Ltc: Same Circus Different Tent

I was just about to post about the cuts at the LTC facility where I work. Well, here goes...

My company has decided to cut nursing hours. This would leave one nurse on the floor with 3 lazy CNA's and 1 good Restorative aid for an hour or so each shift. The problem is this: the patients we're accepting aren't your typical nice elderly people. They're drug addicts, thieves, etc...mixed in with the elderly and developmentally disabled. We have so many folks who are completely dependent upon us physically, mentally, and emotionally. I can't watch 30+ residents at one time + manage the CNA's + deal with all of the exploitation issues we have as well. We do both meds and treatments as well. We answer the phones, do the admits, etc... Many of the co-workers who relieve me are late every single day as well so that puts an added strain on a nurse who has already been alone on the floor for a while.

My company wants to save money. I'm getting the heck out of here because I want to save my license. If I accept an assignment like that on a continuous basis I'm putting myself and my residents at risk. Who do you think is gonna' take the responsibility if the s*** hits the fan and the nurse is alone? I think we all know about that! Sigh...

The other nurses just don't seem to get it. One of them told me yesterday that she has had it far worse in other LTC's. I refrained from asking her if she'd place her mother where we work. I should've. The care we provide there is sub-standard on a good day. A really good day.

You are making a very Reasonable decision to get out of LTC before something worse happens to you or a patient. Even though the LTC is following minimum guidelines that keep them in compliance with State and Federal regulaitons, they do not protect your license or your obligation to provide things to your residents even though the facility does not provide you with enough staff, equipment to do so. If you were to run into legal trouble the accountability would be on you. Remember before you clock in or take report assess the situation for staffing, safety, etc. If it is dangerouse or something you do not feel comfortable with walk out. Report the situation to the Health Department. You can also complain to the board of Registered nursing against the DON for not taking the responsibility to get the place staff adequatly the DON can always call a nursing registry or discharge the residents to a place that can take care of them. You would be better off getting fired then you would to loose your nursing license. If you got fired for being a whistle blower you have a lot of protection. More than if you took a chance with your license and put up with the situation. Home care, hospice, MD offices, and hospitals might be a safer choice. I have had the same exact experience you've had. I commend you're astute observation and even better decision to leave.

GOOD LUCK. Let me know what type of setting you wind up in

:balloons: :kiss As far as staffing ratio, reimbursements, regulations, turnover, staff burnout, stress, etc. all nursing homes are the same. The only difference is the ability the Administrator and Director of Nurses have to manage the limited resources that they are forced to deal with. If these people cultivate a calm, understanding pleasant envornment they will get the cooperation from their staff in return who will pass their good feelings onto their residents. If these leaders are unrealistic dictators who do nothing but criticize, blame, and degrade their staff these destructive forces will be passed onto the residents. The most important skills a leader in nursing can posess are PEOPLE skills. Its not about promoting the idealistic standard of care but the amount of CARING that they show towards their staff that has the most positive impact on resident care.

I agree! I also think that the type of residents you have at your facility make a difference as well!

to a large degree, i do agree....but not all staff are affected by the admininstration or higher up don/adon, down to managers, etc., and their attitudes toward staff. i bet you could greet some people with smiles and hellos, give them good raises every year, not ask for mandatory ot unless the staff want it, give input and not criticisms, and some would still function at substandard levels. some people think that requiring good care for residents is silly. i can see it written on their faces. heck, i can't even get some staff to realize that *teasing* a resident can be verbal and mental abuse if the resident reacts negatively to it and does not want things said to them, even if the staff say it is; " just kidding." ltc facilities are not easy to run or manage. i had a problem today with a staff person who didn't understand that i was not blaming her for the resident's incident but that the fact that the intervention to help us keep better tabs on the resident was not in place due to her not applying it. now, on the other hand, i am on salary and am expected to work for much less than what my hourly rate is because if you add up the hrs., i do make much less! i am a bargain! i need a new job! lol! :chuckle

i totally agree with what everyone stated. but i was under the impression that legislation was trying to reallocate funding to medicare/medicaid since the cutbacks were so drastic. maybe i heard wrong. BUT morale of your staff goes a long way. whether morale is up or down, staff performance will reflect it either way. and it is very very frustrating that while there are staff cuts, that the administrator and don are receiving big dollar bonuses (thousands) each year for christmas. i've always believed that if you invest in your staff, you'll get a good return.

i totally agree with what everyone stated. but i was under the impression that legislation was trying to reallocate funding to medicare/medicaid since the cutbacks were so drastic. maybe i heard wrong. BUT morale of your staff goes a long way. whether morale is up or down, staff performance will reflect it either way. and it is very very frustrating that while there are staff cuts, that the administrator and don are receiving big dollar bonuses (thousands) each year for christmas. i've always believed that if you invest in your staff, you'll get a good return.

I have a very committed and caring staff and I know that they feel valued by me despite the unpopular decisions I sometimes make. They know that the tough situations are not created by me, but by the "system" and they know that I am doing the best I can for our residents and for them. Morale is an important factor in retention of staff. When you read studies on long term care, most people leave because they do not feel respected or valued by their DIRECT supervisors! I believe that!