LTC is getting the best of me!

NursesRmofun, ASN, RN · Jun 2, 2004

ER Nurses hate nursing homes
they send them to us to replace foley catheters
they send them over at 2 am and want us to call the GI lab in to reinsert a PEG tube and then call us back and yell at us for sending the pt back with a foley catheter as a gtube instead.
They code their patients and call 911 and send them to us to either pronounce or save, usually they all have DNRs on their charts.
They send the lil ole pt who had fallen 3 days ago at 2 am, after they finally got the xray report back saying the hip was broken.
thats just a start of a long laundry list against nursing homes in general

I am sorry, but those are terribly broad generalizations and one person's experience. I worked as a hospital nurse for many years and rarely had those problems (in general) with nursing home patients. I work in a NH now and I do not see the kind of things you are talking about go on in relation to my facility.

NursesRmofun, ASN, RN · Jun 2, 2004

Well, they say the most stressed out people are the ones that have the responsibility but not the authority. You know what needs to get done but you know it won't because the guys in authority sit in meetings all day - they're not out there on the floor figuring out why everyone is calling in sick and going on stress leave. But I have stayed in LTC just because I am there for those residents - who is there to advocate for them? I also have to keep in mind how far my energy levels will take me. I am a mom of five kids and when I come home, fetch the kids from school, I have NOTHING left for them, I have to fall asleep in front of Oprah for two hours- just the time they need me. That's what really bugs me. How do you cope with that?

I don't totally disagree with you about those with responsibility and not authority having a lot of stress....but I go to a lot of meetings and still have a lot of stress at times. I am salaried and make a lot less than it seems when you add up the hours I put in. I work no less than 45 hrs. a week and have worked up to 55 in a week with no extra pay. When my staff's work is less than great, I take the heat probably more than my staff do. No nursing job is really a bowl of cherries that I can see.

ktwlpn, LPN · Jun 2, 2004

I am sorry, but those are terribly broad generalizations and one person's experience. I worked as a hospital nurse for many years and rarely had those problems (in general) with nursing home patients. I work in a NH now and I do not see the kind of things you are talking about go on in relation to my facility.

I started to respond to this and then decided that I just did NOT have the strength.....Thanks for taking care of it.....

NursesRmofun, ASN, RN · Jun 2, 2004

I started to respond to this and then decided that I just did NOT have the strength.....Thanks for taking care of it.....

LOL. You are welcome.

bubbacat · Jun 2, 2004

I hear you all, I just started this May as a unit manager on a unit that is now subacute/living assist & I am about to pull my hair out. Everyday someone is chewing my butt. The paperwork is unbelievable & having to micromanage everyone is stupid. Why can't people do what they need to do and shut up about it. I hear complaints all the time, & sometimes I just want to turn to them and ask "your point"? Any suggestions on managing a unit would be most appreciative!!!!

leslie :-D · Jun 2, 2004

Any suggestions on managing a unit would be most appreciative!!!!

yes i do have a suggestion: don't do it. it truly is NOT worth being a middle man. no one could ever pay me enough to put up with the garbage that you have to and to top it off, you don't get support from anyone!!! talk about a thankless job.

NursesRmofun, ASN, RN · Jun 3, 2004

I hear you all, I just started this May as a unit manager on a unit that is now subacute/living assist & I am about to pull my hair out. Everyday someone is chewing my butt. The paperwork is unbelievable & having to micromanage everyone is stupid. Why can't people do what they need to do and shut up about it. I hear complaints all the time, & sometimes I just want to turn to them and ask "your point"? Any suggestions on managing a unit would be most appreciative!!!!

Well, I am pulling my hair out a good deal of the time too! I empathize! I am trying to get out of this management position and out of the facility myself. It's a lot to take. But if you really want to stick it out, my best advice is to do what you have to do and try not to worry what anyone thinks. My crew don't complain much....in front of my face, that is....behind my back, I am sure they do lots! LOL! It isn't a great feeling,...but as a manager, I think you have to expect it. As has been said before,...managers are kind of stuck in the middle, taking heat from both those we manage and those that tell us what to do from above. Not easy.

teeituptom, BSN, RN · Jun 3, 2004

I am sorry, but those are terribly broad generalizations and one person's experience. I worked as a hospital nurse for many years and rarely had those problems (in general) with nursing home patients. I work in a NH now and I do not see the kind of things you are talking about go on in relation to my facility.

Ive called Adult Protective Servicxes so often, Im almost on a first name basis with some of them. And its not just one nsg home in the area either

donmomofnine · Jun 3, 2004

wow. if that's the case, i'd be pretty aggravated too. gee tom, i'm glad you don't stereotype. maybe you should relax and have a cigar.

hmmmmmm, Tom....not REAL sure about your hospital, but we send our residents to the hospital, and :crying2: ......never mind. It works both ways, ya know!

nurseduck · Jun 3, 2004

So when was the last time you worked in a nursing home? I have never worked in an ER because that isn't my cup of tea but I would not dog every ER nurse. I happen to love being a nurse and respect any nurse that works in any field. Sure there are bad nurses but they are few, there are a few bad ER and a few bad LTC nurses but is it becasue they are bad or because of circumstance out of their control like Medicare reimbursement and nursing shortage.

:crying2: :imbar

ER Nurses hate nursing homes
they send them to us to replace foley catheters
they send them over at 2 am and want us to call the GI lab in to reinsert a PEG tube and then call us back and yell at us for sending the pt back with a foley catheter as a gtube instead.
They code their patients and call 911 and send them to us to either pronounce or save, usually they all have DNRs on their charts.
They send the lil ole pt who had fallen 3 days ago at 2 am, after they finally got the xray report back saying the hip was broken.
thats just a start of a long laundry list against nursing homes in general

leslie :-D · Jun 4, 2004

Ive called Adult Protective Servicxes so often, Im almost on a first name basis with some of them. And its not just one nsg home in the area either

as i am just as certain that it's not all nursing homes either.

ktwlpn, LPN · Jun 4, 2004

Ive called Adult Protective Servicxes so often, Im almost on a first name basis with some of them. And its not just one nsg home in the area either

I am quite certain that if your concerns were found to be justified by the investigators the homes in question would be fined or closed-at the very least it would be front page news in your community..........

>>>>>>>>>>>>> Yes-I have had to do this in my nursing career-those big old prostates,ya know? The UROLOGIST gives the order to send the patient in.......

>>>>>>>>>>>>>>>>>>Can't say I have ever done this in the middle of the night but have had to send pts out-and was thrilled when they came back with g-tubes that we can then replace as needed....

>>>>>>>>> I find it hard to believe that full codes are run on DNR's often-but we DO have to code them as long as the advance directive and the loved ones tell us to.....

>They send the lil ole pt who had fallen 3 days ago at 2 am, after they finally got the xray report back saying the hip was broken.>>>>>>>>>>>Having no in-house radiology dept does make for delay in treatment...If the xray report comes back at 2am and the resident is in pain that the home can not relieve,shouldn't they come to the er?We have a limited supply of meds in our emergency boxes...

Now it's my turn-things that happen to my dependent and helpless residents when they are in the hospital......#1 Pet Peeve Pressure ulcers and raw excoriated peri-areas...Or-foley caths and a resulting UTI....Weight loss from nurses dropping the tray off and never coming back to feed them.....Numerous skin tears from restraints....Increased confusion from the massive doeses of haldol given to sedate them into submission....Back to the pressure ulcers---I have lost count of the number of residents that have suffered and DIED from the sacral or heel ulcers they obtained in the hospital...You have to remeber that the nursing home is the person's home and they have the right to refuse treatment.That includes a bath...It's assault and battery if we try to throw them in the tub....or brush their teeth against their wishes..Remember there are 2 sides to every story