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!
Clarification: The prescribers are not making more money by ordering liquid meds - the liquids cost the resident or his/her insurance company more. Some insurers do not cover the liquids if the med can be crushed.
Yikes, wouldn't it be easier to call the Dr and get the "unimportant" ones discontinued.
LOL If only!
I agree with most of the comments here. I'm an ICU nurse but I have a PRN gig at a LTC. It makes me crazy how nursing homes operate. Unlike the hospital, at an LTC, if you (or someone) don't pay, you don't stay so you know they're raking in the dough! It's crazy.
It's True! I really want to know who did the studies showing how they got to the numbers they chose for "safe" care? And when were those studies done? And did they allow for changes in acuity in the residents' conditions? And for admissions, that take up HOURS of the nurse's time? I am willing to bet that as long as these basic questions go unanswered, they remain unchallenged on that point. And the point is that those numbers are driven by Big Business, NOT SAFETY!
In the end, we all get really good at writing "unusual occurrence" reports, and put OUR licenses on the line to become just more collateral damage where the issue is concerned. WE will be the ones to take the fall in court because WE are the expendables. Hospitals are no different, overloading their nurses with high acuity patients and few or no available resources when things start going down the tubes with several patients at a time!
I have SO much more to say, but what's the point?!! Can't wait til retirement!
Forgive me, but Jimmy sounds like he either worked for a private pay facility or as management? Because there are WAAAAY too many of us busting out on the other side of the issue, and he is raving how everything has a solution IF you're a good nurse! I call BS! I wonder......
I refuse to ever work in LTC again. They treat their staff with absolutely no respect. The amount of work expected for nurses to complete in the allotted time is unrealistic and unsafe. I first started off as a nurse working as a LPN. In my first job ever, I was only given two days orientation. I had 40 residents on my floor. I had to give them all medications, and administer treatments. More than half of them had pressure ulcers. Some pts had 3 ulcers. B/l heels and sacrum. It was a nightmare. And to top things off management then had the audacity to ask why are you leaving late daily? Its not like they were paying me for it. I worked 8 hour shifts and got paid for 7 hours. It didn't matter if i stayed 1-2 hours extra. I wasn't getting paid so idk what the problem was. Its not like I wanted to stay late. Its just that it was impossible to me to complete all of that work in the given time. I never even took breaks. And out of those 40 residents, so many had GTs, JTs, eye drops, suppositories, nebs. So many needed BP and HR checked. Half the time the BP machine was MIA or not even working. I started bringing my own manual BP cuff and pulse ox. Everytime atleast 1 tube was already clogged when I went to give meds and feedings. It took forever to unclog them. Sometimes they didn't even unclog and the pt had to be sent to the ED. Ugh it was such a mess. LTC is a joke. I honestly applaud anyone that can work there for so long. I worked in LTC for about 2.5 years on a part time basis (2days/week) and completely lost my mind. No idea how people do it on a full time basis and for 10+ years. I'd shoot myself.
Every bit of that sounds familiar and I only do it on a PRN basis.
I'm sure they know it but like everything else, there needs to be some type of survey or test in place for LTC facilities because the funds that are being billed to these places are enormous. Someone needs to make sure these people are being taken care of properly hence the surveys. They aren't a joke because at any time the survey people will come so the expectation of doing things properly is there for a long time before even the surveyor comes.
I work in LTC and I love. I like the fact that things can fall into a routine but there is still come crazy stuff going on there to keep one on their toes. Ive been working in LTC for 8 months and plan on working for two years and then getting my geriatrics certification. It takes a special person to work long term care.
I wish we could do something in the UK. It's the same here. I currently work in LTC and what we are expected to do is UNREASONABLE. I phoned the NMC(Our national board of nursing?) to ask if it was legal to be the only nurse on duty at night with 40 patients? Seems it is.
I used to LOVE nursing but I don't get time to nurse now, it is just writing about nursing
It's interesting but sad to hear that things are the same in the UK. Perhaps the problem lies in the fact that historically nurses have primarily been women - and women and women's work have always undervalued. Nurses are bullied more than respected.
It was not my intent to call nurses of LTC's or anybody who works in a LTC a joke. LTC nurses are hard working and commendable.
I am frustrated with the fact that workers in LTC's are held to impossible standards. Bottom line I feel like if the government truly cares for the elderly/residents in LTC's then there should be better staff to patient ratios. It just makes me angry that they expect so much, and know that a "show" is put on for them during survey. Why? My facility always knows when survey is coming, within a 2 week window...shouldn't it be more random so facilities will always be in "survey mode"?
So yes, wording of my title was bad. Sorry...love and respect to all who work in LTC's, we all deserve it!
I find there is truth in your comment that LTC nurses are held to a lower standard. I used to work in the ER of a hospital with an attached LTC. We would have residents brought in for the simplest things. Diabetic shaky and sweaty but no one bothered to check a CBG. Low O2 sat with SHOB but no one put them on oxygen.
Things like this were common and ER nurses brought it before the safety board of the hospital and we were basically told that very thing: LTC nurses are held to a lower standard and are only expected to provide the most basic care. Although checking a glucose and applying oxygen are as basic as you can get...
In my opinion, that's ridiculous. They went to nursing school and passed boards just like every other nurse.
Forgive me, but Jimmy sounds like he either worked for a private pay facility or as management? Because there are WAAAAY too many of us busting out on the other side of the issue, and he is raving how everything has a solution IF you're a good nurse! I call BS! I wonder......
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Sixtyseven
47 Posts
Clarification: The prescribers are not making more money by ordering liquid meds - the liquids cost the resident or his/her insurance company more. Some insurers do not cover the liquids if the med can be crushed.