I don't like what my job has become...

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Specializes in Education, Acute, Med/Surg, Tele, etc.

This seems to be the trend in Assisted Living...one, the residents are getting more complex because the more services the facility provides, the more money for them! Then two...why pay a staff of nurses when now you can delegate many things to CNA's, including po, pr, and sl med pass as long as it is delegated and monitored by an RN??? It is getting very scary!

It is all about the mighty dollar...and I am afraid with the numberous law suits r/t elderly that that is exactly what the Assisted Living have become. Hide behind the words "assisted living" instead of "nursing home" for both asthetic purposes (sounds so much better than 'I sent mom to the home') and liablity purposes...because assisted isn't skilled nursing is it??? It puts the responsiblity back on family or the resident themselves to manage their own care if it comes to a bottom line because "hey, we are assisted living, if you needed more care you should have spoken with your MD about transfering to a facility more suited for you...not our place to tell you what to do...we only assist."

It is scary, but I don't see this one going away too quickly...the idea makes management drewl, takes care of the nursing shortage issues by not having to hire a full staff of nurses, can pay CNA's less and have them do MUCH more, hide behind the liablity issues by being "assisted" not "Skilled RN care", and fills a gap between folks that just need some extra help and the 'home'...no this idea is too quick and easy to many families and management...it is going to be here for a long time!

If you don't want to be the RN who delegates duties to caregivers, or you don't want to be the "paperwork token RN so your facility looks good to State" then I would advise a serious and quick departure from this job! Your facility sounds like it is just starting things that my facility has been doing for over 6 years..and believe me..it doesn't get better!!!!!!

Oh no..you will have more paperwork that management will find will look good for state you will be in charge of, you will spend your days teaching caregivers how to put on a nasal cannula correctly EVERY three months, you will be teaching OSHA requirements and safety, you may even be asked to learn to teach CPR (oh and at your current pay level..they won't do extra for that!).

Oh yes, and the most recent hot topic of pure pain in my keester...the assessments and service plan meetings you will attend as the RN, for the use of siderails..oh now this is a pure joy! These must be done every 3 months, and family, admin and RN staff must attend, prove that all other measures besides the use of rails have been tried, and resubmit permission to the MD..who must sign, then it is submitted to state for review! It is a doozie, and more paperwork than Donald Trumph has cross his desk in a day!

Then add the numberous faxes to MD's r/t each and every skin care issue asking them if they would like to D/C that 81 mg of ASA they are on per day because lord knows it is that ASA causing the unsightly eccymosis on your patients arms vs the fact is lowers risks of strokes/MI's! (those are SO embarressing for me to have to do!!!). Or have to ask an MD for Telfa and silk tape (which was within an RN's scope..but now because insurance will not honor an RN order...we have to have an MD order for these...).

I could add the things that have happened just over the past few months at my facility that they have put on the shoulders of the RN's (and the pure liablity of it all too!), but I think you get the picture...

Keep your eyes out for something else...get out when you can. I will be as soon as I get my home loan finalized..that is, if anyone will hire me...I mean, even last year I went to several interviews and I was labled "nursing home nurse" and considered unskilled or not worth their time (another thing that chapps my hide royally...some of the best Nurses I know work LTC, SNF!!!!!).

Good luck to you, and folks looking for work and see assisted living...watch and ask very carefully about what your duties will be...Watch their questions to you and read between the lines a bit...trust me ;).

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Specializes in Education, Acute, Med/Surg, Tele, etc.

"only use plastic med cups if they're absolutely necessary. don't use the pill crush pouches for to-go meds...use cheap paper cups. now they're complaining about us using the box of gloves on the med cart and how many boxes of gloves we're buying. pinny pinching would be understood if these people weren't mostly private pay residents"

during my med cart audits every month..i am suppose to count all paper cups, bandaids, plastic spoons....another rn counts all supplies in our bandage kits...qtips, cottonballs, steri strips...the works. all these are submitted to management for bookkeeping, and if a service area is using too much..then it comes back to us nurses for investigation to make sure these are not being stollen by staff! oh yeah, great use of nursing time! and who is paying for us rn's to do this...the patients!!!!

i had a caregiver so freaked out because she broke a plastic spoon before she was able to use it to give her resident medications..and she begged me not to report her! what??? oh this is grand, caregivers so scared of us nurses they think we are going to get them fired over breaking a spoon? that only leads to them not telling us of other more important things..like forgetting to pass a med, or not taking a pulse before digoxin...or covering up for a skin tear they accidentally did that needs attending before it gets infected???

who came up with this assisted living thing anyway????? it is a pure disaster waiting to happen, and i hope i get a chance to jump ship before it sinks!

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Specializes in Home care, assisted living.
During my med cart audits every month..I am suppose to count all paper cups, bandaids, plastic spoons....another RN counts all supplies in our bandage kits...qtips, cottonballs, steri strips...the works. All these are submitted to management for bookkeeping, and if a service area is using too much..then it comes back to us nurses for investigation to make sure these are not being stollen by staff! Oh yeah, great use of Nursing time! And who is paying for us RN's to do this...the patients!!!!

I had a caregiver so freaked out because she broke a plastic spoon before she was able to use it to give her resident medications..and she begged me not to report her! WHAT??? OH this is grand, caregivers so scared of us nurses they think we are going to get them fired over breaking a spoon? That only leads to them not telling us of other more important things..like forgetting to pass a med, or not taking a pulse before digoxin...or covering up for a skin tear they accidentally did that needs attending before it gets infected???

WHOA!! :eek: That's bad...I thought we had it bad because our maintenance director locked up the only good vacuum and gave us Bissell brushes instead. (He was convinced that we stole one of his vacuums.) But counting med cups and plastic spoons?? Just wait and see...admin will have you rationing sheets of toilet paper next...:uhoh21:
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I'll bet most of the paperwork you are filling out is to avoid and/or lessen the cost of lawsuits. This is common in all areas of nursing today.

I find myself dealing with this all the time.

When you get frustrated becasue you are neglecting your patients in order to fill out all of these bogus, time-consuming forms, don't get pissed at your boss, they are simply enforcing the new so-called protocols to protect patients. These are written and enforced by personal injury lawyers. Case in point, John Edwards;

he has made a multi-million dollar fortune sueing doctors and insurance companies over a condition which is NOT supported by medical research!

I still wonder how nurses, knowing this information, could actually have voted for John Kerry. If you want to see nursing go completely in the hopper, elect Hillary Clinton in 2008, she thinks we should have goverment subsidized healthcare where nurses will average an unthinkable 20,000/ year. I would like to see that knucklehead try my job for even 3 hours for that kind of money. I feel confident she would not .

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Specializes in Home care, assisted living.

Today we had a staff meeting at work, and as I read the handout given to me, it occurred to me that we med techs are being asked to do a nurse's job. It made me uncomfortable for the first time in all the years I've been a certified med tech. We are not only responsible for checking and passing meds, we have to fax new med orders, reorder meds that are running low, and keep an eye out for changes in a resident's medication (new meds, new dosage, new time, etc.). Some of the med techs have not even been trained properly! I had to teach a new med tech how to do a narc count and why it was important--and I'm not even certified as a nurse's aide, only as a med tech.

I'm not saying I don't enjoy being a med tech--but today, my eyes were opened a little bit to the reason why so many nurses don't want to work in Assisted Living. It's a big responsibility to handle medication, and I'm beginning to dislike it.

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Specializes in Home care, assisted living.

Med techs at my ALF don't get extra pay, either. I still made $7.50/hr. after my training (now it's $8.00--whoopie). I know several people at work who have refused to become a med tech because they don't want to take on all that added responsibility for free.

At my ALF, med techs double as shift supervisor. This is uncomfortable for me, because I don't like having being in charge of other people and telling them what to do (we're all grown women!).

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I think I've seen the best one yet. Facility was assigning Nurse Techs (i.e. not-yet-graduated nursing students) to be charge nurses. About died.

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Sounds like the perfect time to move on to a job you enjoy and dosen't endanger your license! Good Luck to you! :)

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Specializes in MICU, neuro, orthotrauma.
In this day and age working any sort of LTC or RCF setting is like playing russian roulette with your license, especially if your on the front lines. If you go look at your SBON's website (if they list such actions online) you will almost always see about 50% of actions on licenses are for nurses working LTC, and the other half are usual drug diversion actions.

I work for an agency and occasionally pull a shift at a state run LTC facility because the agency pays real well for LPN's to go there. Every time I leave I say I will never come back lol.

this should be a wake up call for any nurse in the LTC field.

get out. get out. get out.

if enough nurses refuse to work in these dangerous conditions, the climate will change.

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