I don't post much, but I always lurk...and now I need to vent
The state has been in for 5 days investigating complaints (yes, more than one). I feel like a complete failure as a nurse. I knew my facility needed work, but now I feel we are about to be closed down. I know it is not only on me, but as they are racking up the tags, I feel that I SHOULD HAVE KNOWN to do more. We are a small facility with 46 residents. I thought we gave excellent care. A lot of the issues are valid and some aren't, but the documentation and policies are not there to back it up.
Specializes in LTC, assisted living, med-surg, psych.
I don't want to paint them all with the same broad brush, but after being in the business for more than 15 years.....people don't become state surveyors because they are likeable or competent or nice. Most of them are zealots who couldn't possibly do what they expect US to do...and that's why they are surveyors.
Ummm.........I'm in the process of attempting to become a surveyor, and it's not because I'm incompetent, mean, nasty, or a zealot. It's certainly not because I can't do what I expect others to do! It's BECAUSE I've been there and done that, and I know a few ways that care can be improved without driving the nursing staff to drink. It doesn't matter to me what the building looks like---I've been in enough LTCs to know that even the ones that look like Caesar's Palace often hide poor care and bad sanitation. But if the staff is giving the care that they say they are giving, if the care plans are updated regularly and followed, and if the residents look happy and well-cared-for, the facility would receive kudos, not citations.
OK---now back to our regularly scheduled thread. And thank you to the OP for doing a great job in the face of impossible odds!!!
I don't post much, but I always lurk...and now I need to vent
The state has been in for 5 days investigating complaints (yes, more than one). I feel like a complete failure as a nurse. I knew my facility needed work, but now I feel we are about to be closed down. I know it is not only on me, but as they are racking up the tags, I feel that I SHOULD HAVE KNOWN to do more. We are a small facility with 46 residents. I thought we gave excellent care. A lot of the issues are valid and some aren't, but the documentation and policies are not there to back it up.
I just needed to vent!
Hang in there! As long as your facilty does not get taged with immediate jeopordy the facilty will not get closed down, the facility will have a certain time period to get things up to code per state standard there will be a lot of changes but hey sometimes change is good. It isn't the care that the state is questioning it is probably the charting. you know if it was not charted it didn't happen even though it was probably done. Documentation is the key, its just hard to remember to chart every small detail of everything you do in an 8 to 12 hour time period.
You say they are coming back next week? Well then you have a week to improve and show them that you are trying your best. We all know if they have complaints they have to check them out. If you know you have done your BEST then don't worry. You cannot fix the rest of the staff but you can do your best. State will notice that.
Specializes in Did the job hop, now in MS. Not Bad!!!!!.
But if the staff is giving the care that they say they are giving, if the care plans are updated regularly and followed, and if the residents look happy and well-cared-for, the facility would receive kudos, not citations.
OK---now back to our regularly scheduled thread. And thank you to the OP for doing a great job in the face of impossible odds!!!
Hey Viva,
this is exactly my mindset for leaving the hospital venue. No one on the OB floor was happy. All the staff nurses came in draggin each shift, non-stop complaining, archaic work conditions and quite frankly the place (esp the smelly garbage claustophobic breakrooms) was disgusting and a JCAHO/HIPAA nightmare.
So w/ great difficulty I find that hospitals just aren't my cup of tea and Im looking to get into Nursing Homes.
I am a bit scared at all the stories I read of high ratios, falls, pressure ulcers and vents of being alone on a nightshift w/ no one to turn to but the one RN on duty (um, this could very well be ME!)
So what is the reality of Nursing Homes?
What can this "new grad" xpect?
If this is not in line w/ this post, please PM me? I see you have years of experience to offer for advice and it sounds like you're going to be doing MDS now? Is this something this new grad (
When I said they are coming back next week..I meant tomorrow..Monday. Not a week from now. Do I feel I give good care...yes. Do I think everyone gives good care...not always. I have always felt I was pretty good at documenting, but as this survey is going along, I realize that I really, really have to step it up. Unfortunately, when will I have the time???
Truthfully, I don't really have too much of an issue with the surveyers. They are there to do a job too. Yes, there are some that I could live without LOL, but the majority are ok. My greatest fear is this of course is all going to fall on nursing. Which I know will happen.
Thanks for listening...and I will keep you updated
Specializes in LTC, assisted living, med-surg, psych.
Hi, Chloe!
To answer your question, no, I wasn't planning to do MDS, although I have done it in the past and would probably do it again if I had to (unlike hospital nursing, which I wouldn't touch again with a ten-foot pole).
I would recommend getting a year or two of floor experience in before becoming an MDS coordinator/care manager. Nursing homes have a completely different focus, the pace is different (although no less hectic), and it's much more intimate than acute care where you barely get to know your patients' names before they are discharged. You need to hone your assessment skills as well, and that takes more a few months of nursing. Just because it CAN be done by anyone with an RN license, doesn't mean it should be.........the best MDS nurses are the ones who know what can be accomplished with x number of staff on x shift, with x residents, because they themselves have done it.
"so shove a broom up my butt and i'll sweep the floor when i walk."
omg, i thought that expression was unique to the ltc facility i work in, as i'd never heard it before then! our nurses now tend to just say "hand me a broom" when they're given something else to do.
Specializes in Did the job hop, now in MS. Not Bad!!!!!.
Hi, Chloe!
You need to hone your assessment skills as well, and that takes more a few months of nursing. Just because it CAN be done by anyone with an RN license, doesn't mean it should be.........the best MDS nurses are the ones who know what can be accomplished with x number of staff on x shift, with x residents, because they themselves have done it.
Good luck to you!
Thanks Viva,
good to know this. The one thing my many preceptors at my last hosp said pleasant about me was that I have strong assessment skills. The bad thing was poor time management. I was accused of spending too much time in my pt's rooms. ????
Guess I spent so much time getting an accurate assessment on my pts I got too much pt care in and didn't have the time to spend gossiping at the nurses station or shopping online and lounging about.
I think I may never want to go near a hospital w/ a 10-foot long pole again either. I just hope that my meager few months of acute care in a clinical setting won't be my huge downfall.
So no major medical issues to need to know before I go selling myself to a nurturing. (oops, I mean nursing) home?
I don't want to paint them all with the same broad brush, but after being in the business for more than 15 years.....people don't become state surveyors because they are likeable or competent or nice. Most of them are zealots who couldn't possibly do what they expect US to do...and that's why they are surveyors. No matter how well staffed you are or how beautiful your facility might look, we are all human and therefore we all make mistakes. We can only hope that our mistake doesn't harm someone.
Have you done a good job taking care of the residents?
And please, don't say "let the facility fix it'...you ARE the facility.
Good luck and let us know how you make out.
You are NOT the facility, you are human and only one person.The staff nurse HAS no choice but to practice within the limitations her facility provides her with, short staffing and all the other"goodies" that the facility graces her with. The buck stops at the top.
VivaLasViejas, ASN, RN
22 Articles; 9,996 Posts
Ummm.........I'm in the process of attempting to become a surveyor, and it's not because I'm incompetent, mean, nasty, or a zealot. It's certainly not because I can't do what I expect others to do! It's BECAUSE I've been there and done that, and I know a few ways that care can be improved without driving the nursing staff to drink. It doesn't matter to me what the building looks like---I've been in enough LTCs to know that even the ones that look like Caesar's Palace often hide poor care and bad sanitation. But if the staff is giving the care that they say they are giving, if the care plans are updated regularly and followed, and if the residents look happy and well-cared-for, the facility would receive kudos, not citations.
OK---now back to our regularly scheduled thread. And thank you to the OP for doing a great job in the face of impossible odds!!!