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. ?

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.

I worked inpatient oncology nearly the entire 12 years my hub had CLL, and he was immuno-compromised the entire time. Medical oncology is filled with the stuff you see only rarely in any other setting....all the abx resistant stuff, and oddball infections we don't know how to treat. Other than the precautions mentioned by previous posters, I did nothing....so far as requesting assignments was concerned. My better half passed of complications of his disease in an expected manner, and the only infections he suffered in that time were either treatment-related, or those he brought on himself (cellulitis, community-acquired pneumonia, etc.) It's difficult to accept that, although you know HOW to protect them, you truly can NOT protect them from everything. So relax a bit, and be the best nurse you can possibly be. In the setting your talents suit you best ❤️

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!!!!

Nodding my head with enormous respect for all of you. The straws that finally broke this camel's back were: 1) having to "fix" something....the phone, the fax, the computers, the orders, incorrect meds (or none!) sent by pharmacy, the med cart, the plumbing, the food, the temperature, etc, etc, etc...every time I turned around. And: 2) the verbal abuse of families/visitors/(and yes, patients). When I wasn't turning around to fix something, it was time for another "verbal colonoscopy". Nurses in LTC are these ridiculously shaped funnels attached to huge Cuisinarts. General information, nursing duties, provider orders, meds, treatments, labs, xrays, social issues, therapies, out-of-facility visits, documentation...are all funneled into the nurse, appropriately combined, and disseminated to 40-60 patients, one by one. Gack. Got the willies just writing this.?

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. ?

Thank you all for posting on this topic! I just made the decision to retire from bedside nursing....a profession I was proud to be in when I started so many years ago. There are many fond memories of lives touched and I feel fortunate to have participated. I can no longer withstand the moral injury of being torn (more like shredded!) between the needs - and unreasonable/impossible demands - of patients, families, other staff and administration. The main reason I stayed in it this long was to support ill parents and an ill spouse. Now that I no longer have those responsibilities it is time to be responsible for ME. Like some of you, I mourn for what has happened to my profession; more so for how the chase for the Almighty Dollar has changed health care in this country to a soul-less, compassion-less quagmire for those who work in it. Sorry about the soapbox. ☺️ It will be financially tough until I hit Medicare age, but my physical and emotional well-being are more important to me than repeated soul-sucking and burnout for a nice paycheck. I have value, and will find a niche. In some ways, nursing has been "berry berry good" for me.... .....as long as I no longer have to practice it. lol All my best to everyone!

"It's The End Of The World As We Know It" by REM If not the end of the world, the end of my license.....

Bluegeegoo2....GREAT!!!! You have my respect, and best wishes for a happier, more fulfilling life. I am still stuck in the insanity of LTC/Rehab - and given the fact that the ENTIRE administration in our facility is in the process of resigning AGAIN, it's becoming an ever more insane proposition to stay. My husband passed away in January, and I took FMLA to care for him THE DAY AFTER THEY FORCED ME OVER FOR 16 HOURS ON WHAT I KNEW WOULD BE HIS LAST CHRISTMAS. When he passed, I had to reinstate a separate FMLA claim for myself (3 days off for bereavement of a spouse? ARE YOU KIDDING????), but ended up taking a month more before I felt in any way ready to going back to Crazy World...because, I need insurance. Never been closer to quitting the profession than now. We can't keep staff, let alone staff who will work and be nice to each other. Been on same merry-go-round with this place ever since we were taken over by Big Out-Of-State Corp. Our SIXTH NHA IN TWO YEARS is leaving because she developed significant health problems as a result of the stress. Mea culpa. This is your thread. I wish you all the good fortune in the world! Please keep us posted on your adventures!

Purplegal, it intrigues me that - a year into it - you continue to be concerned about the "status" of your position. Or is it your career in general? IMHO, the "status" of a nursing position - or even as a career choice - is irrelevant. Good LTC nurses do more with less than any other specialty I've ever worked in (my favorite expression is that we've been doing so much for so long with so little that we now feel qualified to do anything with nothing ), and require expert assessment and intervention skills; something learning all the procedures in the world may not necessarily teach. As another poster said, we can make chicken salad out of chicken crap - and do so, every shift. Who needs status when we make magic happen?

Having been a victim of "extenuating circumstances".... I recall allowing myself to be swallowed by the Guilt Monster once, over this. Called in a "I might be a little late" alert, four hours before the start of my noc shift, because I got caught in a white-out when a blizzard showed up earlier and more fiercely than predicted. Got 10 miles of my 50 mile rural commute out of the way in the first hour (some of it probably on a curb or in a ditch? regardless, my 4WD wasn't happy), and had to call off and turn around (could not see to get around an accident). I was insanely fortunate, because my supervisor had put the word out before the storm, knowing my commute was 10 times farther than most of the staff, so I was covered. Granted, from then on, I "over-prepared" - that was the first and LAST shift I missed due to weather. Made some friends at the nicest hotel closest to work, got a sweet discount, free breakfast, and a quiet room on the end of the hall, guaranteed, whenever I needed it. Better than a 50-mile white-knuckle commute ANY TIME.

To kbrn.... I hope clarity re: benefits has reached you by now. Our takeover actually got us better health insurance choices and other benefits (some of the Mother Ship's Right Coast facilities' staffs are unionized, I understand), and although the definition of a FT employee was changed to exclude us 12-hour shifters (raised from 36 hrs/wk to 37 - kinda blatant slam), we were at least allowed to keep our benes. After 2 rounds of "open enrollment", little has changed (except the premium increase, disguised as a 52-week/yr deduction to replace the 50-week/yr deduction....sneaky, that). BTW, hiya neighbor - Wisconsin here, too. FWIW? I'd keep your resume UTD. All the best to you!

HA! Just when I thought it couldn't get much worse....(kinda like using the Q word )...it has, with Mass Staff Defections. Our core nursing staff is down to 3 RNs and 2 LPNs (ALL part-timers), MDS and DON have put in their notices, our NHA was replaced by someone who has a history as a "closer" last month - and I can't even keep track of the CNAs. Have to keep this job until I can find another, but if I have to face another NOC with only myself and one CNA, I may have no choice but to run away faster. Difficult to surprise this curmudgeon anymore, but I've never been so close to refusing an assignment on the basis of patient safety in my entire career. Posting here simply to vent - yes, I see the handwriting on the wall. Appreciate any/all understanding and support. Who will care for the patients who have no choice in this after the last employee quits? (Frosting on the cake? We got our first raise in 3 years. I'm donating mine to charity....I'm already conflicted about accepting pay from a company that so blatantly cares nothing about people, nor safety, nor facility, nor paying bills, ad infinitum...)

The rolling tide of SNF Takeovers hit my 5-star facility well over a year ago, and we became LT and PAC. Since then, our once-happy little organization has been afflicted with several maladies: vendor service issues r/t non-payment, staff and nursing policies that change almost weekly, unfilled staff shortages r/t revolving-door-dissatisfaction (read abject terror), an entire HR department "disappearing", admin forced to become salespeople (as if they didn't have enough to do), necessary building repairs being ignored, IT and telephone issues beyond staff capability to fix, and yes, even "delays" in payroll. More than a few of our LT residents have left us for other "better" facilities. Of course, we staff members are being 'coached' (read expected) to maintain the correct attitude, and to desist from any comments remotely construed to be complaints. Too much other deterioration to mention. I know we're kinda late to be afflicted with TakeoverItis, but I need a reality check. Has this happened in other places? (Limited options for other employment, but am watching opportunities like a hawk and networking with those who've successfully found other positions. Not even a battle-hardened curmudgeon like me can nurse in this environment. Not without a better hammer for the chisel I'll need for charting in stone.....)

Thanks for the update, mtjoanna. Big Fish In A Small Pond/Small Town Mentality Nepotism Blacklist Blues here, too. Relocation isn't an option for me, but as I've reached a point eerily similar to yours in your previous position, I'll take a much longer commute for a little more sanity and less chance of finding myself afflicted with 'tire tracks'. Soooo glad to read things are happier in your world!

The BEST "thank you" I've received (in my current position) was a hand-written note from my NHA, praising a unique strength I bring to the team. Granted, I'm old-fashioned, but that simple note beat any monetary or other expression of gratitude hands down. So, I agree. Go for it! Congrats to your entire team on your survey results!

Dear OP, As a (now) curmudgeon, who was in a similar spot in her career as an RN about 2 years in, I have to agree with Nurse Beth. Co-workers you trust acknowledge your skill and ability - in departments that are often tricky to navigate for newer nurses. You can do what you do, but it just doesn't satisfy your definition of nursing. Self-confidence in nursing is not always the easiest thing to acquire, and perhaps consultation with a professional might help you tease out the tiger in your tank. I entered my career as an RN with a TON of previous medical experience in different roles. I was sure I wanted to be in the MICU, SICU, stepdown, etc. After about 2 years floating between all of those and telemetry/oncology, I found that oncology was my "heart's desire", and, like you, I snagged the most complicated cancer patients from nurses who were glad to make an assignment switch. I put blood, sweat, and tears into certification....and it was the best thing I ever did. Caring for oncology patients not only improved my nursing judgement and clinical competence, it also fired the tiger in my "fulfillment" tank. Listen to your heart....it may be trying to tell you something. We all have different gifts, and our hearts lead us to the discovery of how best to use them. Best of luck to you!

No matter what setting, this has ALWAYS been a bad omen for me. That, and someone using the "Q" word....

Wow. Just. Wow. When I transferred to current from facility from an equally good 5-star sister, we had a hard-working but caring, cohesive facility. A new EMR sent a few staff into retirement, then a big out-of-state corporation bought out our collection of neighborhood LTCs. We were turned into a sub-acute rehab, with LT residents (a new world for many of the staff). Our existing corporate HR completely disappeared, and we are required to sign for a employee handbook with new policies about every 6 months or be terminated. (I have time to respond to this only because my admin was lucky enough to find someone to take my shift so I could take a few hours of vacation before I lose it.) Since new ownership, approximately 85% of our nursing staff has departed, our payroll has been late several times, our building is falling into ruin, our failing phone system is being ignored, and we can't keep enough computers up and running for staff to document ever more interventions in the dwindling hours being assigned us. Admin is being pushed to accept patients that are much too acute for rehab. I consider my coworkers heroines/heros. We are, literally, "doing so much with so little for so long we are qualified to do anything with nothing". There is an intense level of stress. Constantly. That said, I work with folks who care and share the load. This is, seriously, no joke. Still, I envision a happier day when our facility becomes more like the one where jeanrnurse works.

I collected several "scope coats" in bright colors and flowery patterns before the company stopped selling them. Not only do they keep the skin oils away from the tubing and my neck rash-free, but I can spot My Ears a mile away in the dark. Most docs/residents tend to shy away from borrowing the 'garish garb', so My Ears remain My Own (engraved, as well).

Did all the right things. Mentored the youngsters every chance I had. Carved myself several 'niches'. Became a Super User for the new EMR From Hades (and was one of the few SU's patient/dedicated enough to lead the docs through their first, frustrating experiences with it). Heard from many of the docs what a "travesty" it was that I became 'too expensive for the organization to keep'. Even left a very helpful negative review of said organization on Glassdoor. I miss the "edge" I honed in the hospital. The idea of spending the next 10 years in LTC/Rehab is, for lack of a better description, anti-climactic. As long as I have a disabled spouse to support, options to flex my Experience Muscle are somewhat limited (as in no 9 to 5). When I passed the NCLEX I was relieved that as long as I could give good care, I could find a job. So far, that has remained the case. Not in the way I anticipated, but then, life has a way of adjusting our expectations. Like any good nurse, I can still roll with the punches. Go ahead, sling more ageism my way. Yes. That's a dare.

Agree with posters who discouraged MA to RN (although the skills training helped me significantly). CNA to RN, at least in the states I have practiced, offers more easily accessible options for "upgrade". Also agree that, if you have a dependable support system in place, RN is possible, as long as you grasp the tail of that comet and FLY. All my best to you!

Sad as this is, I think another tactic to "influence" new staff (of course, I am being kind). Lots of deadwood being pruned lately (AEB a 30-year nurse in uncontrollable tears over this), and Press-Gainey and ACA being what they are these days.....to me, it seems there are no depths manglement will not sink to.

Respectfully and in good faith, if subjecting myself to abject poverty to obtain an MSN causes me to consider those who don't "victims", I have no desire to do so. I happen to love bedside nursing, and I am danged good at it. A career as anything else (and yes, I have tried other areas of nursing) holds no appeal for me, and therefore, no satisfaction. Secretperson, I forgive you your perception that our mentality is responsible for our lot. I have forgiven those responsible for my journey away from the hospital, and will, with my last breath, respect and honor those nurses in the trenches. That said, I joined this discussion to express my solidarity with those experiencing this, and ALL bedside nurses; not to engage in a philosophical discussion of victimization, nurses eating their young, and resistance to change.

Tru dat. I'm still uncertain if it was my age, my wage, or my disabled spouse's drain on the corporation health plan that got me canned.