This is difficult however, given that we can not find enough staff because people want to be paid for what they do and that nurses are worried about the high number of patients they are given and it seems like nobody sees that this is unsafe, not having enough staff to watch out for these people who need help! They pay more at McDonalds! Also, have you not been taught the growing importance of documentation? We must chart it or we did not do it. Today, I wrote more than I got to see my patients! That was not my choice! However maybe someday you will get that warm feeling I get when a resident asks for me personally because they know I will get it done, or when a family member tells me, " We are so glad you are here. I am not worried now." Oh yeah, thats when I remember why I wanted to be a nurse. It is a neat feeling. I hope you get to feel it or have felt it sometime. Good luck! You are going to need it.
  10. by   lyndalous
    Thanks CatLady.... I agree all of the other points were explained very well. It made me happy to know that I was not just the only lover of the older people. It made me happy to hear all of the positive reply's... maybe we will make a difference!!!!!
  11. by   deebsn98
    I have been an RN for 27 years in various specialty areas, including the "cushie" Substance Abuse Tx. center (I am a VA nurse). My last 12 years in geriatrics has been the absolute best part of my career, and I NEVER regret the move. I am 9 credits away from MSN-my thesis will focus on the need for more exposure and education regarding the needs of our aging population so that nurses just MIGHT have the desire to enter the field of gerontological nursing first, rather than the "sexy" ERs, etc. I really hope you take the time during your education to really LOOK at long term care, and what REALLY goes on there. The elderly population of this country- who by the way are NOT using nursing homes, but rather maintaining functional dependence quite well, thank you!!!-need caring, commited caregivers. In light of your current perception and attitude, perhaps this is a field you do not have the stamina-or "heart" for.

    Thank you for you responses, geriatric nurses of the world! (Or at least this discussion group!!!)
  12. by   ALISHAJO
    RE: Nursing Home Patients....I work in an ER and I can tell you that Nursing Home patients are some of my most complicated and time consuming patients. What should be and usually is a simple problem for most of the population is LIFE THREATENING to them. They have trouble communicating what type of symptoms they are having....maybe I should have stopped with the fact that some have trouble communicating!!!! While these patients can be my most frustrating at times, they are also the ones who are most likely to thank me, hug me, kiss my hand, pat me on the back or just be appreciative in general (something that can NOT be said of a lot of the rest of the population). Personally, they do tend to try my patience level to the limit and that is why I like working in the ER where I have limited contact. The Nursing Home environment is as clean as the staff has the ability/time and personeel to keep it clean which can be said for any unit in a hospital or in a doctor's office. I know that there are many times that there is a nasty smell and noises coming from the ER, especially at Gastroenteritis times, with GI Bleeds, Overdoses.....etc. I do appreciate that there are gifted nurses who enjoy working in the Nursing Home environment and strive to make it the best that they can for the patients and their families that wish to be involved.
  13. by   BeBeSweet
    If your loved ones nursing home smelled like urine when you walked in the door,if they continued to have bruises of unknown origin,If they appeared to have been drugged to the point where they no longer appeared to have the will to live, why did you keep them there?
    In a long term care facility, the staff is sometimes the only family that resident has.Ours is a throwaway society and sadly enough many of these long term rsidents have been disposed. I can remember many days when the staff at one facility I worked at would bring in bags full of goodies and clothing for the residents that they themselves had payed for. Do you know how much a cna or housekeeper at a nursing home makes?
    I no longer work in long term care, but in the happy world of med/surg. In the nursing home, we did not chemically(you have been mislead) or physically retrain. That has been one of the hardest hurdles to overcome in the hospital.
    It takes a very special,patient and caring person to work in long term care. It dosn't sound likes it's for you.
  14. by   P_RN
    Everything Y'all said!

    I want to add my specialty is ortho. The majority of our patients were older folks with total joint replacements and hip repairs.

    I love the older folks. They have such a lot to show us. How to maintain composure, how to show respect. How to show us where we will be in our later years.

    I agree that Alzheimers can be so terrible. My grandmother had it, and my mother has it. Grandmama talked to Granddaddy all the time.......it never occurred to her he had passed away 20 years before...it made her happy. She died while my father (her son) was listening to her and Granddaddy converse......WOW.

    I can tell you that all nursing homes are not the same. Sometimes there are terrible ones. Those patients are so sad to see. Sometimes though their condition was such BEFORE they entered the home, and they will improve by being in a controlled situation.

    My own mother-in-law has just taken up residence in a facility. Her son (my brother-in-law) is 65 years old and has a severe progressive neurological disease.....He was trying to care for her alone and wasn't able to. His health is as bad as hers, maybe worse......I tried as much as I could, but I don't live there and it was very hard..... By getting her to the facility, it has literally saved her life.....and HIS. She is very happy. She goes to the lunch room and for the first time in many months feeds herself, goes to the beauty shop there and has folks her own age to visit with. And I credit the NURSES, techs and aides there for this miracle. Like I said I LOVE older people!!!