LTC Smell?

vashtee, RN · Mar 2, 2008

I don't know about the workload, but I've never been to a LTC facility that didn't smell that way. I wish they didn't, though.

StNeotser, ASN, RN · Mar 2, 2008

One I used to work in was a building from the 50's. I don't think if the building stood for 100 years without any people in, they'd be able to get rid of the smell of urine.

It was probably ingrained into the fabric of the building because we did rounds every two hours (I was a CNA then) and didn't leave people unchecked.

YellowFinchFan · Mar 2, 2008

I applied at a LTC facility in my area. I have never worked in a LTC before and my only experience with them was when I was a student and did a clinical rotation in one. I am interested in changing into this field from hospital nursing because I enjoy the elderly and I think the job is far more interesting.
When I went into the facility they took me on a tour and showed me around. The place smelled like urine and tube feeding formula. The patients appeared clean and I could not find anything on the internet regarding state write ups at this facility. My question is: do LTC's just smell this way or should this be a sign to me?
Also, the workload is as follows: 117 patients, 3 LPNs and I charge per shift. Is that the norm?
Thanks,
Kalai

I've never worked LTC but I'm shocked at that nurse patient ratio!!!!!!!!

sharlynn · Mar 2, 2008

Even if the Charge nurse took patients (which she probably does not), that ratio is very high. You don't say how many aides are staffed per shift, but that number is probably also inadequate. That would account for the urine smell. If you are very busy, the wastebaskets don't get emptied every time a brief is changed, just at the end of shift. Most places I have worked do not have that problem.

It would be a HUGE red flag to me!

Kookabaer · Mar 2, 2008

That ratio seems really high, but the smell doesn't necessarily indicated lack of cleanliness. I work at a LTC facility for children w/MR and Autism and many of them wet the bed every night. No matter how quickly you change the sheets, the pull-ups, the trash with the dirty pullup, clean the mattress, mop the floor, etc.... the smell just lingers. It gets in the walls, I think. We have those odor-absorbing blocks, but as long as the clients continues to wet, the smell stays.

But the big thing, IMO, is that most facilities either have non-openable windows or it's too cold/hot, etc to open it. No matter what, if there is never fresh air, the smell is never really going to go away.

CapeCodMermaid, RN · Mar 2, 2008

My facility does NOT smell. The building is old but we are constantly cleaning and changing the carpets if necessary. The dirty, wet laundry goes into the soiled utility room and taken off the floor several times a shift. When I interviewed there on my tour with the ED I sniffed here and there. She said 'What are you doing?" I said, "I won't work in a place that smells of urine."

As an aside- if your facility smells like urine, you can be cited. If your facility smells like air freshener/lysol/bleach...you can be cited.

TheCommuter, BSN, RN · Mar 2, 2008

Also, the workload is as follows: 117 patients, 3 LPNs and I charge per shift. Is that the norm?

117 patients divided into three LPNs averages out to about 39 patients per nurse. That sounds like a normal, very typical LTC workload to me. There's nothing shocking about this ratio to me.

CT Pixie, BSN, RN · Mar 2, 2008

I have worked in several LTC facilities (as a CNA). There were a few that smelled like urine all the time and a few that NEVER EVER smelled of anything at all. Now, this is just MY experience so take if for what its worth.

The ones that smelled of urine were places that were always understaffed, the majority of the staff hated their jobs, the residents weren't happy, and most would treat the residents as just a body, and the management had no respect for their employees. I was out of those facilities within months.

On the other hand, the facilities that never smelled had staff that were there for years (yes, like all people they would gripe about this and that but for the most part they were happy at the facility), the residents truly seemed if not happy at least content, and the residents were treated with the kindness and respect that they deserved. There were occasions that we were understaffed but we got through it and made the best of it. The management respected their employees and went to bat for them time and time again when needed. Those were the places that I spent years in and loved it.

Yes, there are times that you would catch a "whiff" of something. But that was far and few between. I am actually looking forward to going back to those facilities when I get my LPN license (fingers crossed..summertime!)

As I said, thats just MY experience. I'm not saying that ALL employees in a facility that has an odor is a bad person who doesn't care and neglects their residents, just as I wouldn't be as bold to state that ALL employees in a facility of a odor free facility is a great person who cares about their residents. Oh, add to what I previously said: when doing clinicals, I've noticed the same pattern...if it smells, watch out, the staff would not be helpful, welcoming or caring of the residents. If it was without smell, the staff were genuinely helpful and welcoming to us and would go out of their way to teach us anything they could.

For me personally, when I get my license, I'll be high tailing it out of any facility that reeks of urine. For me its a HUGE RED FLAG.

Lovely_RN, MSN · Mar 2, 2008

I have 40 residents on my floor when we have a full census and it's not bad at all. It really depends on how many of those residents are total care versus walkie talkie. Out of my 40 residents 15 of them require total assistance with ADLS. I have 3 CNAs on evenings so it's really only 5 total care residents per CNA.

When you are looking at ratios make sure to ask how many CNAs there will be. This is very important because if you don't have enough CNAs and you have many total care residents then you will run into trouble. As the LPN on the floor I really do not have the time to toilet residents and change briefs because I have a killer med pass as well as my treatments, GT feedings, finger sticks, paperwork, and managing all of the crises that tend to occur on a daily basis.

CNAinNeb · Mar 2, 2008

My LTC center does not have a urine smell, but we have a strict policy that trash must be empied and the bag tied off at least once per shift, or as soon as a soiled brief goes in it. We also bag off all linens soiled or not. All the bags go into a bin, in a closet. The bins are carted off to laundry in an extrenal facility several times per day. We also have the carpets shampood quite often, or replaced if need be. I really don't think that smell is a necessary part of LTC- its hard for smells to spread through plastic, there is no reason they can't just bag off the briefs.

nightmare, RN · Mar 2, 2008

We have a bag of small bin liners in each residents toilet and as soon as a soiled pad is removed it is bagged and tied and then placed in a yellow waste disposal bag.These yellow bags are then taken out of the building during each shift and put into waste skips for collection.The carpets are regularly shampooed or replaced and we have ionisers in some of the rooms to minimise smells.We also have air fresheners in some places.