Has Anyone Here Ever Worked in Assisted Living?

nurse4ever08 · Jul 21, 2014

Usually med techs do the meds. Nurses are more directors and program coordinators

westieluv · Jul 21, 2014

Thanks for your reply. So directors and program coordinators? What exactly does that entail?

I did some more online research, and I found one source that said that since RNs are licensed to work under the direction of a physician only, and since assisted living residents don't have a "house doctor" in the same sense that a LTC resident does, then all hands on nursing care is delegated out by the assisted living RN. The example they gave was if a resident went to the hospital and then came home with a wound that needed dressing changes, the RN at the facility would not do the dressing change but instead arrange a contract with a home health agency and the agency nurse would then come and dress the wound as needed. Is that really how it is? I mean, if it is and I were a new, young, nurse, I would have some concerns about losing my hands on skills, but since I have been an RN for 24 years and really just want to finish out my years (I admit it) as easily as possible, would this be a good fit for me, or is there more to it than that? If it's really just a matter of arranging for other people to do the hands on work, then why would these places ever be hiring? They should have a waiting list of experienced but tired nurses like me, lol!

Debilpn23 · Jul 21, 2014

Westiluv

Assisted Living s are licensed different states. Some are similar to what you found in your research I work at one as a charge nurse on a dementia unit 11-7 at my facility we do all med passes and treatments We have licensed nurse s 24-7. I hope this helps .

westieluv · Jul 21, 2014

Thank you, that does help! I have a feeling that this facility does require a licensed nurse to act as such and do the hands on care. If I decide to pursue it I will definitely ask.

Thanks again!

vintagemother, BSN, CNA, LVN, RN · Jul 21, 2014

Based on my limited, bad experience working in an ALF, one of the most challenging problems was the fact that we were regulated by laws that didn't align with what I thought/knew to be good nursing practice. For example, there is a rule that the family can sign a doc stating that the facility is not to order meds for their family member. In my case, the family signed the doc but didn't provide meds. Even though I documented all of this, I was still written up.

Furthermore, my official supervisor was a non medically trained person. I don't think she knew a thing about nursing scope of practice.

The smaller challenges I found in LTC included: passing meds to approximately 50 residents in a timely manner and working with non-licensed personnel who know the facilities procedures (but not nursing practice) better than I did and as a result, presumed to tell me how to do my job.

Besides those issues, Working in an ALF was about the same, stress wise, as any other nursing job.

Mom2boysRN · Jul 21, 2014

The duties of an RN in an ALF can vary greatly, even in the same geographic area. I worked for an ALF as a LPN then an RN. I had the same duties in each role. I was responsible for passing meds and it was horrible!! I had 42 residents to pass meds to they would come to the wellness center and I would pull their pills as they came it my morning med pass was from 7-10 non stop pulling meds. There were of course the people that you had to hunt down to give their pills. I also had meds to refill, labs to arrange to have drawn, families to talk to, call physicians if residents were sick, fax/call in results of labs when they came in, and respond to resident emergencies. My days were insane.

Carrie RN · Jul 23, 2014

You will need to find out what the state regulations are governing ALF/RCF. In the state where I am; the residents had the same rights to refuse to comply with doctor orders, but it comes back on you if they are not compliant. Generally, you will be training employees, writing service plans, and triaging medical problems. You may end up on call 24/7 which is the norm in these facilities. In the facility where I worked (several years ago) the management pushed to fill beds regardless if the person was stable to be in a facility without nurses on premises. The people working as aides and passing medications were all trained by me. (This was good as I could train to my standards, and have taught BON approved CNA and CMA classes. There were people that had been admitted with PICC lines, G-tubes, unstable insulin dependent diabetics, and complex wounds requiring hyperbaric treatment. So it can be a fun job.

westieluv · Jul 23, 2014

Thanks for your reply, Carrie. I'm not sure what my state requires, but honestly, at this point in my nursing career, the last thing I want to do is train aides, med techs, or whatever. I just want a job where I can do my work, punch out, and go home.

Things are improving at my current job, so I think I'll pass.

Thanks again!

Chica22 · Jul 24, 2014

Good to hear Westieluv. Besides, ALF salaries are known to be lower anyway. Best wishes!

Carrie RN · Jul 24, 2014

Then staying in your current position was the right choice. Keep on trucking. :cat:

nurse4ever08 · Jul 24, 2014

Home health does all wounds and catheters. The nurses just review mars over see med techs and such. If issues come up the nurses does call the patient's pcp