Nursing home blues.....

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I work at a LTC facility and it is so very frustrating; the day starts at 6am and ends at 2:30pm. I take care of 23 patients and for those 23 pt I have 2 aids that are expected to get those people up, shaved, face washed, dressed, changed and teeth brushed in two hours. Night shift gets up one person because by 6am she is crawling out of bed. I am expected to be in the dining room to help feed at 8:00am, never mind the hellish med pass I am trying to get done so I am in "compliance". I also have BS, skin checks, dressing changes (we dont have a Tx/wound nurse), PRN meds, creams and Tx to administer. Needless to say I am usually late getting to the dining room and the aids are busting their butts to get everyone up.I do what I can to help my aids; laying people down, getting them up, toileting, shaving...etc. I brought it to managements attention that if we had an additional aid from 6-10 that would help us get people up, ready, in the dining room and fed, and laid back down after breakfast. They told me that we are "overstaffed"; apparently state minimum requirements are acceptable. We have patients that dont get turned ( I try to keep up with it), skin is breaking down and cares are not getting done. I am ready to rip my hair out and say what is wrong with you people!!! Cant you see that if we spent an extra $30 a day on an extra aid it would save HUNDREDS of dollars on wound care????? Not to mention our reputation would actually get better and people would want to come live here....(((((headdesk)))) Is it just me or do other nursing homes run like this? With a skeleton crew and saving a few pennies at the expense of good care?

Does anyone have any ideas about how to run a nursing home not only efficiently but so that people are well taken care of?

I have also been offered a job at a hospital but its a huge paycut and I will be barely scraping by financially, but I will have my sanity...

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I feel your pain I work on a unit in a LTC facility (Neuro) I am burn out. I take of 28 residents the same thing you mention in you quote. The place is under staff and managers expect every thing to get done in 8 hrs. I work 3-11 shift and sometimes i'll be there until midnight. It is very difficult for me working in the nursing home.

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We get in trouble if we dont take a 30 minute lunch and if we stay late! I usually work my lunch and just write it in...

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Specializes in LTC, SNF.

Have had the exact same experience with LTC as you have (& 2 different places) - skeleton crews, cares not getting done -- no way to do it in 8 hrs, DON pissed if you clock any OT....fast way to burn out. Got the he11 out of there cuz realized couldn't make any difference!

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Specializes in LTC, SNF.

and almost forgot -- we had to do breakfast and lunch in the lunchroom also (2 meals). Left feeling frustrated every single day - and then if something went wrong (ER transport, new skin issue, etc. -- goodbye any kind of plans)!

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Specializes in LTC.

The bottom line is always money. "Its not in the budget " are the words I hear when I ask for more help. I can totally understand where you are coming from. I work nights and pm shift. Pm shift at least is getting an extra nurse for a couple hours to help at the beginning of the shift. Nights 50 residents 2 CNAs and myself on one floor. 3 frequent fallers that usually sleep in recliners in the lobby because they are VERY restless at night. Usually need one at the desk just to watch them.

Then god forbid being the only RN in the building if there are any falls or incidents in other parts of the facility I have to go and assess. This is in addition to doing the work I have on the floor I am assigned to.

Those are the times I just wait for someone to approach me about getting overtime. They would get an earful!! Being able to prioritize and get a system down to get things done helps but it doesn't take much to throw that all out the window.

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our midnight shift aide gets up 9 total care patient during midnight shift during the midnight shft so the day shift aides have lighter load of people to get them up and bring them to the dining room and start feeding the resident. we recently got our citation during our state survey because resident's food was cold. so how many patients are the midnight shift getting patients up? i think that is part of the problem. midnight shift should be getting people up, not just check and change their briefs. nurses duty is to come to the dining room and help with feeding the residents. you should be focusing on passing medications and make sure that aides are brining patients to the dining room that needs to be be fed, not helping them with shaving or getting them up. ask unit manager to let midnight shift aids get more residents up more than one person becuse shes trying to get out of bed.

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Specializes in Cardiology, Pediatrics, Primary Care.

My first nursing job was in a LTC facility, and I encountered the same issues. We had 44 beds and 2 nurses/4 CNA's to staff it. Sadly, the bare minimum was all any of us had time to do, and the resident's were the ones suffering from it. I lasted about 6 months, and took a job on a telemetry unit. It was a small paycut, but worth my sanity. It takes a very special person to deal with LTC issues, and I guess I am not one of those people.

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Specializes in LTC, assisted living, home-care.

ME TOO... I worked LTC for 3 years. Nothing mattered. I couldn't get my people up with good feeling of proper care. If I brushed teeth, combed hair, made beds, etc, I was always late. If I was on time, my residents were not ready for the day. God forbid if there was an extra need. Soiled brief, sheet change, etc. NO OVERTIME allowed. NO working past your shift. Get them out and ready. I left for my own sanity. I never felt I had enough time to care for the residents as needed. God Bless the ones who are able to cope...

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I really think it would help out immensely if the night nurses could do blood AM blood sugars and if the aids got up several of the totals on the hall. All night shift ever seems to do when its mentioned is act put out about having something else to do. I would bet my life that they dont have as much as I have to do on days, granted i understand things get busy on all shifts and there are exceptions to the rule, but pleeeeaaase have my pitcher full of ice water and the cart stocked. Ugh......

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"If the other shift did more, things would be so much better" .......Sorry, I don't think that is the answer. Every shift is working hard. Just look. You work hard, they work hard. The problem is that management does not know how much staff it takes to take care of a human being. There needs to be better staff to patient ratios. There needs to be better communication. There needs to be adequate supplies for patients and staff to perform their jobs. That how we should be taking care of people in LTC.

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our midnight shift aide gets up 9 total care patient during midnight shift during the midnight shft so the day shift aides have lighter load of people to get them up and bring them to the dining room and start feeding the resident. we recently got our citation during our state survey because resident's food was cold. so how many patients are the midnight shift getting patients up? i think that is part of the problem. midnight shift should be getting people up, not just check and change their briefs. nurses duty is to come to the dining room and help with feeding the residents. you should be focusing on passing medications and make sure that aides are brining patients to the dining room that needs to be be fed, not helping them with shaving or getting them up. ask unit manager to let midnight shift aids get more residents up more than one person becuse shes trying to get out of bed.

no. no. no. the only patients the mnoc shift should even think about getting up are the restless ones, you are missing the forest for the trees. the issue is too rigid a routine, and not enough staff. the bottom line.

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