Getting Burnt Out

CapeCodMermaid, RN · Nov 6, 2007

Wow...I feel your pain. I am a relatively new (6 months) DNS and I am frustrated as well with people who won't do their jobs and who,frankly, don't have the brains God gave them. My MDS people roll their eyes when I find mistakes, the nurse managers on the units look at me like I have 2 heads when I try to explain something, the CNAs are encouraging the patients to complain because they thing they'll get more staff, and survey started today! But, at the end of the day, I know I've made a difference in the lives of my residents so I will keep going back----hang in.

noc4senuf · Nov 6, 2007

Oops, just to add to my list, my fulltime PM TCU nurse handed in his resignation yesterday. Oh well, i could always take up sleeping in my office. But, I wish you luck with your survey and hope all goes well for you.

ebear, BSN, RN · Nov 6, 2007

Noc, I learned a long time ago that if you point out problems, you'd better have an alternate backup plan; otherwise, it will be YOU wearing ALL the hats. It could be that the staff is feeling rather threatened by the large amount of recent firings and they are choosing to resign rather than risk that situation themselves. Could it be that you're coming on too strong? When possible, ask the staff their opinions (as in the parking situation) about how to handle certain issues.

Good luck with whatever you decide to do.

ebear

llg, PhD, RN · Nov 6, 2007

Noc, I learned a long time ago that if you point out problems, you'd better have an alternate backup plan; otherwise, it will be YOU wearing ALL the hats. It could be that the staff is feeling rather threatened by the large amount of recent firings and they are choosing to resign rather than risk that situation themselves. Could it be that you're coming on too strong? When possible, ask the staff their opinions (as in the parking situation) about how to handle certain issues.
Good luck with whatever you decide to do.
ebear

Good point, ebear. My hospital has experienced a recent wave of firings and one of the main reactions among those of us who remain is to start thinking about our own "exit strategies." A few people resigned thinking that "It's better to resign than to be fired" and wanting to "get out" rather than continuing to work in an environment in which they don't feel safe and valued. People are also not happy filling in for the positions that were left vacant from the firings. That leads to more resignations ... and more holes ... and more discouragement among those that remain.

Once in that cycle, dramatic action is needed to reverse it -- action that helps the existing staff feel safe and valued and happy to be there. It's not happening at my hospital and, as you know, has made me start to look for exit stragegies for myself. I hope the OP can take the action that is needed now to help her remaining staff feel good about staying.

noc4senuf · Nov 6, 2007

Been a DON long enough to know that if staff are allowed to get away with calling in and no calls/no shows, then you have a mess on your hands. These are the majority of reasons that staff have been terminated. They either want a job or not. One nurse was let go after he not only got us 3 cites with the initial survey but, also a cite when the surveyors came back for their recheck AND he had been educated and trained to know better.

I don't believe in keeping problems around just for the sake of having warm bodies. You also don't understand.... I'm not the person having an issues with the parking and am not going to worry about it either.

noc4senuf · Nov 8, 2007

The reform needed in nursing homes today is at the gov't level. When the surveyors come in, if they find one item, then they try to find as many tags as possible to cite for the one item under both state and federal regs. Right now, when they perfom a revisit, the cost is over $2000 (this is new). Congress has already put into place the actions to get rid of it but, our President has already said he will veto any actions... he wants it left in. So, that is more money in the gov't coffers and less for the care of the residents. If you would take notice and the small amount the annual increases are for medicaid and medicare, you would wonder what programs the gov't is spending our money on. The baby boomers are coming to retirement age and i am seeing more of them entering the nursing home. More is needed for their care. Back in the 70's the residents in the nursing homes could walk, talk and take care of themselves pretty much. Now, what I have coming in on a daily basis have an acuity level that should be in the hospital.

Attitude?? I work 50-60 hours a week. Very little time is spent in my office as I do answer lights, assist with feeding at meals, toilet when asked, ambulate, perform transfers, chart, pass meds.... you name it, I do it. My staff is not expected to do anything that i don't do. I start my day by 6AM just so i can talk to all the night staff and they don't feel as if no one cares; and don't leave until 4or5PM so I can see all the PM staff too. I know all of my 70+ staff and welcome them to come to me at any time. What I ask in return is they show up for their shifts and perform their work to the best of their ability.

In past years, I have bought X-mas gifts for all of them out of my own pocket. I hand out anniversary and b-day cards each month with a pop coupon for the vending machine. I give and receive hugs daily.

As for my 100 residents, I know each one of them and their families. If they have a problem, they come to my office or call and leave me a message on my voice mail. I have had my own grandmothers in facilities where i have worked and they have received the same care as all the rest of the residents. No favorites here. I go to work each day because of my residents, I love working with them and would never consider hospital work.

My wish would be for all of the staff to understand what it takes to operate a nursoing home and the cost and regs involved. Maybe then, some of them would change their mindset. Now.... who has the attitude? You response lends me to believe it is you who is sour over the whole thing and wonder how long since you even worked in a nursing home.

Simplepleasures · Nov 8, 2007

The reform needed in nursing homes today is at the gov't level. When the surveyors come in, if they find one item, then they try to find as many tags as possible to cite for the one item under both state and federal regs. Right now, when they perfom a revisit, the cost is over $2000 (this is new). Congress has already put into place the actions to get rid of it but, our President has already said he will veto any actions... he wants it left in. So, that is more money in the gov't coffers and less for the care of the residents. If you would take notice and the small amount the annual increases are for medicaid and medicare, you would wonder what programs the gov't is spending our money on. The baby boomers are coming to retirement age and i am seeing more of them entering the nursing home. More is needed for their care. Back in the 70's the residents in the nursing homes could walk, talk and take care of themselves pretty much. Now, what I have coming in on a daily basis have an acuity level that should be in the hospital.
Attitude?? I work 50-60 hours a week. Very little time is spent in my office as I do answer lights, assist with feeding at meals, toilet when asked, ambulate, perform transfers, chart, pass meds.... you name it, I do it. My staff is not expected to do anything that i don't do. I start my day by 6AM just so i can talk to all the night staff and they don't feel as if no one cares; and don't leave until 4or5PM so I can see all the PM staff too. I know all of my 70+ staff and welcome them to come to me at any time. What I ask in return is they show up for their shifts and perform their work to the best of their ability.
In past years, I have bought X-mas gifts for all of them out of my own pocket. I hand out anniversary and b-day cards each month with a pop coupon for the vending machine. I give and receive hugs daily.
As for my 100 residents, I know each one of them and their families. If they have a problem, they come to my office or call and leave me a message on my voice mail. I have had my own grandmothers in facilities where i have worked and they have received the same care as all the rest of the residents. No favorites here. I go to work each day because of my residents, I love working with them and would never consider hospital work.
My wish would be for all of the staff to understand what it takes to operate a nursoing home and the cost and regs involved. Maybe then, some of them would change their mindset. Now.... who has the attitude? You response lends me to believe it is you who is sour over the whole thing and wonder how long since you even worked in a nursing home.

You are correct , I AM very sour, so sour as a matter of fact I am involved in a lawsuit with my former employer, a nursing home who fired me in retaliation for reporting an illegal/ unethical practice.I am channeling all that energy in a POSITVE way, by trying to help affect CHANGE. I fall under the WI Healthcare Worker Retaliation Protection Act. I have EXCELLENT attornies who took my case on contingency of winning and for almost two years have been doing much hard work on my case. I thank God for them and their belief in what I am trying to do. I have been in contact with Nursing Home Reform Advocates from ALL over the country and the reform MUST begin with the nursing homes, then you are correct the state level comes next, as they are guilty of NOT enforcing the many rules and laws that nursing homes should be following .I have been in LTC for ALL of the almost 30 years I had been a nurse, SO I DO know the TRUTH.

I see you ARE trying to do your best and you may be one of the rare few who do not cave in to upper management,but DO NOT for one minute think they will have your back when the poop hits the fan. YOU will be in the direct line of fire.

I have been around the block so to speak and I cannot abide the "management" lingo that disparages hard working , OVERWORKED, UNDERSTAFFED nurses and CNA's and support staff to the upper management. IF you are as you describe it will be all the more upsetting to you when you find yourself with your back against the wall and all your upper management buddies have thrown you to the wolves. Bitter, yes I will plead guilty, but better bitter and fighting to improve the abysmal living and working conditions in our nations nursing homes, than bitter and still working in the dungeons amd allowing myself and my patients to be victimized by corporate greed of the nursing home industry. Some of those "lazy" nurses are not so lazy maybe ,as unwilling to be used and abused.

noc4senuf · Nov 8, 2007

I have no need to justify myself to you. You can continue to be mad at the world and the system we have but, I live in the present and know when i go to work each and every day my residents are receiving the best care possible.

So, my response to you is post away and until you have walked in my shoes, do not criticize me.

Thunderwolf, MSN, RN · Nov 8, 2007

.....which brings me to my post here.

i, for one, enjoy lively debates....but do not enjoy reading members taking things personally out on each other. the industry is indeed in poor shape. my elderly patients constantly inform me "don't get old". i believe them...much out of my own fear of what i may find myself in in the future as an elder. yep, the industry needs work....and it can take a toll on its nursing staff. also, unfortunely, one can often find staff there too who really just do the bare minimal, if anything at all. the residents deserve better than that....so, such employees do need to be let go....residents come first. also, i would imagine that being don is a thankless job...god awful at times....and a position that can push one to the limit in order get things accomplished that need done. again, a very hard job, and often thankless. the greed you mention in the industry is certainly there...but, that is out of our control (in several ways)...and the reforms for that have to be put into place from elsewhere. now, if we own the facility ourselves, that is an entirely different story, isn't it? the only reforms we can make as frontline nurses are what is right in front of our noses....the daily realities. again, i really enjoy a good debate, even a heated one. however, the heat needs to be "on the topic" and not brought down on each other. let's become a little more civil here please...each of us to each other. i truly am not asking too much.

peace to you

ebear, BSN, RN · Nov 8, 2007

You've both made your points---truce...

Simplepleasures · Nov 8, 2007

.....which brings me to my post here.
i, for one, enjoy lively debates....but do not enjoy reading members taking things personally out on each other. the industry is indeed in poor shape. my elderly patients constantly inform me "don't get old". i believe them...much out of my own fear of what i may find myself in in the future as an elder. yep, the industry needs work....and it can take a toll on its nursing staff. also, unfortunely, one can often find staff there too who really just do the bare minimal, if anything at all. the residents deserve better than that....so, such employees do need to be let go....residents come first. also, i would imagine that being don is a thankless job...god awful at times....and a position that can push one to the limit in order get things accomplished that need done. again, a very hard job, and often thankless. the greed you mention in the industry is certainly there...but, that is out of our control (in several ways)...and the reforms for that have to be put into place from elsewhere. now, if we own the facility ourselves, that is an entirely different story, isn't it? the only reforms we can make as frontline nurses are what is right in front of our noses....the daily realities. again, i really enjoy a good debate, even a heated one. however, the heat needs to be "on the topic" and not brought down on each other. let's become a little more civil here please...each of us to each other. i truly am not asking too much.
peace to you

i think i need to state my goals in the original posting. it may be somewhat true that i was personal in my critisizm of the don, but generally speaking i was addressing all don's and nurses and nursing home owners and trying to give a reality check. i know what a thankless difficult job it is for a staff nurse as well as a managent person. but i have a valid point that needs to be heard by all involved and this is great place to address issues and those involved.

if one thinks that my few words were harsh, think again. its a harsh reality for patients and nurses both and even harsher words are said in a courtroom or in front of the senate when testifying on these realities. we need to grow a thicker skin if we intend to stay in this field, and sadly when the reletives or the whistleblower nurse brings forth a lawsuit, things get mighty personal indeed. i dont know the don in question, i do know what she posted and i did respond to that posting. i am not sorry that i was harsh and a bit personal, sometimes things need to be said to make a point that resonates loudly. no tip toeing around this issue of reform any longer its way past due and nurses and patients have suffered for it.

reform starts with ourselves, we need to be brave, strong and committed to change in order for change to happen and in that process nurses are being fired, starting unions and finding their own voices. we can affect change in the corporate world, strength in numbers. unions are a first step to getting the protection nurses need to begin to feel safe when reporting illegal/ unethical practices.better laws protecting nurses will follow.better nurse/patient ratios will follow. look at the california nurses association and what they were able to accomplish once under the protection of the union. why do we need so much protection? shouldnt we be good little nursies and bring all our concerns to management? no, this attitude is what got us in the position we have been in for so many years, change is not easy, feelings will be hurt, but the goal is a worthy one for those who have the guts to pursue it.