MsPiggy

Well, I didn't have one lined up, but it still was too risky to stay. I'm an artist in my spare (Ha Ha) time so I have things to do to keep busy, though I would like a nice low key nursing job a few days a week. I thought AL would be that but I was very mistaken obviously.

You comment that there's a staffing company associated has me suspicious. People go to staffing agencies all the time for home care assistance, like cleaning, laundry, cooking, house-stuff. And yes, your AL is their 'home'. But are the CENAs hired to do private 1:1 assist or are they providing assist for multiples? And how close to real nurse responsibilities are they assuming? Here's the tricky area, I guess. Yup. You pretty much nailed it. Slick is right. I'm sure they are within the law as the owners are lawyers. Also the laws a pretty vague in my state. The care giving company was also non licensed providing home type care as you mentioned. However really it was what I would assess to be skilled. I mean their were residents with stage 2-3 pressure ulcer. They did have skilled nursing coming in privately 3 x's a week but this person was a skilled care. I've been told they have since moved to a skilled nursing facility-Thank goodness.

The AL facility I just left allowed a residents family member ( a completely inappropriate total care resident) to have a nanny cam in her mothers room. It was sad really because the Cena's there were all fabulous and went above and beyond to care for this resident. All that camera did was create a chasm of mistrust and bad feelings between the very demanding family member and staff. Thus, no one wanted to be in this residents room caring for her. The daughter would call staff repeatedly throughout the evening to tell them her mother was up, or wandering or needed to go to the bathroom-you get the idea.

I guess because I'v been doing this so long I am pretty good at thinking about "worst case scenarios", because I've seen a lot of them unfold over the years. And yes even though it's their home, it's also other peoples homes and workplaces. Just-no. It's unnecessary and dangerous and I'm not going to argue with the family member that thinks it's not only okay but their right and with no thought to everyone else's right to a safe and serene environment. I have had four calls from CENA's today thanking me for trying and telling me I am the first person there to ever take their concerns seriously and try to address them. This is so sad. They will lose these wonderful caregivers. I'm bummed but the more I thought about it-I don't want to be on call 24/7 every day. I'd like to get into a calmer quieter area. You know like a dermatologist or plastics Doc so I can get a discount on my juvaderm injections:yes: I hope the state develops more solid AL regulations. That must be why they are popping up all over the past few years because the regs are so vague. I wonder if the average consumer realizes that this isn't really a good alternative or replacement for skilled nursing.

"these so-called "AL" facilities are popping up all over the place, and are just another way to drain one of our most marginalized populations of every penny they have. The families feel "better" about placing their parents/grandparents in an AL "community" because it sounds better than "nursing home"... but really these elderly are being dumped on people not qualified to handle their complex need" Exactly. I admit though I'm familiar with the concept-what I experienced was residents in need of skilled care, and in some cases receiving it but all under the guise of unlicensed supportive care.

And you are exactly right- I was even told I could earn bonuses for keeping my budget inline but it was all very vague. The marketer is just driven to fill the beds at all costs. There is no nurse determining if these residents are appropriate for AL, just the marketing person and the family/resident. I pointed this out. No one seemed concerned. n fact I was told it would be discrimination if we refused to lease to someone r/t a disability because again-it is unlicensed AL not a medical facility. The whole thing makes me uncomfortable.

Thank you. They advertise as a supportive style, catered living. Whatever the heck that means. I feel nothing but utter relief this morning-though unemployed at the moment. The Cena's have been blowing up my phone since I left wanting to know where I'll land.

So true! Good CENA's are heaven sent for sure!! I have been fortunate to really work with excellent caregivers.

I think you are absolutely making the right decision and I agree about calling the State Ombudsman. Those working conditions sound horrid and yes those poor poor residents. It's shameful the poor response from the physicians. This is really frightening for those of us getting up there in age as well. What's it going to be like in another 10 years? State staffing minimums just don't cut it in the real world. Counting the DON/Management among the staff? LOL, that's a laugh. I haven't had a manager come work the floor with me when there's been a staff shortage in the last 20 years. Best of luck on your job!

I've decided to quit. I told my employer tonight over the telephone and will take in my keys/phone tomorrow. I just don't feel it's worth the risk or frustration. I might have been more inclined to stick it out were I younger and more feisty but my gut (and everyone else) is telling me this is not right for me. Thanks for responding to my post. Since I am unfamiliar with working in the AL community it is helpful to have others who are confirm what my gut tells me.

Thank you mucho for responding. Of course the owner re-assures and insists since it is unlicensed and the "care company,llc" that I am hired to run is also unlicensed-any licensed care is to be contracted by the family through a hospice or a licensed provider. However as I pointed out, the CENAS are providing typical basic nuursing home skills in addition to dealing with these non compliant patients. There are also a few completely bed bound patients. Owner tells me to think of it as leasing an apt. She wants/expects me to completely balance the medical/health care budget to account for staffing appropriately. I have no idea WTH she is talking about. Like, how many jobs do you want me to do for this crappy salary and no benefits? She told me the budget was my salary & the Cena's salary vs. What we were charging families for care packages-give nothing away for free. I'm off today dealing with a sick dog-The fun never ends! I just cannot wrap my head around this. I also live in a state where AL rules and regs are at this time very vague. I don't think the fact that this place is AL would prevent anyone from suing me or them if something catastrophic were to happen.

Good Morning All, My title kind of says it all. I'm an old LPN almost 26 years and pretty well rounded. After a 2.5 year break after leaving a case management position at a cancer center I recently accepted a position at a very upscale new AL facility. My position is to assist the CENA's/PCT's (they use both) as needed, do the scheduling and be on call 24/7. They (management/marketing) working hard at filling these beds and the pressure is on the marketer to do this and get the facility in the black. My concerns; the woman that was doing my job before me was canned the day after I arrived (not a good sign). She is not a nurse but despite being overwhelmed was attempting to do for this owner/company. I feel there are some very inappropriate residents which leads to what I am asking. We have a resident couple, seperate rooms-they are both HUGE fall risks and do so ever day almost. One the woman has severe dementia and wanders/trips/falls/becomes combative at times. The other, completely non compliant, will not ask for assist with transfer is a two person assist/total care for adl's, etc..Family has a nanny cam in the room. This man has a tool box in his room as he used to be a tradesman-I get that but the CENA alerted me to the fact that he had a large new claw hammer on the table in his room. Fearing for her, the residents wife, or another residents safety..Do I even have to say how uncomfortable this makes me? I phoned the daughter, told her I found it and put it locked in my desk drawer until she could retrieve it and take it home. She was VERY angry and said he had every right to keep this in his HOME and I was to return it. I pointed out all the safety risks to her-"What if he fell on it?, or hit someone with it when upset, etc?" She was not having it. I returned it to his room, notified the CENAS and left a letter for the owner of this AL I about what happened and I wanted to speak with her today. My birthday -Happy Birthday to me!! LOL.. What I am asking is, is my spidey sense right? This seems absolutely ridiculous, dangerous and a huge catastrophe waiting to happen and impact my license. BTW, it is a private pay non-licensed AL, with a separate NON licensed care company (that I am supposed to supervising/running) doing the care giving. These are total care patients-not what I would consider AL, but skilled. There are a few more inappropriate ones but this is the biggy that may have me turning in my resignation today. Thoughts? Input? I feel like there is no protection for me here and when things go down it will get bad. The Cena's are fantastic but they are overworked, underpaid, no benefits and will move along if this will be their typical resident. Also the owner has declined to pay my malpractice because she says it's a non risk for me because everything is unlicensed. I apologize for the length of this post. This is my first and perhaps my last AL position. It is entirely different than what it was/is portrayed to be. I appreciate any insight, advice, thoughts. Kindly, Ms. P

I am 50 and cannot do floor nursing currently as my knees are bone on bone and I need bilateral total knees. So my last job of 5 years which was case management also with abstraction to emr was eliminated due to budget cuts. I ran out my unemployment and am currently interviewing for a similar gig but more coding/analyzing billing errors. Pray I get it as I tried to work rehab but just couldn't do it my pain was extreme. So I'm hanging out here with no insurance-ACA insurance to expensive for my age bracket/budget and praying this comes through for me. Even after I am able to get my new knees I have no desire to work on the floor any longer. I've been chipping away at my RN via excelsior but it is such a financial strain right now I'm ready to just throw in the towel. I hope your able to find something. I think you are on the right track and there will be more opportunities with billing/coding/abstraction for LPNs in the future..Lets hope. I'm not ready emotionally to go on SSI/disability but if I can't find a benefited position I may have too. Keep me posted-I'm interested to hear what you find and I will do the same!

I feel your frustration, but I am still not understanding why you feel the BON or school should look the other way regarding your lack of IV certification? And I am also not understanding what those rules have to do with your sex or race? I am a LPN with 26 years of experience currently in a LPN to RN program and there are lots of classes I have to repeat because my credits are over ten years old. I don't feel I should be excused from the requirements because of my age, race or sex. The rules and regulations are what they are. I'm sorry but I don't see the connection to discrimination just unfortunate circumstances. Best of luck to you whichever route you choose to take. Ms. P

Wonderful-Congrats!! I'm taking transitions next Fri then on to Micro-And although I would love an A- I'd be thrilled to pass with a C :0)