Nursing Home conditions are unacceptable!!! (vent)

[Kanani_Ikike]

and I am darn mad about it!!!!

It really hurts my heart that these people can't get better treatment than this.

As you probably can tell, I work in LTC. And right now, I am wanting to turn some facilities in for unsafe conditions and deliberate understaffing. However, as we all know here, state by state nursing home inspectors are aware but turn a blind eye to the staffing guidelines of nursing homes. Who do we have to tun to if not the state watchdogs? Why is it acceptable for this to go on? I just got off of my 2nd shift where I just had 48 patients on a dementia/Alzheimer's unit. There was only 1 nurse and two CNAs to 48 patients. And to add to the equation, the moon is full. So, y'all already know the rest.

This was my night, last night (and on most nights):

I have 4 tube feeders, multiple diabetics, 20 of the residents are total care, the other 28 are walking "time-bombs" just waiting for a fall, or worse, to happen. I am trying to do med pass in only 2 hours for all these people. I have resident's that are sundowning and having some psychotic issues. I can't finish my med pass because I keep having numerous issues that interrupt me. I have mostly 48 people that you have to sit with for 10 minutes each to convince them to take their medicine due to their mental incapacity. You have 30 of them that will hold the meds, which are crushed in applesauce, in their mouths forever. You can't leave them because of fear of aspiration, so the clock is still ticking. You have the other residents that I have to keep running to check on every 5 minutes because I hear bed and chair alarms going off, all while trying to stay in compliance with med pass. You have only 2 CNAs that are working their butts off. So of course, I won't let them drown. I help them feed and do peri-care (they are lucky to get a bed bath tonight. Showers just ain't going to happen tonight). I have 4 tube feeders that, unfortunately, have not been flushed on the previous shift, so you know what's next. I spend 15-20 minutes on unclogging their feeding tubes just so I can give them their meds, not to mention feed them, flush them, etc.

During the first part of the shift, the doctor was in the building seeing residents on another unit. I have a couple of patients with issues that he wasn't scheduled to see today. Instead of him walking around there to come LOOK at these patients, as I begged him to do, he just gives me orders based on what I tell him. He won't even come and see them. Okay, that pushes my buttons even more. So now I have extra charting to do to cover my butt (and his), if anything worsens with these patients. And lastly, I have a man that was confirmed MRSA positive, but the DON refuses to move his roommate. This man is allowed to wonder around touching other residents because nobody has the time to keep him from coming out of his room. Not to mention that I am getting calls from other units to come and help out when needed.

I ask all of you. What can be done? I hate to refuse to work because this place has some nurses there that will work, but when they do work, they don't hit a lick at anything. I hate to follow them because I have to make up for what they didn't do. We have nurse supervisors that do the paperwork part of their job, but nothing more. They never work the other cart when there is no one else. They just leave you hanging out to dry. This facility does not advertise to get more nurses, so I don't know how they expect to hire any. And because a lot of nurses just accept these conditions, it continues to happen. It's not fair to the residents and it's not fair to the nurses. What can we as nurses do to make a difference and stand up for these patients? There has got to be a way to make these people's quality of life, during their final days, better. They have worked hard and made this country what it is so that we can live and this is how they are repaid? Something has got to be done about this. I'm pretty sure it's not just my facility, but others across the country as well. And y'all, with the baby-boomers growing older and living longer, it's going to get worse. But it has to stop.

Your input and comments will be much appreciated.

Thanks, you guys!!!!!

[TheCommuter, BSN, RN]

I am going to be blunt, and my reply might offend some people. Nursing homes get the short end of the stick because of societal attitudes regarding the elderly. Elderly people in America are marginalized and often deemed no longer useful to society, so they are shoved to the background by legislators, administrators, and some family members.

Any nurse who works in LTC knows very well that a whopping number of their elderly patients never receive any visits. The ones who actually get visits typically receive them on an infrequent basis. Only about 25 percent of my elderly patients are visited regularly by their loved ones. So, yes, many family members are using nursing homes to shove their elderly, unwanted relatives to the wayside. And, how can lawmakers, administrators, and the state care if countless family members no longer care? I call it the circle of uncaring...

At my workplace, caring nurses are viewed as a threat to the nursing home operation. The DON and management will do underhanded things to rid the facility of good nurses, because they are more likely to report wrongdoings. Since many LTCs suffer from bad management, the only people who can get along with bad managers tend to be uncaring nurses and rough CNAs. Like attracts like. Being a good nurse in a bad LTC is a drain to the soul, like a vacuum that sucks the joy out of you. I'd hate to sound pessimistic, but it is immensely difficult to bring about change in a vacuum.

[Kanani_Ikike]

The national standards are shameful. My stste has good ratios for acute care.

It was RNs who did most of the 12 years of lobbying, letter writing, signature gathering, and educating the public.

Because RNs are the minority of healthcare workers in long term care we all have to work together. It will take many brave nursing assistants, nurses, and families to do this. I quit a job at a horrible nursing home almost 40 years ago. It was in a very wealthy area. Nice front and lobby where we were only to take alert, clean, dressed patients with their hair combed.

12 patients and six sheets are not OK when they are incontinent. I was a CNA. I reported them to the health department but didn't have an organization to help do anything else.

Are there patient advocacy, church, or senior groups who can help start a movement? We nurses need to do this. You are right

THIS IS A CRYING SHAME!

It seems that no one cares until it's them that's being treated this way. I wish i would have thought to contact Michael Moore before he made Sicko . I think the world needs to be brought to it's knees with the reality of nursing home conditions. Animals at the Humane Society get treated better. I might contact him to see if he'll do a sequel.

[Kanani_Ikike]

I am going to be blunt, and my reply might offend some people. Nursing homes get the short end of the stick because of societal attitudes regarding the elderly. Elderly people in America are marginalized and often deemed no longer useful to society, so they are shoved to the background by legislators, administrators, and some family members.

Any nurse who works in LTC knows very well that a whopping number of their elderly patients never receive any visits. The ones who actually get visits typically receive them on an infrequent basis. Only about 25 percent of my elderly patients are visited regularly by their loved ones. So, yes, many family members are using nursing homes to shove their elderly, unwanted relatives to the wayside. And, how can lawmakers, administrators, and the state care if countless family members no longer care? I call it the circle of uncaring...

At my workplace, caring nurses are viewed as a threat to the nursing home operation. The DON and management will do underhanded things to rid the facility of good nurses, because they are more likely to report wrongdoings. Since many LTCs suffer from bad management, the only people who can get along with bad managers tend to be uncaring nurses and rough CNAs. Like attracts like. Being a good nurse in a bad LTC is a drain to the soul, like a vacuum that sucks the joy out of you. I'd hate to sound pessimistic, but it is immensely difficult to bring about change in a vacuum.

You are so on point with this post. And you are right, they don't like the good nurses. Not trying to toot my own horn, but I feel like very few of the nurses that work there actually care. They will work overtime out the wazoo because they just do the minimal and get paid for it. Like I told a colleague of mine the other night. If you really come to work and actually do some work in a place like this, you don't want to work all the time. I know I was worn out after my shifts.

And you are right about them getting rid of the nurses that do care because they are working on getting rid of me. I guess I expressed how I felt to the wrong person. They have so many sly, underhanded spies doing their dirty work. But I sometimes say the things I say out loud so they'll know that they're not pulling the wool over everyone's eyes. Some people, like myself, are not part of the clique and I will speak up. These people deserve better than what they are getting and good will prevail in the end.

[BigB]

I hear you, really I do. I also had 48 patients and 4 CNA on a good day. It was terrible. The only advice I can give is to leave that LTC facility. I did, and it was the best choice I could of ever made. LTC is broken in many parts of the U.S.. It's a shame too.

My med pass took 3 hours on PM shift.....that's without being interupted by family members. Be thankful your unit manager does something. Mine was never on the unit, and didn't manage a thing. Her job was diverted to me.

Leaving is the only option when up against a situation like this. It will only get worse.

[BigB]

It seems that no one cares until it's them that's being treated this way. I wish i would have thought to contact Michael Moore before he made Sicko . I think the world needs to be brought to it's knees with the reality of nursing home conditions. Animals at the Humane Society get treated better. I might contact him to see if he'll do a sequel.

Having worked in LTC and the prison system, convicted murder inmates are given far better medical care then our elderly. I was so outraged that I nearly contacted the local news stations who have advocacy segments and spilled the beans about the staffing shortage and hidious conditions on LTC. Someday I just might.

[Kanani_Ikike]

I hear you, really I do. I also had 48 patients and 4 CNA on a good day. It was terrible. The only advice I can give is to leave that LTC facility. I did, and it was the best choice I could of ever made. LTC is broken in many parts of the U.S.. It's a shame too.

My med pass took 3 hours on PM shift.....that's without being interupted by family members. Be thankful your unit manager does something. Mine was never on the unit, and didn't manage a thing. Her job was diverted to me.

Leaving is the only option when up against a situation like this. It will only get worse.

Thank you for your post. I plan on leaving and have a couple of interviews in the next 2 days. I really wish it hadn't have come to this, but I know that I don't leave, I will be ousted just like the others in the past. This place has a reputation of getting rid of the nurses that don't buy into their crap. If they can't find something to get rid of you for, they will make you so miserable that you leave. I guess that's their intentions. And the fact that I've been trying to make a change doesn't help any.

[Kanani_Ikike]

Having worked in LTC and the prison system, convicted murder inmates are given far better medical care then our elderly. I was so outraged that I nearly contacted the local news stations who have advocacy segments and spilled the beans about the staffing shortage and hidious conditions on LTC. Someday I just might.

Oh please do. I'm thinking about writing an editorial in our local paper to get the word out. I'm taking my time with it to make sure I don't "defame" or "slander" anyone or any place. You know that's the first thing they'll come up with.

[BigB]

Oh please do. I'm thinking about writing an editorial in our local paper to get the word out. I'm taking my time with it to make sure I don't "defame" or "slander" anyone or any place. You know that's the first thing they'll come up with.

That would be agreat idea.

[Kymmi]

OMBUDSMAN---every facility has one assigned to them and a phone call is needed to that person each and everytime there is something that isnt right. I've seen so many of you write in your post that you have thought about or come close to calling and reporting or say that you'd like to call but very few of you who have. We can complain all we want to each other and say we've thought about doing alot of things or we wish we could change things but those thoughts and wants need to be carried out. If 100 of us think about doing something but only one does that leaves 99 people who just might have made a difference if only a phone call was made by everyone who thought about it.

[pumpkin92356]

How awful, I am so appalled at this. I worked at a veterans home that was absolutely horrid with patient care. If our war veterans are treated like this in a state run home then why wouldn't it happen elsewhere. My Lord please do something about these greedy insurance companies and pharmac. companys that rob our elderly. Maybe we should bring back the "Eskimo on the Ice" theory? This country is unbelievable when you consider the hard working americans who cant get health insurance. Its all about money and cutting corners and getting all they can get out of medicare.

[deeDawntee, RN]

Oh My God, I am so sorry that you have had to go through this. I truly am glad that you are getting out of there. You are only one person and you have to get yourself to a place where you can survive while you are trying to make a difference. I strongly believe that one person can make a difference and you sound like you already have some great ideas of what you can do. Perhaps some of the families will be inspired to do something as well. I certainly hope so. Thank you for doing what you are doing and thanks for doing what you have for your residents. Nothing goes unnoticed in life, I firmly believe that!!!

:thankya::thankya::thankya: