LTC helped this new nurse develop a backbone

[Kitty Hawk, ADN, RN]

I wanted to thank all of you that helped on this forum for keeping me sane. I knew early on that this wasn't the right setting for me, but I have immense respect for those of you that love this area. Suesquatch (that's how I knew your posts!) you kept me rolling with your antedotes.

I found out yesterday that I've been accepted for a position on the IMCU for a smaller teaching hospital. I'm very excited but also bugged by the stigma that still remains in LTC. I told a few of my residents/families that I am close to and the response was nearly universal with the whole "better and bigger type of nursing" and it irks me b/c it's not "better or bigger" it's different period DAMMIT! I have a thread here that I see pops up still about the whole how public views LTC etc....and I guess it still bugs me.

I do crave constant and new and challenging info. I am not the predominantly psychosocial nurse that I think is a very necessary trait to thrive in the LTC environment. I had no clue what I was getting into. No one in my immediate family was ever there, no close friends. So I had no idea that a primary focus is Alzheimer's which for me is just too sad to be around constantly. I know that I will have these pts in the hospital, but not at the same type of care.

Which brings me to some of the other types of residents I had. The demanding priest if anyone remembers. He couldn't make the silly demands that he does, such as closing the door a certain way. Things facing a certain way. He'd be in a different position. Oh sure, he will still be a demanding PIA pt, but I can handle that. Being treated like a slave and made to listen to stories, I can't.

Which brings me to how I ended up not having him as my resident. That next day after my post, I decided I wasn't going to let managment bully me for something that I had nothing to do with. The nurse down the private hall (with 17 residents) as opposed to my unruly hall (24 residents) had a falling out with one of the residents who demanded someone else to care for her.

She actually had the other nurse in mind b/c that's who she adores (there are 3 of us) but that nurse told the mgr she didn't want to b/c she was a PIA resident and since they are buddies, the mgr said okay we'll have the other two switch halls!

I was beyond ticked b/c this is a hall that they gave me in the beginning b/c no one else wanted it. It was extremely unruly with many Alzheimer patients that can get violent, or constantly fall, in additon to the admits that are there recuperating and are a handful and/or are also new fall risks. (I had the most fall risk patients).

I get it was their right to put me wherever. But being miserable in general this was the last straw. I told them I was going to the DON. Because my solution was in addition to me taking care of my 24 residents, I would also take on the problem resident down the private hall. It made no sense to me to upheave two halls and upset the other 16 residents who adore this other nurse BECAUSE of her exquisite pyschosocial skills. They require much hand holding and talking to. I'm a get in there and be pleasant, witty and get out. Well my mgr backed down and gave me what I wanted. And I was told no one ever stood up to them. Her and her other nurse buddy end up bullying other nurses. For some unknown reason they generally like me. I do not hang with them and their click although per se I do not have any real problems with them. They are pleasant enough on the floor and I get very little grief from them. I really did enjoy my co workers for the most part.

So from learning how to handle a resident with a g tube that constantly pulled it out, to that situation. I not only honed some excellent time management skills. I took an unruly hall that no one wanted and made it work for the most part. And I learned to stand up for myself and not take on something that would truly make me miserable. This private hall in addition to the priest has these other 2 brothers that visit their mom and it's beyond creepy. I can take a lot of demanding people and situations, proven by my hall which has had it's own share of demanding patients and family members, but in a way that I could handle. But these 2 residents? No way. In fact the one I do have to take on is also on my list of PIA's but I can handle her b/c I can get in and out. I don't put up with her prying to get gossip to spread to the other shifts.

It's good to see there are so many of you that do have the heart for this speciality. Our elderly deserve the best care. I thought I wanted to be part of that not realizing the mental toll that it would take. I beat myself up quite a bit for not being "good enough" or "that kind of nurse" I"m done doing that b/c I realize that just isn't how I'm made. It doesn't make me less than or whatever it just makes my gifts that I have to share and my goals different.

I also learned to not ever say something will be a "dream job". I don't think there is such a thing in nursing anyway, owning a seaside shop...now that's a different story!

[SuesquatchRN, BSN, RN]

kittyhawk, understand something. Some of the residents, old and worthy of respect and dignity as they are, could get on Mother Theresa's last nerve. NO ONE is made that way.

:)

[Kitty Hawk, ADN, RN]

kittyhawk, understand something. Some of the residents, old and worthy of respect and dignity as they are, could get on Mother Theresa's last nerve. NO ONE is made that way.

:)

Oh I hear you! It just seems some have so much more patience than I. I get embarrassed if I'm credited with being so good with the residents etc... I don't feel I am. I feel I am tolerating....treading water.

If you remember the cutie that we have to keep behind the gate b/c of her fall risk. (the merry widow was vetoed w/o discussion) She's one I do have to cajole to take her meds. She goes off on radom subjects, but I'll come up with silly things to say back. This is all while trying to chart. Sometimes it's entertaining for all of us. (my quick comebacks and ability to have an absurd conversation with her) Sometimes I think that's just bad handling of it. I don't know.

I know the ones I work with say they love what they're doing there. They knew early on that it was for them, they didn't have to grow to love it. I do believe some may need that growing attachment and then they know. I also know myself well enough that no amount of time is going to make this any better for me. Sure I will miss some of them, I may even pop by for a visit, but I was fortunate to not let myself get "too" attached.

I couldn't stand the 3-11 shift either. I could not get it together to do stuff before work. There's others like me, so I know there are some of us out there like that. I will be moving on to 2 twelves and 2 eights between day and night shift. I'm excited to get some evenings back.

OH! and you know how I told you my facility comes up with some assinine plans (or non plans) we had a lady who was startled out of bed from the fire alarm and fell on her face, in addition to some serious bruising and swelling, she broke her nose! She's a sweet little thing that is scared much of the time and cries for attention near constant. Their solution is to keep her snowed on either Ativan or her sleeping meds. Her daughter is furious and rightfully so, right now she's in the hospital with pnuemonia. Anyway she dove out past her fall mat (she has 2 on either side) to land on the tiled floor. One of our plans should have been to get an additional fall mat to extend past. Apparantly no, we can't they can only have 2, one on each side that's it. Their solution is the usual (and not reasonable) more frequent checks. Maybe it will be different for her when they open up the behavior unit wing, though their not sure she qualifies! as there's many others on the list.

Lastly, our brilliant management is test driving a new plan involving ALL of the aides taking dinner break at the exact same time!! (1/2 hour) Seriously?? Anyone with ANY commen sense knows that's a disaster waiting to happen. Talk about chaos, will be interesting to see the fall report times with that happening. People don't think it will last, but still to even suggest it makes upper mgmt look like idiots IMO.

[SuesquatchRN, BSN, RN]

I have one right now who I keep "snowed." The only time she isn't miserable is when she's asleep. And if she's awake she wants her Vicodin and Xanax. Here ya go.

I get annoyed at TPTB insisting that everyone be treated up to their last breath. I have one LOL right now who is dying. She has PN. Corporate wants her up. No way. She is in bed and comfortable and the family knows that this will hasten her death. She is NINETY FREAKING THREE. She has had multiple strokes, is oriented only to self, and it's time to let her go in peace. It's all documented up the proverbial wazoo.

[rosey2007cna]

I worked in a LTC as an aide and they would make me get up these dieing residents. I had one poor lady who was like a wet noodle when I got her up in the morning. The reason I had to get her up was because she was a feeder and had to go to the dining room . Anyway, I guess they had their reasons for getting people up who in this position but I always felt bad for the residents that I had to do this to.

[oryxandcake]

LTC was the first area I worked. I was there for about three years - the first year full time and the rest casual. It was an eye opener and like you, over time was the reason I became much more assertive and confident in my nursing. I worked with many people who would bulldoze or take advantage of you, no problem. Or they would just be miserable and pass on their attitudes to everyone else.

It was this job that almost had me quit nursing; however, going back to school and finding a different type of career changed my attitude.

While my co workers were difficult at times, I still appreciated the residents and the time I had with them. There were a few difficult ones - but overall, they were great and deserve way more respect than what is given to them. I don't know if I would return there in the near future. I would recommend it to others though as it demands organization and assertiveness which are extremely important in nursing. It can also give you better management and communication skills... or have you go the opposite route.

Anyhow, good for you :)

[gentlegiver, ASN, LPN, RN]

I get annoyed at TPTB insisting that everyone be treated up to their last breath. I have one LOL right now who is dying. She has PN. Corporate wants her up. No way. She is in bed and comfortable and the family knows that this will hasten her death. She is NINETY FREAKING THREE. She has had multiple strokes, is oriented only to self, and it's time to let her go in peace. It's all documented up the proverbial wazoo.

You have to get your actively dieing patients out of bed????? What in the good graces are they thinking? I have the descresion (spelling??) as to wether or not my people are gotten out of bed. If family insists on getting Mom up (as she is struggling for her last breath) I will simply inform them that that is NOT in Mom's best interest. Just because family or management doesn't want to accept the ultimate passing of a patient doesn't mean that I have to torture the poor souls.

[SuesquatchRN, BSN, RN]

You have to get your actively dieing patients out of bed????? What in the good graces are they thinking? I have the descresion (spelling??) as to wether or not my people are gotten out of bed. If family insists on getting Mom up (as she is struggling for her last breath) I will simply inform them that that is NOT in Mom's best interest. Just because family or management doesn't want to accept the ultimate passing of a patient doesn't mean that I have to torture the poor souls.

No, I don't get them up. However, she is now rallying. Energizer Bunny she is.

:)

[CT Pixie, BSN, RN]

No, I don't get them up. However, she is now rallying. Energizer Bunny she is.

:)

Always the way Bub! Amazing how they rally. Wish I had 1/4 of the energy of the rallying patient :)