Don't state surveyors know that med nurses (and other nurses for that matter) cannot possibly do everything the job entails? That it is impossible for one nurse to pass meds to 25+ plus patients within the 2 hour window "by the book"? That the facility basically puts on a show once a year when they arrive?
I especially feel for CNA's. Its bad enough to be on the bottom of the totem pole, so to speak, as far as pay and "status". Its such a difficult job, especially when there are so many patients to care of in an 8 hour period. What makes the department of health think its okay or feasible for one nurse to care for so many patients?
It almost makes me sick...it really takes a special and strong person to work in LTC's for many years. Okay...rant over!
Specializes in Prof. Development, New Grad. Residency.
I'm sorry your experiences in LTC are so negative, but not all are like that. There are good facilities in every field.
I worked as a Staff Development Educator in acute care settings for over 37 years of my 44 year career. I had misconceptions that LTC facilities were as you describe. However, 2 years ago, I taught in 3 different nursing programs & learned that there are good facilities, where the Chief Nursing officer (DON) DOES Care, and that very good care is given. Those experiences led me to choose to work as a Staff Dev. Educator at a nursing home, & I plan to stay here until I retire (a long way off). Yes, there are a lot of meds, but our N/P ratios are better than the state standards, our staff CARES and DO give very good care. It is like a family atmosphere; everyone helps each other (nurses help lift, toilet, etc), staff behave in a professional manner, not "it's not my job/resident". We provide FREE CE on all the State mandated topics.
P.S.: I work on the Gulf Coast of Florida, & I'm very happy.
I know there are facilities who function the same whether state surveyors are in the building or not. I know this because I work in one of them and I'm sure there are others like mine that are great places to work and provide quality care to their patients.
One day I will get tired of defending my chosen career but I'm not quite there yet.
I was a CNA at a nursing home before becoming a nurse. It was one of the bad ones. Everyday I could list countless things that made for poor care and even neglect. I did not work there long.
They have this reputation for a reason; it's difficult to justify getting upset at someone for feeling quite negatively at the existence of MANY very poorly (unethically?) run LTCs.
Your post gives me hope and makes me so glad to know there ARE good LTCs out there. So...what's the SECRET? And I'm not asking in order for you to tell ME, but perhaps you can turn your passion into efforts to change the system. You seem to have a lot of insight and experience in this field...
I honestly believe that one day in the history books, people will read and not believe that our elders were placed in these LTCs to be neglected, forgotten, and disrespected by workers, resulting in a faster/premature and undignified death...that was my experience and I don't believe my experience is isolated. Talking about stuff can be helpful, but people can change things - we wouldn't have history to read if it weren't so.
My nursing career is long. I have worked in LTC several times - at least at a per diem level, in approx 8-10 facilities over the years. It was hard to take and I never worked there long term. LTC is *usually* not at its' best, in my experience. While there, I did my best to up the level of care.
I'm sorry your experiences in LTC are so negative, but not all are like that. There are good facilities in every field.
I worked as a Staff Development Educator in acute care settings for over 37 years of my 44 year career. I had misconceptions that LTC facilities were as you describe. However, 2 years ago, I taught in 3 different nursing programs & learned that there are good facilities, where the Chief Nursing officer (DON) DOES Care, and that very good care is given. Those experiences led me to choose to work as a Staff Dev. Educator at a nursing home, & I plan to stay here until I retire (a long way off). Yes, there are a lot of meds, but our N/P ratios are better than the state standards, our staff CARES and DO give very good care. It is like a family atmosphere; everyone helps each other (nurses help lift, toilet, etc), staff behave in a professional manner, not "it's not my job/resident". We provide FREE CE on all the State mandated topics.
P.S.: I work on the Gulf Coast of Florida, & I'm very happy.
Probably depends on the state you work. If you work in the midwest or south, chances are you are working with a very high nurse-direct staff/pt. ratio so quality of care is poor, experience is poor.
Re kimwarren72 ...You are an amazing leader. We have very few office dwellers that emerge to help no matter how bad the floor staff is drowning. They will however answer a call light and tell the pt let me find your nurse/aide and come tell us that 105-1 needs some ice. We have one nurse in particular who will openly announce "that's not my job, I'm an RN." We will work horrifically short, like nurses sharing whole units because we don't have anyone to cover call ins, and the nurse managers don't have to come on the floor. Lately they've been making us 12 hour midnight ees stay for the first 4 hours of day shift and calling it mandatory overtime, with threats of reprimand for abandonment if we leave or say we're too tired to work safely anymore. It happens multiple times a week. And we stay, because the patients shouldn't lose care because the same nurses call in all the time. It's never our own units either... Rehab covers the building, but because of our acuity, the ltc nurses can't/won't work our unit and will flat out refuse if we're that stuck and they are asked. In 5 years I have seen maybe 3 times a management nurse on the floor to work a cart. They aren't mandated to take carts if we're short because they're management, not floor staff. We need more nurses like you, desperately.
I think that "management" nurses just become lazy and also jaded - they just give up because the staffing will never improve as long as LTC facilities are run by corporations whose main concern is the bottom line.
Of course they know but do they care? All I ever see them is eat donuts and coffee with a stack of paperwork in a beautiful office. Then they do the walk through and all is fine and dandy.
Our state team gets put with the floor nurses and they have full access to carts, charts, and can demand to have any task demonstrated. And they do.. And we get dinged any time something's not exactly textbook. It's incredibly stressful. We are a 4 day facility, so they'll come on a Tuesday and leave Friday. They'll even call on a night shift and grill us.
I had misconceptions that LTC facilities were as you describe. However, 2 years ago, I taught in 3 different nursing programs & learned that there are good facilities, where the Chief Nursing officer (DON) DOES Care, and that very good care is given. Those experiences led me to choose to work as a Staff Dev. Educator at a nursing home, & I plan to stay here until I retire (a long way off). Yes, there are a lot of meds, but our N/P ratios are better than the state standards, our staff CARES and DO give very good care. It is like a family atmosphere; everyone helps each other (nurses help lift, toilet, etc), staff behave in a professional manner, not "it's not my job/resident". We provide FREE CE on all the State mandated topics.
Wow. Just. Wow.
When I transferred to current from facility from an equally good 5-star sister, we had a hard-working but caring, cohesive facility. A new EMR sent a few staff into retirement, then a big out-of-state corporation bought out our collection of neighborhood LTCs. We were turned into a sub-acute rehab, with LT residents (a new world for many of the staff). Our existing corporate HR completely disappeared, and we are required to sign for a employee handbook with new policies about every 6 months or be terminated. (I have time to respond to this only because my admin was lucky enough to find someone to take my shift so I could take a few hours of vacation before I lose it.) Since new ownership, approximately 85% of our nursing staff has departed, our payroll has been late several times, our building is falling into ruin, our failing phone system is being ignored, and we can't keep enough computers up and running for staff to document ever more interventions in the dwindling hours being assigned us. Admin is being pushed to accept patients that are much too acute for rehab.
I consider my coworkers heroines/heros. We are, literally, "doing so much with so little for so long we are qualified to do anything with nothing". There is an intense level of stress. Constantly. That said, I work with folks who care and share the load. This is, seriously, no joke.
Still, I envision a happier day when our facility becomes more like the one where jeanrnurse works.
a big out-of-state corporation bought out our collection of neighborhood LTCs.
Yes. I do see this happening alot!! No more small family/private nursing homes. Nowadays, its chains of nursing homes owned by big back corporation who only care about the bottom dollar. These corporations swoop in, drop cash in the laps of the private owners, then take over the nursing home, astronomically drop the pay stance of senior and tenured staff to the point they have to quit in search of better/equal pay to what they once were receiving. These corporations come in a change all the rules; for terrible NOT better. And before you know it, the loyal staff resigns only to leave the door open to new employees who are hired in at a "we dont care/appreciate you" rate of pay. And the only people who suffer in the end is the residents and their families. Sad. Just sad.
jeanrnurse
33 Posts
I'm sorry your experiences in LTC are so negative, but not all are like that. There are good facilities in every field.
I worked as a Staff Development Educator in acute care settings for over 37 years of my 44 year career. I had misconceptions that LTC facilities were as you describe. However, 2 years ago, I taught in 3 different nursing programs & learned that there are good facilities, where the Chief Nursing officer (DON) DOES Care, and that very good care is given. Those experiences led me to choose to work as a Staff Dev. Educator at a nursing home, & I plan to stay here until I retire (a long way off). Yes, there are a lot of meds, but our N/P ratios are better than the state standards, our staff CARES and DO give very good care. It is like a family atmosphere; everyone helps each other (nurses help lift, toilet, etc), staff behave in a professional manner, not "it's not my job/resident". We provide FREE CE on all the State mandated topics.
P.S.: I work on the Gulf Coast of Florida, & I'm very happy.