Low Census...and LOVING IT!

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This past weekend, I had 7 less residents d/t a combination of hospitalizations and discharges. For the first time in MONTHS, I have had two wonderful shifts in a row. I felt like a caring nurse: I had a few minutes to talk to the residents and visiting families, I was able to complete all the treatments w/o rushing; charted thorough explanations; and best of all--punched out on time :up:! Also, had a lunch and two breaks. It's almost surreal, lol.

Specializes in Gerontology, Med surg, Home Health.

I'll probably get flamed but here goes:

how do you think the facility makes money? It's by having the beds filled and making budget. Y'all like raises. Where is the money going to come from if the beds are empty? It's been estimated that the medicaid reimbursement doesn't even equal minimum wage to care for a resident...so where is the money going to come from?

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I'll probably get flamed but here goes:

how do you think the facility makes money? It's by having the beds filled and making budget. Y'all like raises. Where is the money going to come from if the beds are empty? It's been estimated that the medicaid reimbursement doesn't even equal minimum wage to care for a resident...so where is the money going to come from?

I totally get that it is a business, but I think a lot of us cant see why when we have xyz pts (as this post is saying....a few less than a full house) that we can actually give quality care. Care that the residents deserve in the first place. Nursing care with all the basics and not the short cuts. Time to really listen when you ask them "how are you today?" Time to brush their teeth after dinner, time to give then the shower, time to teach them about their diabetes, time to write a complete and good nurses note, time to have lunch or go to the bathroom when you have to and not wait 2 hrs.

Don't get me wrong....I really do love LTC.

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The other day one of the nurses complained that she had 6 patients (which right now is the max). The problem was that four had PCA's, 3 were contact isolation, 2 had dementia/confusion, one had an NG and continuous feeding with all meds crushed going in tube, and one had to have everything crushed and fed in apple sauce, and one had to have dressing changes 3 or 4 times per shift due to edema/weeping. When the nurse got her sixth patient she said...."Hold on, this is more than I can handle". The supervisor told her this is the load so get used to it, or I will give you seven.

I have told them I couldn't take anymore previously, and been told " I am sorry, but we don't have a choice". I got into this profession to make a difference, and I barely have time to keep everyone alive.

Refuse. Say no. You might get fired but you'll keep your license. If nurses actually stood together and took up for themselves, maybe something would change.

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Specializes in LTC.
I totally get that it is a business, but I think a lot of us cant see why when we have xyz pts (as this post is saying....a few less than a full house) that we can actually give quality care. Care that the residents deserve in the first place. Nursing care with all the basics and not the short cuts. Time to really listen when you ask them "how are you today?" Time to brush their teeth after dinner, time to give then the shower, time to teach them about their diabetes, time to write a complete and good nurses note, time to have lunch or go to the bathroom when you have to and not wait 2 hrs.

Don't get me wrong....I really do love LTC.

Exactly and what kind of successful business is it if you have a frazzled nurse who barely has 2 minutes to pee and CNAs who are so overworked that they are calling out because their bodies can't take another night of working short. Residents see this.. FAMILIES definitely see this. And it doesn't look good for the business when they do.

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Specializes in Med nurse in med-surg., float, HH, and PDN.

Besides which, just because census is down, thereby possibly creating a wobble in the business wheels, doesn't mean you can't ENJOY THE BEJEEBERS out of the easing up of the pressure. It doesn't usually last too awfully long, and then you're back up scrambling as if the breather never happened..

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Exactly and what kind of successful business is it if you have a frazzled nurse who barely has 2 minutes to pee and CNAs who are so overworked that they are calling out because their bodies can't take another night of working short. Residents see this.. FAMILIES definitely see this. And it doesn't look good for the business when they do.

I think there really are people that sit in a room and just look at the numbers. Its sucessful if they are making money and earn a profit that quarter and aren't getting into too much trouble in the surveys. Who cares about the nurses?

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Specializes in Gerontology, Med surg, Home Health.

Hmmmm....who cares about the nurses? I can't tell you how much time in my day I spend defending the nurses, the need for increased staffing, arguing with admissions about taking residents way too sick for us. I'd say I care about the nurses since I am one. But since we still have bills to pay, the bottom line has to come into consideration.

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I am a new nurse, working in ltc for my first job. Why do people think this is easier than medsurg? Wound vacs, picc lines, tube feeds and 20+ patients. How is it even safe?

I read somewhere an efficiency expert complaining that they have been unable to make nursing 'more efficient' - they get to a certain point and can't cut staff any more.

So, no emotional connection, no time with the patients, no time to get everything done now - and they just keep adding more people.

It is discouraging to say the least.

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Specializes in Med nurse in med-surg., float, HH, and PDN.
I am a new nurse, working in ltc for my first job. Why do people think this is easier than medsurg? Wound vacs, picc lines, tube feeds and 20+ patients. How is it even safe?

I read somewhere an efficiency expert complaining that they have been unable to make nursing 'more efficient' - they get to a certain point and can't cut staff any more.

So, no emotional connection, no time with the patients, no time to get everything done now - and they just keep adding more people.

It is discouraging to say the least.

It's beyond me why anyone would think LTC is easy! The next to the last sentence of your post, when I c/o same, earned this statement from a DON: "That's the reality of things today." Well, that still doesn't make it right.... or safe....for the patients or for the nurses! And that really burns my 'bottom-line' !:mad:

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Specializes in Cardiac.

FYI--Bliss over! 2 admits daily this week...back to overtime :)

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I'll probably get flamed but here goes:

how do you think the facility makes money? It's by having the beds filled and making budget. Y'all like raises. Where is the money going to come from if the beds are empty? It's been estimated that the medicaid reimbursement doesn't even equal minimum wage to care for a resident...so where is the money going to come from?

You are exactly right. Thank you for standing up and making this point.

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I think there really are people that sit in a room and just look at the numbers. Its sucessful if they are making money and earn a profit that quarter and aren't getting into too much trouble in the surveys. Who cares about the nurses?

Oh yes....this is EXACTLY my job. I NEVER go out and check on the care of the residents. I just sit slumped over my desk all day counting ppd, and overtime, and trying to figure out ways to cut staff and still make more money. Absolutely. Oh, and not get in trouble for poor resident care, because, of course, I care nothing about the resident care in general, or how the families feel. NOPE. Don't care at all.

Please.:confused:

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