Nurses Working Conditions

[vintagemother, BSN, CNA, LVN, RN]

I've been taking nursing school prereqs to get into a BSN program for a few years. I recently took on a job as a C.N.A. in an SNF and I'd really appreciate some feedback as to whether my experience here is typical of the nursing field, or whether it is typical of SNF or if my experience is not to be expected as a general working condition of being a nurse.

People sleep at work, in the hallways and all over the facility, both nurses and C.N.A.'s. I do work the noc shift.

We are short of supplies. I understand being low on things like briefs (as long as another size is available), special soaps, or bed sheets but we have been short on gloves!

Some patient care tasks must be pushed aside. Examples are not changing all of their briefs more than 1 time per shift. Another example occurs when certain patients call for help due to pain from bleeding wounds. I was told by a colleague to ignore her so I can get my other tasks done and I was told by a nurse to never ignore anyone.

We are told not to wear gloves all of the time to respect the patient's dignity, but I just contracted scabies.

No-one on my shift appears to wash hands between residents, nor change gloves between residents. New gloves aren't put on even after removing a soiled brief.

Briefs with feces and urine in them are tossed on the floor and picked up later on.

I don't know if the management knows or cares about any of this. I kind of think that some of them do know.

I want to know if this is typical of the nursing profession and I will need to develop a higher tolerance in order to work in the field or if these are indeed unusual behaviors.

[TheCommuter, BSN, RN]

working conditions are highly dependent upon the setting in which you are employed. major hospitals, clinics, doctors' offices, and other healthcare settings typically do not offer the lackluster working conditions that you describe in your post.

i recently took on a job as a c.n.a. in an snf

i have worked at multiple snfs (commonly known as nursing homes), and some are better than others. however, i have worked at several facilities during the night shift and have observed the same issues that you describe: employees taking naps, a lack of supplies, not following standard precautions, and so forth.

there is no excuse for sleeping while on the clock (on duty). however, it is hard to follow standard precautions when the facility has run out of gloves. it is impossible to perform sterile trach care when the facility's central supply manager refuses to purchase trach supplies because 'they are too expensive.' it is impossible to change linens regularly when you work at a facility that is stingy about doing laundry regularly. this is the working reality of many snfs (a.k.a. nursing homes).

[Perpetual Student]

That is DISGUSTING! I would be tempted to punch the leadership in their faces on my way out the door. Quit and report that place to the appropriate regulatory bodies today. That level of negligence and complete disregard for residents warrants severe sanctions.

I have a feeling that the rules of this website prohibit me from saying the rest of what I want to say. So just ask yourself, "what would Jack Bauer do?"

[TheCommuter, BSN, RN]

Quit and report that place to the appropriate regulatory bodies today. That level of negligence and complete disregard for residents warrants severe sanctions.

After having worked in several SNFs/nursing homes over the years, they're all still operating. They all pass their state full book surveys because they increase staffing, purchase abundant supplies, and do everything by the book the very moment a state surveyor walks into the facility. Once the state surveyors exit, many of the shady facilities go back to their corner-cutting ways. I've personally seen this game played many times.

When a complaint or accusation is called into the state regulatory body that handles SNFs/nursing homes, facility management tends to be on their best behavior while the state surveyor is in the building conducting the investigation. Again, management beefs up the staffing and purchases plenty of supplies while the investigation is occurring. Employees are doing everything by the book while being watched by the state surveyor. Guess what happens? The complaint or accusation cannot be substantiated without hardcore proof.

If the facility happens to be 'tagged' after a complaint or accusation, they'll usually pay any fines, come up with a generic plan of correction, and continue operating in the same shady manner to save time, cut corners, minimize costs, and maximize costs. It's wrong, but it happens all the time.

[Perpetual Student]

It boggles my mind that the regulatory agencies aren't more aggressive. The police get 15 year olds who look 30 to go buy a pack of smokes to fine some poor sap at a gas station. It seems it wouldn't be that hard to infiltrate a SNF by posing as agency staff, a family member, or something to have a more honest appraisal.

[karamarie91]

You're going to have to just leave. Management knows what is going on, they just don't bother to do anything about it but intimidate from time to time during in-services. I work at a facility where certain items are scarce during all shifts, but it has just been accepted as is.

Oh, and short on gloves?!yuck.

[joanna73, BSN, RN]

Sorry but no gloves goes against infection control. I won't do it. I'm a charge nurse in LTC and I change my gloves in between tasks for the same patient ALWAYS. Yes, we go through tons of gloves but so be it. That place sounds awful, and they are not all like this. Briefs are changed when they are soiled, not once a shift. I would be looking for something else, as well as giving the DON a piece of my mind once the other job is set. Just....YUCK! For the staff, and those residents.

[NocturneNrse]

Whoa! Not changing a resident for lack of briefs? So leave them in a soiled brief = more wound care w/o a change of gloves or just ignoring the wound = horrible patient neglect!! I wonder what that LTC facilities "scores" were on their last review.

That is patient neglect.. report report report. And, if the management is aware.. bypass them and report to the state. You can do so anonymously I believe.

People sleeping during the night shift isn't uncommon. BUT, only on their 1/2 hr breaks or 15 min breaks. I've also worked (VERY briefly) in a facility where I constantly had to be after the employees for sleeping, or neglecting to do tasks for the residents. HORRIBLE! Left there right quick!

Really the shortage of gloves is super bad! If management is aware, then shame on them! If you see your employees using the same gloves for different patients, make them change them. It's got to be done. Make it a problem for the facility, not the employee. There definitely should be an adequate supply of gloves.

No, this is not typical of LTC facilities.. but there are some really bad ones out there. It is your responsibility to be the patients advocate.. you've got to either let management know, and if nothing happens, you have to go above their head.

Good luck to you, it's going to be a rough road, but your patients will thank you for your hard work in protecting them. = )

[carolmaccas66, BSN, RN]

Absolutely revolting practices! This is why I don't work in LTC anymore.

And if they had no gloves, I would refuse to work & would report them to the Health Department (or ur equivalent). I DO NOT touch anyone's skin without gloves. You can also transfer any infections you have to the patient.

It disgusts me as a RN and makes me feel ashamed to read this, that people can be so blase & slack that they just do not care. They should not be in the health profession.

They should all be sacked I think!

[vintagemother, BSN, CNA, LVN, RN]

Thank you all for your words of encouragement. I feel so sad right now, as I really need to work.

In my heart and mind, I do know that these conditions aren't in the best interests of the adults who live there. I have a migraine and a stomach ache, I am so stressed out. I am so glad to hear that not every medical facility or hospital operates like this one. BTW: This place scores a 4 out of 5 by the state scoring system and appears very clean and smells better than most. I'm not sure if these things occur more during the over night shift than the day - this may be the case.

[nurseprnRN, BSN, RN]

don't let this pigpen color your opinion of all nursing. it's not like that "everywhere," or even most places.

[KelRN215, BSN, RN]

I work in a nationally recognized hospital and we run out of necessary supplies ALL.THE.TIME. I have had to use the wrong size catheter to straight cath patients or to suction patients because "we don't have any of that size in the hospital". I have had to put patients in the wrong size diapers because "we don't have any of that size in the hospital". I have had to swap feeding pumps back and forth between several patients over night because "we don't have any more of those pumps in the hospital." Today we "didn't have any more cribs in the hospital".