Originally posted by ChainedChaosRN
.....asked tons of questions, evaluated systems to see why people were not staying. Wages was not an issue, surprisingly. Lack of supplies, systems and leadership were.
I am an RN. I have worked for years in LTC/SNF as an RN, LPN, and CNA.
I just quit a LTC job after only 2 days, and I will tell you why-
Lack of supplies, lack of organization, systems not in place.
I spoke to the DON for over two hours during my interview. I told her of my extensive experience in LTC/SNF, and the problems/frustrations I've encountered. The DON assured me that everything was running smoothly, and I had nothing to worry about.
She was very much mistaken.
Nurse:resident ratios are very rough in LTC- I've been the only nurse on nocs w/ up to 70 residents.
Granted, this is a heavy load. But, I would be able to do it (without staying over), if the systems, supplies, etc. I need are in place.
Well, my first noc, only one aide showed up, I was supposed to have 4. I pulled one from the other unit. We had only 5 pads for 58 residents. We used bath blankets, well of course, it was one total bed after another all noc.
Report sheets were illegible, they'd been xeroxed so many times, and had out-dated, incomplete info. No copy paper on the unit. Finally got a ket to the ADON's office to get copy paper.
I had a res in the middle of the noc whose sats were at 55-60%. (COPD, DNR). I got an order for HHN w/ Albuterol. The nebulizer machine I brought into her room, needed an adapter for the tubing, which was not available. 1/2 hr wasted looking for one. Finally had to put the machine back in the supply room and go all the way to the other unit, borrow a key and get one from their supply closet.
Pulled stickers from "bingo" cards to stick on refill forms to fax to pharmacy. No copy machine on the unit, only a fax. Well, the stickers kept getting caught, and jamming the fax machine. I had to waste precious time covering the stickers with long strips of tape to keep them from sticking in the fax machine. Would have made a lot more sense ot have a copy machine, so I could have xeroxed the refill sheet, and faxed over the SMOOTH copy! Also- How about using black and white laser printers and faxes? Do you know what a time consuming hassle it is when ink cartridges run dry in the middle of the noc? And everyone uses a different brand, seems I've had to learn how to change cartridges and films in 10 different brands, when there are refill cartridges available!
Used, back and white laser printers are cheap and easily available. I have one myself, an eleven year old laser Epson. It has never failed me.
Went to change out syringes for tube feeders- they had the wrong kind.
The facility is using a type of Kangaroo pump with a Y-connector tubing and 2 bags, one for flush the other for feeding. No one knew how to work them, and they shut off and beeped every two hours. More time wasted dealing w/ that. Cans of liquid nutrition were supposed to be stocked in pt rms. They weren't. Had to run all over the place, wasting time looking for some.
In the am, no monoject was available. I had to do the FBS by stabbing the lancets in res' fingers manually. That hurts them!
Housekeeping did not empty trashes, I couldn't find trash bags.
Ran out of cups in the middle of the noc. Had to get the key to dietary and waste more time looking for cups.
Very aggressive CNAs who think they run the place...and they DO, if allowed to. Many DONs keep bad CNAs (and nurses) on, as it is too much trouble to fire them and hire someone else. Insubordinate, inappropriate, aggresive CNAs are a HUGE problem in LTC. No matter how much I speak to them or write them up, it does no good at all if my DON DOES NOT BACK ME UP.
I am a highly organized, intelligent nurse, with extensive experience w/ geriatric pts. I have excellent time mgmt skills, and I love working w/ the elderly.
However, I cannot make bricks without straw. Nor can I take care of residents when all my time is spent running around lokking for supplies and dealing with rediculous time wasters like lack of copy paper, and illegible forms.
I am at the point in my career where I really do not care much about the money anymore. All I want is a POSITIVE, WELL SUPPLIED, ORGANIZED working environment, where I can get just a little respect, and where STAFF AND MGMT REALLY CARE ABOUT THE RESIDENTS.
Well, I have finally given up. I quit the job, and I have vowed never to go back to LTC again. I have worked LTC in two different states, and many different facilities, both as full time staff and as agency. The same, exact problems exist in all of them.
I gave it my best, but I am done.
I hope this info is helpful to you. It was helpful to me to vent!