Anyone else dislike the nursing home?

mookiebear516c · May 11, 2004

I started working in a huge county nursing home as a CNA. I feel like some of the other responses that it is not for everyone. You have to have alot of patience and tolerance because it does get trying at times. You have to keep in mind that to some of these residents you are their family ,many are alone. It is a relief for some of the families to know that you are willing to take on a task that so many aren't willing to do. I am currently an LPN doing home study to become an RN and just wanted to say that it is not all bad and someone has to do it. Also many Nursing Homes are not geriatrics. In the one I work in there are quite a few "young People". Nursing homes are not just to live out your last years. I am one that gets gratification from seeing a smile on the face of a resident for any little deed you do for them. Hoping you can make the best of it if you are required to do a rotation in a Nursing home.

Thanks:)

AmyLiz · May 11, 2004

I had my CNA clinicals in a really nice, well-maintained nursing facility. It was clean, safe and really nice. However, I still didn't like working there. I don't mind the elderly...I like them, actually...but the whole LTC experience is just not for me. It doesn't make you a "bad nurse"...it's just not your bag! :)

nursnancy, LPN, RN · May 11, 2004

You are certainly not alone. You probably wouldn't have gotten many replies if you had asked, 'Do any nurses out there like nursing homes?' Most nurses hate them. The main reason is that they are so poorly staffed. Even the nice ones that try really hard to have a lot of activities and nice decor to make it a nice place to live, have staffing problems. Virtually all the other problems with nursing homes result from that one. I'm an LPN and I wanted to specialize in geriatrics, so I worked in nursing homes for the first 5 years of my career. I had 20 patients, which is not bad as nursing home patient loads go, but it just got to be too much, especially when I would have to do a lot of CNA work along with all my other duties because we were short. The one thing I did like about it was that I got to know and love my patients. Now I work the evening shift in a Geriatric Psych unit in a small hospital with an average patient load of around 7 or 8. I still get to work with elderly patients, but I can actually go home on time most nights and not be stressed to the max.

justjenny · May 12, 2004

I just finished my nursing home clinical....and all in all it was a good experience!

First, we were at one of the best facilities in the area (and NOT CHEAP to go to!) They were strict on proper cleaning to cut down on smell...and that place hardly ever smelled! (thank goodness!)

For those with complaints...perhaps you have not been properly educated:

Hurting your back lifting is using improper technique or trying to lift a person who is a 2 or 3 person assist..... next time ask for help or ask for more instruction on properly lifting (or use a hoyer lift if they've got it!)

Next, residents in wheelchairs in the hallway is not a bad thing...they get to socialize, smile and see every person who walks by (and our facility was BUSY) so they are recieving stimulation every couple of minutes rather than staring at the TV or worse, the wall, in their room.

Next, the dementia pts. are always the WORST - but if the regular staff is NICE enough to warn you that so-and-so likes to smear the contents of their brief all over the place.....you will be darn sure to monitor that pt. a little closer in the hopes of getting them cleaned before they have the chance (there are some moms out there who know what I mean!)

No, I didn't love my nursing home experience and I do not want to be employed in one...but I can say that if you give it a chance and try to find the GOOD in it (the method to the madness kind of thing) you will leave with the same good feeling that I have! Also, keep in mind the limited funds and limited staffing and you may realize that the ones there everyday caring for those residents are real heroes (cuz lord knows I couldn't do it!)

Jenny

Tony35NYC · May 12, 2004

I won't be doing rotations in a nursing home and I'm glad because I don't think I could handle it. I've repeatedly seen some older adults admitted to the hospital with some of the most unsightly pressure ulcers, malnutrition, severe fluid and lytes imbalance, unkempt hair, and smelling like they haven't had a bath in weeks. I cringe to think about what really goes on in some nursing homes out there. We fix them up, feed them, and pamper them, and most of the time they don't want to go back to the nursing home. Take it for what it is---an experience. I recall my first time working on a floor with end-stage AIDS patients who had the worst imaginable complications. I was CONSTANTLY cleaning vomit and poop from all the diarrhea, and changing diapers and bed linens. The smell was awful, and for the first few weeks of clinical, man I hated it! But, after a while I got used it, and before I knew it the rotation was over.

bbear · May 12, 2004

I believe it is quite normal to be so turned off by a nursing home experience during clinicals. Aside from the foul smells and deplorable conditions, one also has to work with patients who have multiple chronic conditions and very bleak prognoses. That too can be very hard for many people to deal with. It's a lot easier to provide care for an ill person when your care is helping to make them better, rather than merely making a patient comfortable until they die. I have witnessed many nurses get frustrated in this situation because they feel as though they are not making a difference.

What I did during my nursing home clinical rotations that helped me tremendously in coping with the situation was to first stop and put things in perspective. I looked at these unclean and combatant patients and realized that they were somebody's mother or father, or somebody's grandmother or grandfather. They had given so much of themselves to this world, they had so many interesting stories and recollections stored somewhere in their minds. They once held babies close to their breast, cooing and playing with them. They once guided and nurtured their children about the ways of the world.

By doing these things I was able to see these elderly as loving people rather than difficult patients, and this allowed me to do something I never thought I could do in a nursing home--I made a difference. I would work hurriedly through my nursing duties so I would have more time to just sit and talk to these patients. And the patients who couldn't talk, I would just sit and hold their hand. You would never have caught me exchanging idle chat with my classmates when I wasn't busy with my nursing duties. I was with my patients.

Not only did it make my days go very quickly, but I was amazed at some of the transformations that took place in some of these patients. Even the most difficult of patients warmed up to me--the ones that throw bedpans and intentionally dump their urinals on the floor. They didn't do that during my shift. The ones that wouldn't take meds without a fight, they took meds from me without objections. And several that seemed completely flat in affect, smiled when I would walk into the room.

These things didn't make the smells go away, and they didn't make the prognoses any rosier for these patients. But by humanizing the experience it not only made my nursing home experiences more bearable, it made them one of my fondest memories of nursing school. Maybe it could work for others, or maybe I'm just warped in some way. But I figured I'd pass on my experiences just in case it might help someone else with their nursing home experience.

PBAJS · May 13, 2004

bbear - I see myself in much that you had written. :)

If you are 'warped', then so am I. :chuckle

.

Hellllllo Nurse, BSN, RN · May 13, 2004

For those with complaints...perhaps you have not been properly educated:
Hurting your back lifting is using improper technique or trying to lift a person who is a 2 or 3 person assist..... next time ask for help or ask for more instruction on properly lifting (or use a hoyer lift if they've got it!)
Jenny

I worked in LTC for many years- as a CNA, then LPN, then RN.

It's not that LTC workers are not educated on proper body mechanics- it's the understaffing, and with some tasks, it is really impossible to use proper body mechanics.

Did you know that LTC workers suffer more back injuries every year than any other occupation? That includes construction workers, police, EMS and even lumberjacks!

Did you know that 80% of nurses will suffer a serious back injury during their careers?

shel_wny · May 13, 2004

I believe it is quite normal to be so turned off by a nursing home experience during clinicals. Aside from the foul smells and deplorable conditions, one also has to work with patients who have multiple chronic conditions and very bleak prognoses. That too can be very hard for many people to deal with. It's a lot easier to provide care for an ill person when your care is helping to make them better, rather than merely making a patient comfortable until they die. I have witnessed many nurses get frustrated in this situation because they feel as though they are not making a difference.
What I did during my nursing home clinical rotations that helped me tremendously in coping with the situation was to first stop and put things in perspective. I looked at these unclean and combatant patients and realized that they were somebody's mother or father, or somebody's grandmother or grandfather. They had given so much of themselves to this world, they had so many interesting stories and recollections stored somewhere in their minds. They once held babies close to their breast, cooing and playing with them. They once guided and nurtured their children about the ways of the world.
By doing these things I was able to see these elderly as loving people rather than difficult patients, and this allowed me to do something I never thought I could do in a nursing home--I made a difference. I would work hurriedly through my nursing duties so I would have more time to just sit and talk to these patients. And the patients who couldn't talk, I would just sit and hold their hand. You would never have caught me exchanging idle chat with my classmates when I wasn't busy with my nursing duties. I was with my patients.
Not only did it make my days go very quickly, but I was amazed at some of the transformations that took place in some of these patients. Even the most difficult of patients warmed up to me--the ones that throw bedpans and intentionally dump their urinals on the floor. They didn't do that during my shift. The ones that wouldn't take meds without a fight, they took meds from me without objections. And several that seemed completely flat in affect, smiled when I would walk into the room.
These things didn't make the smells go away, and they didn't make the prognoses any rosier for these patients. But by humanizing the experience it not only made my nursing home experiences more bearable, it made them one of my fondest memories of nursing school. Maybe it could work for others, or maybe I'm just warped in some way. But I figured I'd pass on my experiences just in case it might help someone else with their nursing home experience.

How eloquently written! I can only hope to be as warped as you.

Shel

Long Term Care Columnist / Guide · May 13, 2004

Treating the elderly and/or demented patients with gentleness and dignity has always been my philosophy as well.........even the most "difficult" elderly patients were young once, they had hopes and dreams, they have loved and been loved, raised families, and contributed to society. Thus they deserve respect, and I've learned that you don't treat them like two-year-olds even when they're acting like it. Somewhere, in even the most demented individual, I believe that a part of the person he or she once was still lives, and that little spark of consciousness is horrified at being in this situation........I find that addressing that part of the person is far more effective in reducing their stress level (which prevents a lot of undesireable behaviors) than medication or talking to them as if they were little children ("Now Mary, we don't hit the nice nurse, remember?").

I worked in LTC for several years off & on, and even in Med/Surg I deal mainly with elderly patients, and I have never once been hit or kicked. (It's the younger patients with ETOH and drug issues that you can't reason with, and I've gotten my share of bites, scratches and bruises.) There are very few elderly or confused patients who don't respond favorably to a gentle hand and a calm, quiet voice, at least in my experience! However, I had to get out of LTC because I kept bumping heads with the reality of never having enough staff to take proper care of these fragile souls or enough money for proper supplies...plus, there was just too much freaking bureaucracy and paperwork that, IMHO, never made a single improvement in care. I admire those who stick it out in LTC, because the only way to change the system is from within........I just couldn't handle it any more after years of having to fight, tooth and nails, for every single thing I wanted for my residents, whether it was a medication that the state wouldn't pay for, a wheelchair, a walker with a seat, another aide on evening shift to feed residents, a medication nurse to pass meds and do treatments so the charge nurse could actually focus on the Medicare residents who require so much documentation...... :angryfire

The problem with nursing homes, IMO, is not so much that many of them are smelly and depressing---it's that people have become just so many commodities, and they end up being treated like so many widgets on an assembly line because there are so many tasks that have to be done during the course of a shift, and the State will come down on the place like white on rice if every 'i' isn't dotted and every 't' crossed. The corporations that own these places also have to make their profits so their CEOs can drive Lexuses (while the CNAs and nurses make do with fifteen-year-old Buicks) instead of putting the money back into the facility and improving care for the residents who live there.

Again, this is just my opinion on nursing homes. I will now get down off my soapbox, and salute all LTC nurses who continue serving their residents despite the financial and time constraints, the paperwork, and the sheer volume of production that's expected of them.