Xauphkamia 658 Views
Joined: Jul 9, '08;
Posts: 5 (60% Liked)
; Likes: 13
Unfortunately this IS the nature of LTC.
I do not know why we still call it that since it is often anything BUT long-term care anymore.
You need excellent organizational skills and you have to learn to manage priorities, keep tabs on the staff your supervising (you have to be a good leader), and be able to hop back and forth pulling PRNs while doing medpass because many patients (guests, residents whatever your facility is calling them) in SNF/LTC are more alert, aware of what they take, and aware of how often they can have it, and they come with multiple co-morbidities, complications, and wounds.
On top of this a new nurse must learn to pull her weight ie take care of her own orders, contact the MD when needed, do changes of conditions, assessments, and charting because many of these "guests" or "residents" are Medicare and on copious charting for MDS so the facility can get paid and you can keep your job.
Many nurses think SNF/LTC is the place to start because it is often viewed as "easier" than other areas of nursing. This is a false assumption which usually results in many new nurses getting in over their heads.
These facilities are everywhere and they share the same things in common - a bad facililty will put you in jeopardy (license or safety), there will be staffing issues and unsafe practices going on. You will have way too many "residents" to take care. You will quickly become overwhelmed in your duties, You will be asked to work extra shifts, you will be hounded day and night to "please can't you just come in so and so called off again". You will be used, mistreated and abused by administration and possibly your co-workers and staff underneath you.
A good facility might have moments where you feel unsafe or in jeopardy but overall you feel fairly safe practicing there. There will be staffing issues and call-offs frequently but you have a solid group of "regular co-workers and staff that you have learned to rely on and who can rely on you. You will have too many "residents" to take care and get overwhelmed at times but you have some reliable co-workers and you help one another out. Your co-workers work together as a team (for the most part) and there is minimal back-stabbing. Administration will back you up sometimes instead of throwing you under the bus. You will still be asked to come in "please, please because so and so called off again" and there is nothing for that one. And lastly people will still try to take advantage of you unless you stop them. Nothing for that one either, it's human nature. The harder you work....well...the harder you work and you get asked to more.
If after you have been there for 6 months and you STILL feel overwhelmed (as overwhelmed as when you first started - then perhaps your in the "bad" facility category. In any case it is hard to tell at first unless we're talking blatant issues from day one. In that case....run....RUN very, very far from this position and try another one.
SNF/LTC is not for everyone but jobs are tight right now. You have to learn to balance dream job with reality job. Good luck!
Bullying is prevalent in nursing - as someone who has worked various different jobs throughout life I am amazed at the down right nastiness of some nurses.
Now that I have been a nurse for awhile in a facility that is far from a pleasant work experience, I can see firsthand both side of the bullying issue.
Yes some are born bullies - but I truly believe not many are born to be this way. I truly believe it is a combination of many things including working environments and co-workers and administration. I also believe more men in nursing is a GOOD thing. I see a lot less bullying when there is a mix of male and female nurses on the floor.
I also see decent nurses get chewed up by the "bullying" from administration and corporate and this gets passed on. Kind of kick the dog. Sadly, I found myself getting short and snappy this past week and had to check myself.
I would say stress has more than a lot to do with the making of a bully as well.
In the end - it exists in nursing, it is the elephant in the room out on the nursing floor, and we collectively as nurses need to address it.
I suffered horribly from this as well for many years!
After trying a ton of different foot wear and going through the injections, stretches, ice, etc I discovered Sketcher's Step-ups.
I have not had foot pain again. I work 12's all the time on my feet all day.
I have bought several pairs of them now. I have a pair for everything. At first I had to wear my home pair for housework etc. Eventually the pain went away and I was able to wear other shoes off and on. Generally I just stick to the Step-ups because my pain has been relieved, I have lost 40 pounds and the shoes have helped me tone muscle in various places to boot.
Don't give up hope! Keep trying shoes out.
Times are tough and jobs are incredibly scarce.
Go read the current US news - we're about tip over into no-man's land with a double dip recession and who knows what else as our elected officials continue to bungle management of our government.
Nursing is not recession proof.
The room for growth and transition from one area of nursing to another is gone ie if you don't like your current employer you can not easily find another one.
Nurses can be catty and back biting. They can also be honorable leaders and esteemed co-workers and teachers. It's a mixed bag and get what you get.
Nursing is H A R D work both mentally and physically. Many student nurses and pre-req takers might think they understand what that means. But often, they are not prepared even if they have previous medical experience (CNA, phleb, MA, etc).
If you require constant praise or encouragement - nursing may not be the right place for you. Often it is a thankless job for which your only reward, if you are lucky, might be a smile.
Currently our government is about to default on it's debts. In order to stop that there may be tax hikes for all and medicare may be slashed. These things will almost certainly cause jobs in healthcare, particularly nursing where we are over-saturated, to be non-existant.
Lastly - have you considered going on to be a PA or med school? I see everyday MD's are short, PA's are short, PT/OT is short. There are probably tons of other occupations that are in the medical field.
I personally would not wish nursing on my worst enemy. I've worked better minimum wage jobs as a super market checker with more rights and a union.
Wound care encompasses pressure ulcers, peripheral vascular ulcers, diabetic foot ulcers, chemical burns and regular burns, lacerations, surgical sites, wound vacs, etc. My experience is strictly as a wound care nurse for a SNF - however, I imagine it is similar to hospital work.
Generally, you are responsible for wound care for all wounds, documentation, implementing interventions, care plans, MD and family notification. Also you are responsible for weekly measurements with appropriate documentation. In some facilities you may have secondary functions such as weights variance or IDT along with the RD.
I was relatively inexperienced when I accepted a wound care position at the SNF where I work. However it has changed my desired path and I truly enjoy doing it. You have to have a strong stomache at times, and you have to not mind poking around in someone's gaping wound with a cotton swab as well.
Hope this helps fill in the basics. I can reccomend looking in the wound care forum here at All Nurses, there are links to good sites for learning more. Also you did not mention if your LVN or RN - but there are two different certs for wound care nurses depending.
I think important skills for wound care are attention to detail, a sense of humor, excellent documentation skills, and the desire to continue learning everyday.
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