On the frontlines

[DaisyMountain]

I work on a ltac unit, Long term acute care. This is a new area of nursing and most think it is based around the elderly, but far from the truth. Everything you learn in school is right here, from diseases, procedures, traches, vents and so on. I sometimes feel as if I work on the set of "House"

Anyway, When patient's families are being given tours we hear the director making promises to the families. "Your parent will have their own room", "the nurses only have 2-3 patients a piece" (YEAH RIGHT. nothing like having a patient on a drip, another on a vent, another getting blood, one who can let their needs known, and another who's blood sugars are in the toilet, and whatever the 6th one may be), "physical therapy is done everyday here". When some of this is only true some of the time and then WE deal with the families, "why has my mom not had physical therapy for 3 days", "Where is the private room", and so on.

Is this common?? I am a new nurse, so I do not have experience working in multiple places. Who cares about the patient's safety, we want the beds full and the money coming in. Ugh So frustrating. I feel like my license is in jeopardy.

[DaisyMountain]

Sorry I know I am all over the place with this. It's my first post on here and I have some venting :) basically I am just curious if it is common to promise the families of a possible, future patient the world, and not live up to these promises.

[mazy]

Absolutely. LTACs are can be very shoddy, shady places. It's about the big bucks, or any bucks, as they usually have problems keeping their census up. I worked in one and went screaming for the hills.

But to be honest, any health care facility can be accused of the same behavior. LTACs just have less visibility, thus less accountability.

[SweetLikeSugar]

My parents put my grandfather in respite care at one of the many many LTC places in our community so they could go on a vacation for a few days. My grandfather was about 89 years old with dementia. When he had stayed there before, he was always placed in the locked alzheimers unit. This particular time, there was no bed available in the locked unit. The director assured my mom that the nurses didn't have high patient loads and that the CNA's would have no problem checking on him every 15 minutes throughout the night. My mom fell for it hook, line and sinker. I told her repeatedly that that most likely wouldn't happen, that they just wanted to fill a bed and get the $$$. But she assured me that the director "promised her. And she seems really nice."

My parents left for their vacation the next morning and after about 2 hours on the road, they got a call from the director herself that my grandfather was found at about 6am at the bottom of the stairs covered in blood and was being sent to the hospital for a head CT. They had no idea how it happened. When the director was asked by my parents about the q15 minute checks, she had absolutely no answer. She did however continue to call my parents every week for about a month checking on my grandfather's condition.

[linearthinker, DNP, RN]

It isn't just there. My NM stood right in front of me and told some real bold faced lies to joint com surveyors.

[DaisyMountain]

I am so sorry to hear that, Sweetlikesugar. Our director is so nice to their faces it's repulsive and I wonder how she sleeps at night. She also throws us under the bus in a heartbeat. One day I had this patient who's family had been complaining of all kinds of things, which they had EVERY right to and the director went and talked to the patient (very rare for her to do, must have been some big time threatning going on) and I was in there to support the conversation to make the patient feel better and answer any questions. The director looked at me and said "have you not brushed her hair today?"..WTH?? I wanted to say, "no but I have cleaned her behind multiple times due to her c-diff along with my four other patients", mind you this is a hi-ops unit, with five patients. I said no and found her a brush and handed it to the director, and she softly brushed her hair trying to make the patient feel better. I wanted to scream and vomit all at once. "Thanks alot!!"

They promise the families the world and I am sorry to anyone who has been lied to. I just hope the families understand that the nurses are not ignoring their loved ones and if we could all of their hair would be combed and they would heal and be clean and safe at all times. At these facilities, I am the nurse (we know how many duties are listed under this), the CNA, the RT, Pt, OT, advocate, and so on. the other day I got to give a patient a bed bath, lotion her and put a shampoo cap on her head (very rare moment and used my lunch break without thinking twice). She was so appreciative. I just love that part of nursing. *sigh*. I could go on and on and on.

I think I need to look for another job.

[classicdame, MSN, EdD]

of course you could mention to the manager that she is putting the staff in uncomfortable positions when you cannot live up to promises. Maybe recommend to her better phrasing?

[DaisyMountain]

It is pretty well known that this happens on a regular basis.She gets the patients and Corporate is happy. Don't get me wrong, my job is so rewarding. I am so lucky to care for these people, and I am honestly lucky to have gotten this job as a new grad, so I am thankful for my work in many ways, but I wish i could spend extra time with the patients, and I always can't. These people are so sick, and then sometimes even on comfort care, we are all over the board with patient conditions. The last couple of weeks have been extremely crazy so I think I just kind of vented in my post. I just want everyone to be safe and properly cared for as promised.