FrustratedLPN

And the general public wants to know "why" or "how" there could possibly be any stress involved????? If the patient were in a hospital, the families certainly wouldn't be telling them how to do their job, would they? Yet, let them come to LTC, and the families behave as if we are nothing more than glorified babysitters. Nevermind the education, continued education, shifts worked on holidays, doubleshifts, etc. Time and again, I have heard families demand to see the RN. LOL!! Usually the RNs are only around during day shift, and then usually in an office tucked far away from any actual patient care. Shhhhh.. don't tell anyone, they are still counted as RN hours worked on the census report. Nevermind they don't actually touch or see patients. Oh the State Licensure Boards know this, administration knows this, and the nursing staff know this. The people that don't KNOW are the very ones that should. Let's hear an admission person tell a family just once..."oh yes, there are eight RN's in the building during the day... now they don't actually go out on the floor, they don't actually have any patient contact, they don't get vomit, blood or poop on themselves, and they get an hour (sometimes more) for a lunch break." I have tried to educate family members, give explanations as to what I do and why... all to no avail. This same person will be waiting either for the DON or administrator to come in the next morning asking the same questions again. Even when families sign a DNR or ask for HOSPICE care, they still want intervention for that family member. What is not understood about a DNR? Have any of these family members ever actually witnessed a "code" being performed? Especially on an elderly frail person? They should all have to watch a film with an actual code being performed. It's not the "movie of the week" they think it is. Family members want someone to "blame" for the condition of their loved one. Often times that anger pours over to the nursing staff, the very people that are there to HELP and care for the patient. I would love to have family members walk down that long hall with me just once.... if HIPPA were not an issue.. and look in the room of a patient that has stroked many years ago.... no speech, little if any recognition, tube feeding, incontinent, and contractured. Eyes that plead... "why"? I go outside the room, shake my head, ask how any loving family could condem anyone to this type of living hell... and go to the next room.

Only ONE of the many many reasons after 18 plus years as an LPN, I currently no longer work!! Having been on the "other side" as a "family member" when my Grandmother was in a LTC facility, I feel I have seen and understand from both sides of this issue. Does anyone ever think of the time factor involved in dealing with the same family members day in and day out? One nurse for 30 plus residents, our responsibility is patient first.... BUT administration demands that family members be kept happy no matter the time, cost, or demands involved. I have reported problems to administration, unit managers, and finally the State. Who came out the winner? Not the patient, not the families, certainly not me BUT the facility, yes... the facility. When the chips fall (and eventually they will) administration will NOT be there to support YOU. Administration will be there for the FAMILY MEMBERS, begging them NOT to move their loved one out of the facility. Time and again at several LTC facilities including those within the large "chain" of LTC facilities, I have witnessed the same attitude from management. Often times the best most educated, most caring and hardest working nurses will be terminated for various reasons, while the lazy, uncaring and unfeeling nurse will remain in their positions. Why? Because administration does not want to know the problems or the solutions. If they know there is a problem, they are obligated to acknowledge and "fix" the problem. Better for them they never know. Either way, management can't be held accountable for anything. No matter what administration may tell you i.e. "we want this to be the best facility around, we want you to bring us suggestions on improvement, it's always patient first". Blah, Blah, Blah. It is not patient first for administration, the name of the game is BUDGET. You'll see this particularly toward the end of the year when "savings" is all that is preached when you ask for supplies or staff. Face it, most LTC facilities are for profit, which means... at the end of the year, each department manager that manages to come in under budget receives a hefty Christmas Bonus usually in the thousands of dollars. Of course the Administrator shares in the wealth and good times along with the managers. Charge Nurses are necessary, but forget being actually "in charge" of anything. You won't find a unit manager's name or initals on the restorative nursing sheets. (In order to qualifty for restorative, the exercise has to be done 5 out of 7 days for at least 10-15 minutes). Now we all know CNA's barely have the time to do their required 2 hour rounds, let alone stretching muscles, walking residents. These same CNAs are feeding, changing, showering, dressing, etc. Many the shift has gone by without anyone getting a lunch break. The DON certainly isn't going to sign off on work she/he knows is not being done. Emails from the Corporate office showing what documentation is necessary to keep the patient "skilled" for a bit longer (therefore bringing in more fees to the facility). The MDS coordinator also making rounds to the floors asking that certain phrases be used in nursing notes and documentation, so the patient can be kept skilled... "do they become combative?" And yes, the one thing I am certain of is that my documentation skills are top notch. Having come from a legal background to nursing certainly helped in that aspect. As far as family meetings, care plan meetings.. reality will prove they do little if any good. I have heard managers talking with possible new admit families, telling them of the varied "choices" residents have for meals, how their loved ones will have quick and attentive staff members within minutes of putting on a call light. When are the family members going to be informed that there are two CNAs assigned to 30 plus patients? That they will be giving showers, tending to ALL these people (usually total care)? Should there be a fall or incident, this will also take time from staff. Let admissions tell the families just how often the physician is actually in the facility, AND is it the Doctor or his P.A.? I could continue, but I'm sure by now you're quite tired of reading the long list of complaints. I would love to just once before I completely retire, find an ADMINISTRATOR or DON that has the gumption to do the right thing, do what they profess to do, and care like they profess to care. After almost 20 years of looking, I haven't found that.

Hun, after reading your response to my thread.... "older nurses being phased out"... I"ve no doubt you're not only a caring, intelligent human being, but a grounded and terrific nurse. Trial by fire is what you're now experiencing, you'll come out being a gracious, caring, attentive nurse. What doesn't kill us only makes us stronger. After all, isn't that why God made us just a bit more resilient than most? Life experience is where most of your "nursing experience" comes from.... You've already made a difference in someone's life, now keep up the good work!!! Thank you for being you!

i sit here reading all the wonderful replies to my original post with tears streaming down my cheeks... thank you for the words of encouragement, hope, and spirit. although i'm moving from my hometown to accept another position, maybe a "fresh start" is what i need. two interviews this monday, (maybe three) waiting on the phone call!! i think there are times we all "hit the wall", question whether we are capable of being in nursing any longer, whether we can make a difference in someone's life. you've helped me remember "why" i chose nursing so many years ago, whether it's a patient or a co-worker....it's all about being of service/help. thank you from the bottom of my heart...and good luck in your nursing career. if i can stop one heart the aching, i shall not live in vain

There is a joke on the "Humor Forum" that aptly applies to this situation.. Capsulized it's something like this... Potential employee dies and is given the choice of Heaven or Hell.. First visit.. Heaven, nice, charming, peaceful, harp music. Nice but lackluster. Then for the initial visit to Hell... Greeted by charming, smiling people....tanned, toned...all youthful in appearance. "This is but a small taste of Hell, there's a 24 hour buffet, free cocktails, you never gain weight. You'll have a choice of activities, leisure time. Anything you desire, you only have to ask and it will be yours." Needless to say, she chooses to live in Hell for eternity. Waves goodbye to those in Heaven, enters Hell's gates... it's gloom, doom, hideous people, wailing. "Where's the buffet? Where are the lovely people that were here yesterday? Devil turns to her, "oh yesterday you were a recruit, today you're staff". Sad to say, just a taste of the real world, especially in LTC. They will say anything to get you in there. Several weeks of orientation, if you want more training you'll have it, we'll work around your schedule, etc. etc. etc. You're lucky if you get an entire week of orientation before you're on your own. Schedules are in place before you've finished orientation. So true, they are short staffed.. is it any wonder? Good Luck, and welcome to Nursing 101!!!!

Actually, it was a LTC facility where this occured, "for profit" I might add. HR goes to the graduating class and presents "employment opportunities". Over half of one graduating class was hired. Of course fewer than 6 of them remain, but considering the floor nurse totals are fewer than 10....And yes, you can "feel" the atmosphere. Others going to breaks together, being left out of meetings, discussions, hushed whispers, etc. Thanks so much for the replies and encouragement :)

Although I do realize it is illegal for an employer to discriminate with regard to age, I was curious as to whether any other nurses out there had faced issues with only new grads/young nurses as co-workers? Long story short, at 60 years of age, I don't qualify for retirement benefits, and I'm not financially independent. Working is not an option for me, I HAVE to work. My last employer (where I worked for nine months) was very "youth" oriented as far as hiring. I was the oldest employee at the facility. Although I gave respect to the DON, ADON, and other Management, I never felt as though I was given any respect in return. New graduates on their first job trying to impress management, young enough to be my children, trying to tell me what and how to do things. Granted, I have always tried to be gracious, wanting to learn any new or better ways of doing something, but when a new graduate LPN, walks into the room of MY assigned patient, and begins to make a decision regarding their care... 'nuff said. It became very clear that the facility only wanted the new graduates coming to work there, even going so far as to hiring "graduating classes". They would take a job for a couple of dollars less than what I was paid, I was used to train them, then I was of no further use. The new graduates were the protege's of the DON, ADON, and I suppose "revered" the DON. Maybe this is what they wanted rather than quality and experienced nursing care. I must also say that I was accurate, never was late, able to do my assigned tasks, worked overtime, all holidays. There was never a question as to whether I was physically able to do the job. One young nurse, admitted to giving a patient insulin that wasn't even diabetic... didn't report the incident to management. This same nurse gave medications that were d/c'd for over a month... nothing happened to her. She had numerous occasions of temper tantrums in front of other nurses, patients, and visitors, again.. nothing happened. New orientee nurses complained about the hateful attitude she had with them... again, you guessed it. This nurse also takes prescription diet drugs that make her hyperactive, not able to concentrate (known by the DON, and ADON). This same nurse is a beautiful, blonde with a perfect smile, the doctors loved to flirt with her, but face it.. the experience is not there, mistakes were made and noted by other nurses. She was able to interact with families, laugh.. be everywhere at once. Oh, did I mention that this nurse was and is allowed preferential treatment when it comes to overtime, etc? Other than looking at their nurses employed there, the majority in their 20's, and 30's, how can I go about proving an age discrimination issue? As I said, I was the oldest employee at the facility, nursing and non-nursing. It just seems that instead of managment regarding older nurses with years of experience as an asset, we're seen as a liability, when it comes to the bottom line.:sasq:

Only 250lbs? Sorry, had to say it!!! I've worked corrections as well, small and large facilities. It's a different world, isn't it? You forgot to mention intakes, daily/weekly sick call. One thing I learned, NEVER EVER question the charges an inmate has, whether by asking the inmate, officer, or searching on the computer. It can influence the way you perceive the inmate. The most personable inmate you may see could be a child molester/rapist, spouse abuser, prostitute, murderer. It's better never to know. HIV is usually rampant as is MRSA and other Staph infections. Lice, spider bites, boils, addictions, psychiatric issues, mental illness, just to name a few. After all that you'd think no one would want to be a correctional nurse, wouldn't you? Again, it has to be your passion. I loved it!

Amazing what "really" goes on behind the scenes at a lot of places isn't it? I was the senior nurse in much the same scenerio you described. Was replaced by new graduates for less pay.. No one seemed to mind that also means NO EXPERIENCE. You will find your niche, don't give up or give in. The patients need and deserve nurses that care, are willing to go the extra mile, and really want to help. It can be a struggle, a long hill to climb, but it is also the most rewarding job anyone could have! When one door closes, another opens. Yes, there is a nursing shortage, unfortunately LPN's are under-utilized for the experience and training we have.

I just happened to come across this post, and wanted to respond. The first thing that "jumped" out at me in the post... was "any EASY LPN jobs out there?", followed by "I have zero tolerance for the smell of body waste", and ending with "any INTELLIGENT responses?". Whew, I suppose I'd have to begin with asking you a couple of questions. 1. Why did you elect to go into nursing? 2. Did you have any background in the medical field? i.e. CNA, before you decided to go to nursing school. 3. Are you changing careers or going back into the work field? The responses you have for those questions would probably give insight and some clarity to your statements/questions. After 17 years in nursing, I've never found any nursing job "easy". You might find some positions with fewer patients, lower levels of acuity, shorter hours, etc. but you will not find any jobs EASY. Nursing is a "hands on" profession. I have worked LTC/SNF, Correctional Nursing, Psych, Ortho/Neuro, and Occupational Nursing. I have been Director of Nursing Services at an Assisted Living Facility. Noticed in a previous response, a reader stated she thought nurses in prisons/jails received firearms training...... Had to laugh at that one. Correctional nursing is NOT "prison guard". There will usually be one guard that either accompanies you on med pass, or watches you via monitor. If you happen to be stationed in a progressive prison/jail, you will have a barrier between you and the inmate, but there will still be an opening for passing meds, talking, etc. No need to even comment on some of the bodily fluids that have been thrown during this opening or the comments made. You will receive training re: riots, safety, emergency response, NOT how to use a gun. Correctional nurses are there when new inmates are brought to the jail. Whether they be drunk, under the influence of drugs, combative.. you will do an admission assessment, TB skin test, and vital signs. If they are capable of talking, you will do an intake and physical exam. There are pros and cons to each job. There will be smells associated with each job, some more objectionable than others. Ever had excrement thrown at you? Ever had a very ill patient vomit on you? Ever been cursed? pinched? hit? Ever had to search for a missing digit, pick it up, and bag it? There is no such thing as a "glory" job in nursing, you are primarily responsible for "caring" for ill, injured, or dying patients. At some point in your nursing career, you will unclog a toilet, clean up vomit and/or excrement, be responsible for obtaining a stool, sputum, or urine specimen. You will be exposed to blood or blood products, be coughed on, sneezed on. There will be days you will not be able to identify what is on your shoes or uniform after your shift. Welcome to the world of NURSING!!!! If I didn't love it, I would never had chosen it! If being of service to others is not your passion, nursing is probably not your best choice for a career. Just my two cents worth, hopefully it meets your criteria for "intelligent" response.

You'll do fine. Just remember, any new job is tough. You have the basics, but the first couple of days feels as if you're in a foreign country, the med passes seem as though they'll never end... and you may even wonder if you really did go to nursing school or was it all a dream? How will you ever remember all those names and faces? Just take a deep breath (several during the shift), remember it's "experience". Don't rush, you'll develop your own pace and way of doing things once orientation is finished. If nursing is your passion, you'll succeed. Even when you don't think you can walk that hall one more time, one foot in front of the other.. one step at a time. Good Luck, have faith and confidence in yourself... you'll do well.:scrm:

Thank you so much for this forum... as the wife of a prescription seeking husband, it's been two years of stress.. stress.... and more stress. Of course I have my own addictions *smoking, eating, and co-dependency*, so this will indeed be a tremendous support and learning experience. Those of us that want to feel "needed" have our own reasons for being in the "helping" profession. It's taken me many years to comprehend and admit this. Consider the labyrinth... many twists and turns, but continue to walk the path, seek enlightenment and understanding, ask for guidance. There is a place of peace, comfort, and love. Some may arrive sooner, some later, but if one keeps on the path.. eventually we do reach our center. Balance in all things. If I can stop one heart the hurting, then I shall not have lived in vain.

Thanks so much for the welcome and the information!! I have one interview set up for this Wednesday, 1/30. Keep your fingers crossed for me please! Hopefully, the move is planned for the weekend of the 2/1. Taking nothing but my uniforms, some jeans, and the two dogs.... (actually after the prior divorce, there isn't much left to take!!) Just as well, starting over means starting over. Even at my age, we can learn new "tricks" Oh yes, the Honda has over 200,000 miles on it... keep me in your prayers that it keeps on trucking for another month or so.

Thanks for the reply... I'm moving from Eastern Tennessee... and I'm seeing what you meant about the larger hospitals not hiring LPN's Ah, well I'll keep looking. Seems the agencies hire more LPN's than anyone, and I'm not opposed to doing some of that. I've applied to the VA, Recruitment for Ft. Bragg, Camp LaJune. Although not in Western NC or Piedmont... I'll do whatever it takes!! Thanks so much for the info and you HAVE been helpful!!! Thank you for the welcome.. I'll be there permanently after the 1st of February. Look forward to chatting with you.... email me at anytime.

It really wouldn't surprise me if the DON did get a bonus for not using agency nurses... I've seen this happen more than once. The facility where I worked maintained the philosophy that "we have never nor will we ever use agency nurses, because we believe it is in the best interest of the residents/patients to have someone committed to the facility where they work, and take "ownership" in the patients they care for". sounds good on paper as if the Board of Directors actually cared for the welfare of the residents, what they care about is the extra money forked out to "agency" nurses. What they don't get is "what about the overtime that's paid to your regular employees in addition to the stress and exhaustion they face?" Most regular employees will come in on their days off, work over, whatever it takes to assure these people are cared for. What you WILL NOT see is the DON or ADON picking up a shift. It's been said before, but worth repeating...."if administration or owners cared about the patients/residents and the employees, follow an LPN for a day, on an off shift." It would be interesting to see how many of them would remain on a job with the conditions they face, for the pay they receive. It's also interesting to note, that once new graduates are hired, and trained by the senior staff, it's not long thereafter that for "some reason" the senior nurses are either terminated, laid off, or pressured until they leave. The new graduates work for less money. Personally, I wouldn't want my family member's welfare entrusted to anyone with less than a year of nursing experience under their belts, and NO ONE physically there with more experience. (Happens all the time on the off shifts).