Nursing Home, chronic understaffing, and dealing with profit driven business owners?

[NFuser]

As few as 2 years ago, I thought I could do anything nursing-related....but LTC broke me. I feel fortunate to have retired (much earlier than planned) with my integrity (and license!) intact.

LTC nurses have my unending respect and admiration. ?

[Anne36, LPN]

I understand because I happen to be in a similar position. The longer I have been at this facility the more duties I have been given along with more residents to care for. Corporate is driven by profits and puts us in a difficult position. I've seen Nurses cry at work because of the stress. I would search for something different if I were you. Long term care has turned into a circus with the acuity and expectations for care at end of life. I should not be doing such things as calling lab, pharmacy and Dr in the middle of the night. I do not work in a hospital but sometimes I feel like it. Difference is we have 50 patients instead of 5.

[NFuser]

On 3/16/2017 at 8:46 PM, TheCommuter said:

Only the threat of impending homelessness would prompt me to return to the LTC industry. I salute those who still fight the good battle in today's nursing facilities

The post I am quoting was well over 2 years ago. I am humbled beyond words to admit that I retired before my time (and may, at some point be faced with homelessness) because of what you faced. Perhaps it was because I'd been faced with similar moral injury and could no longer accept that. I'd rather be poor than return to LTC/Rehab. My hope is that it becomes easier for ALL of you. PRONTO!!!!

[garciadiego]

The only thing that keeps me from cynicism, from anger and from all those other negative emotions is my belief that this is not all there is, there is a moral order and justice will ultimately win out, in the mean time while I have to cope in the world and my 37 years in healthcare experience is that when it comes to healthcare, money is more important than people, it's that simple and this truth seems to be true in politics, insurance, etc. Sorry I can't help you, I think the only thing that will change this Nihilistic world is massive revolt by the masses.

[NFuser]

Bless you. I appreciate your thoughts, garciadiego, and I still believe in those things. Had I spent one more moment in the environment we are discussing, I no longer would believe those things. There is much I still have to offer the world, but without obligation to an employer, my motivation can once again be pure and hopeful.

[FashionablyL8, CNA, LPN]

I'm not a nurse yet- in an LPN program and will graduate in 2021. However, I've been a PCA, HHA, CNA and now a med tech/direct support staff for many years. I used to do private duty, then was offered a job working at a residential home for developmentally delayed adults and have been there for over 6 years now. I hope to stay there after I graduate, but if they don't offer me enough hours or pay (the pay there is not the best) I'll have to find another job. Unless I can find another place like my current job, I'll probably be going into LTC. I love bedside care, and plan to do it as long as I'm physically able to, which will probably be quite a long time. I like to get to know my residents, everything from their behavioral quirks and life histories to whether they take their crushed meds in applesauce or yogurt and their normal vital signs. I enjoy having coworkers too (well, most of them!). We certainly have our issues at my facility, but when I hear about the problems in LTC these days, it worries me. It's terrible that the owners of these places are so money hungry that they are endangering their residents and staff, and driving skilled, experienced nurses out of LTC. It's just creating an endless vicious circle. Without good nurses with proper training, residents will suffer more harm from accidental errors and falls, which leads to loss of $$ for the facilities, which leads to more cutbacks in staffing and less pay, which results in more nurses leaving and the new nurses not having qualified preceptors, which starts the whole thing over again. It's so clear yet seems to just keep getting worse. I know I didn't add anything to the conversation but the perspective of an older new nurse-to-be, but I just had to comment because I think about this issue a lot.

[NFuser]

You have my best wishes for long-term success and fulfillment, Fashionably L8. Be that Good Nurse, be true to your patients AND yourself. ?

Edited Nov 19, 2019 by NFuser

[Straight No Chaser, LPN]

On 3/16/2017 at 2:18 PM, AnOldsterRN said:

Why oh WHY do nurses take shortcuts or come in super early to start care care then clock in on time, clock out but never leave for lunch then clock back in, lock out and continue working? I absolutely won't do that. I suspect I'll be let go due to that.

If more nurses stuck together with regards to the impossible workload, perhaps things might change.i don't see that happening though. It's going to take the law and their are bones minimum staffing.

I suck at time management. I spend too much time talking to my patients and doing "extra" stuff for them. In order to allow this, I sometimes document off the clock. If I stay clocked in I get in trouble. If I rush through my documentation, it is sub-par at best.

Today I had a discharge, an admit, and a patient actively dying who was getting morphine every hour. That's on top of my other 15 residents. I consider myself lucky because this facility is the best I've ever worked at and the staff are amazing. Management is amazing too. Its just a broken, broken system.

I stay because I love what I do. I love it. I love having some rehab patients, some long-term and some hospice. I love getting to know these people and making a difference in their lives. I love being able to bring things up to the MD and have them addressed when other nurses just blow it off. I feel like I'm helping them and making their lives better.

But, I digress. Its a horrifically broken system and society likely has no idea what goes on.

The kicker is we are almost always in the red. medicaid payments are at an all time low, and most of our medicare patients only stay for short durations. We mostly get cardiac and respiratory pts. that don't qualify for acute rehab. So, while people think the facility is being cheap and someones pockets are getting lined, they're actually losing money.