Is this the norm everywhere? Should I turn & run the other way?

LPNKY2012 · Jul 30, 2012

The scary & disappointing part is I didn't find out until I'd been hired & got in there working....State is ALREADY crawling all over this place. Thank you all so much for the input. I have a part-time seasonal job that doesn't start until mid-August, & I am looking into clinics for positions that are a little more low-key. I just had to find out if this is what I'm going to face everywhere, & if it's worth it to stay & try to get my year of experience so that I might find a better position. Not worth it.

DizzyLizzyNurse · Jul 30, 2012

I've seen pretty much all of those except for not being able to do testing. Calling the state won't do a damn thing because LTC is already super regulated and most LTC are good at following the rules when state's there. It's not all LTC's fault either; the demands set on them are unrealistic and unfair. So glad to be out of LTC.

Baubo516, RN · Jul 30, 2012

"Is it common to have a policy of "Here's what you're supposed to do, but in reality here's what we do to get by. I'm not telling you to do this, I know you're going to do it because you gotta do what you gotta do...but if you get busted it's your butt on the line.""

I am a CNA, and when I worked at a LTC, that was TOTALLY the attitude I observed. It was really hard for me to deal with, but the problem is they just don't have enough staff to give us the time to do things the right way. So sad, because I love taking care of the elderly, but detested the working conditions - not enough staff to get the job done so everyone was stressed out! I don't believe this will change until the law mandates higher staff to patient ratios.

I believe if a situation is bad (like the one you describe) you should either change the situation to make it better or remove yourself from it. It sounds like it would be hard to change all of the bad things going on there, and you would be better off leaving.

Wild Irish LPN, LPN · Jul 30, 2012

sorry, but how can you even question if this is appropriate?.....you know better....my advice is to get out, and fast.....your worked so hard for that license, so why put it in jeopardy?....find a new gig and do exactly what one post said earlier, report this place to the state regulators.....these things are just horrible..... :no:

JNG_nurse · Jul 30, 2012

I'm a new grad, new LPN, new orientee to my first job in a LTC facility. Friday was my 3rd day on the floor, & my first time on the med cart. I am a bit frightened by what I saw & what I ended up having to do under pressure. Maybe I'm just a rookie, naive to the reality of what goes on in this type of facility & what you have to do to operate from day-to-day. Please tell me... Is it the norm to have patients run out of meds & to have to borrow/steal from another patient's meds? Is it the norm for a facility to run out of testing/treatment supplies & not be able to do proper treatments & tests on dozens of patients for the entire day? Is it normal for nurses to sign off on whole med passes & treatments & not actually do any of them? Is it common for nurses to skip vitals on multiple patients & then just "come up with something" to put in the chart? Is it common to meet what seems like an excellent nurse only to have to do a double-take when they sneak a pill out of the patient's cup of meds on the way down the hall & pop it into their mouth - slide of hand? Is it common to have a policy of "Here's what you're supposed to do, but in reality here's what we do to get by. I'm not telling you to do this, I know you're going to do it because you gotta do what you gotta do...but if you get busted it's your butt on the line." To be honest, I like the facility I've been hired at. I like the people. I wanted to work there. But, after the last few times out on the floor I feel like I'm putting my license on the line. I'm hoping with all my heart that this is not the reality that's out there & you guys tell me to turn tail & run like the wind. I have a part-time temporary seasonal job lined up to start next month, but I don't want to burn bridges - I had connections to help me get this job. Any advice for a newbie? Thanks!

No it is NOT acceptable! Occasionally, I have had to borrow from another pt's meds, but it is rare. Make sure your cart is stocked! Everything else you mentioned is lazy, reckless, ILLEGAL behavior! You know how you should practice and if you start adopting these bad habits, you are not doing yourself, and furthermore, your patients any benefit! Stay true to your correct nursing habits and notify your supervisor of anything you see that is of this nature! Those nurses don't deserve their licenses!

emmasgrandma · Jul 30, 2012

I am also an LPN. I work in LTC. Just because you see others do something does not mean you have to follow along. Those elderly people are defenseless, and trust you with their lives. If you follow the crowd, when you decide to move on, you will have a multitude of bad habits to get rid of. Where I work there are 36 residents to each nurse, all with varying degrees of disabilities. I rarely get more than 30 min, break a shift. It is typical here in my area. I do my job the best I can, when I am there.I love working with the elderly. I consider it a privilege.

If things are really that unbearable, get out. You will be doing yourself a great service. Follow your gut instinct. It is never wrong.

SinikRN101 · Jul 30, 2012

The norm... I hope not. Have I seen and heard of all this happening in the facility I worked at... yes. Unfortunately a very sad thing, some nurses were fired for not doing med pass/treatments. I agree that you have to cut corners to accomplish all the work on time, but vitals and rounds are NEVER a good one to cut. I worked in LTC for a year and a half but if you have a problem doing "what the other nurses are doing" trust me it's better to find a new job because you won't really fit in anyways. You don't want to be there AND they don't want you there. It will be less stress in the long run.

BrandonLPN, LPN · Jul 30, 2012

It's sad, but you'll see and hear some pretty awful things in LTC. I had one nurse actually confide in me that she almost never gives inhalers, neb tx, eye drops, nose sprays etc. She also admitted she often "skips" the non verbal and/or dementia residents because no one would ever know. The really horrible part is she has plenty of downtime each night. It's not like she's too busy....

bbie17 · Jul 30, 2012

It doesn't seem like a good environment for a new grad. I would not work there even if I was desperate for a job/money. What you need is a nurturing environment that provides you a good foundation on nursing practices. When you're new and just starting out (in any job, not just nursing), the most important thing is doing the job correctly and safely. Being fast, efficient and knowledgeable will naturally come with time.

Is it the norm to have patients run out of meds & to have to borrow/steal from another patient's meds?

This is acceptable- if your patient needs ambien 5mg, another pt has ambien 5mg. Same dosage, same med, it's ok to use the other patient's med. However, only do it when you absolutely need the med and it can not wait. Don't turn it into a routine practice because you can easily make mistakes (ie. wrong dosage/wrong med)

Is it normal for nurses to sign off on whole med passes & treatments & not actually do any of them?

wow, absolutely not.

Is it common for nurses to skip vitals on multiple patients & then just "come up with something" to put in the chart?

absolutely not.

Is it common to meet what seems like an excellent nurse only to have to do a double-take when they sneak a pill out of the patient's cup of meds on the way down the hall & pop it into their mouth - slide of hand?

Not common, but one of my coworkers got caught stealing narcs and was fired. You need to report this nurse before it becomes a problem. He/she needs help. This reminds me of that guy in New Hampshire who stole Fentanyl and got people infected with his Hep C. This could've been a result of unreported events.

I feel so bad for the residents at this facility...

LPNKY2012 · Jul 31, 2012

I'm not questioning whether or not this is "appropriate," & yes, I absolutely know better. What I was questioning, in my lack of experience is whether or not this kind of stuff is the reality of the workplace in LTC. Thus far, my only experience has been in the lab & in a choice few clinical settings, & therefore I really am ignorant as to what the real work environment is like. My gut told me that this could not be the reality everywhere - & that is why I wanted input from real nurses who are out there working in real LTC facilities, to tell me whether or not this is the norm - meaning this is what I will find wherever I go in LTC, or if this is just an exceptionally poor facility. I appreciate everyone's input & advice. I did resign from my job, as my gut told me that my license was in jeopardy - I haven't been able to get malpractice insurance yet, so it was definitely a bad idea to stay. You live, you learn. I definitely have learned my lesson - as much as I love geriatric patients, I cannot work in a facility that is so poorly run, ethically, morally, & legally.

BrandonLPN, LPN · Jul 31, 2012

It's impossible to keep all the meds for every resident 100% stocked all the time. So, yes, EVERY facility borrows meds at least once in a while. As long as I follow up on it and notify the pharmacy I feel no guilt whatsoever in borrowing meds, whether it be a vitamin or a narcotic.

CapeCodMermaid, RN · Jul 31, 2012

Not true, Brandon. Be careful with your EVERYs or NEVERS.