RNMLIS

worked in LTC fairly common to admit (dump) new resident late inafternoon which leaves new pt. with NO medications of any kind barebones overnight crew left with no recourse but maintain constant monitoring .... scared confused abusive mentally unstable often dementia...out of control pt overworked staff essentially unskilled in this level of care but expected to manage... call MD - usual answer - I don't know this pt = not willing to perscribe..nothing to HELP resident calm down Struck in face called 211 mental health hotline pt crying remorseful scared confused - locked up in horrid mental health eval. pt outta there DON laughed "expected a problem" OK,Now Who is really resposible for this assult!

auuuggghh Had a extruded disc L3-L4 spinal stenosis L4-incision L2-L5 intractable pain misdiagnosed for years the knee-hip guy never took a mri of spine (after mri of hip or knee sent to PT) worked for 3 years in pain... was a new RN so those 3 years are all the experience I have 6 months tele floor GN to RN had a flare up of pain - had no insurance at the time...let go 2 1/2 years in LTC/sub acute hell 2 level bone fusion and laminectomy sx one year ago... This was my third career...57 y/o On disability - ah whats a girl to do

Worked in LTC - The residents were too cold with the AC on...the DON had AC in closed office, the residents rooms had horrid AC/Heating units in the rooms blowing gale force wind on the B bed, curtain closed nothing for the A bed. In the hallways the nurses melt... Over night forget about any AC - I figured out how to unlock the thermostat =)

Again so many LTC facilities venturing into areas that they are unprepared for...understaffed, lacking appropriate equipment. Venturing into the skilled facilty arena with LTC mentality and in the long run that wil not work - an accident waiting to happen Yeah it is all about money for these facilities- fill those beds - but in their ' greed' they put the patients and the staff and the facilitys' reputation on the line my former LTC - considered adding bariatric patients to their repitoire They were unable and unprepared to take care of the larger residents they already had Once we were expecting a large person and upon arrival the bed is too small..aides outright refusing to boost large residents, no large commodes, wheelchair too small... it was like they figured they or rather the nurses / staff would manage... and there seems like there was some kind of negative reinforcement in 'getting away with it' and running a business on a just in time or almost on time mentality that leads to increased irresponsible decisions.... We had a woman with airborne infection...she was put in a room with another resident (another facility could not take her as they had no isolation room available) She was sick, diarrhea and insisted on an assist to bathroom - did not want diapers had very high maintence demanding and verbally abusive I and other nurses could not go in as needed and the aides would/could not go in there as needed - poorly educated re care of isolation cases - well duh the faciiity was offering inappropriate care - we frequently ran out of masks no dedicated equipment for vitals - acutally only one bp/pulse ox for 46 residents and that rarely worked as it cost $$$ to recalibrate - Long story short she went out - almost died for lack of care from management, the staff on down to kitchen that repeatedly sent her food she could not eat. So were her caregivers worn out from her attitude yes and she was avoided yes unable to handle the acuity level with the 25 to 45 other residents to handle No one really helped anyone else - all overwealmed with own tasks her mental condition was detoriating as her respiratory condition worsened big clue, right her family noticed the change... Lessons learned - none Keep on getting away with just getting by The slippery slope of not caring and getting away with it... They sure do spruce up come survey time 6 month prep for survey Shoulda spent more time and money offering better care to the resident In 2009 they got 5 stars Lessons learned - this posting made me reflect on the care I gave this woman. I may have been more perceptive of her needs and her conditions if I had been less overwealmed by the amount of work, less affected by her attitude and avoided her a little less. she was sick she was scared she needed help

I was very vocal about many issues in the LTC facility. I did get some of the nurses to stop punching out and returning to finish their jobs as ordered by the DON Most of what I said fell on deaf ears Each overworked and stressed nurse had their own issues In a small LTC facility - where does one go to stand up for - To push back... I am no longer nursing r/t disability (temp) but I will not return to LTC industry and yes I experienced insanity when I worked at that place and am still reeling from the crazy making in that place - personal abuses nurses suffered abuses the residents suffered as a new nurse what went on in LTC went way beyond "first year in nursing vs what was learned in nursing school" I think understaffing and poliicies of divide in conqueur threats and misinformation and others were useful tool for nursing management in increasing tensions and lack of trust with in the staff the aides hasd a union the RNs did not I always wonderd about that... So where do I PUSH

Uh are you working where I used to work ! Sad to say I never resolved my cna issues while in LTC - the aides had been in this facility forever...they act as one - with a mob mentality Management did not support my actions but then cited me for inabilty to do my job r/t poor managment of cnas. I was told that the cnas were testing me - to see if I was a team player translated (if I would do their job) the cna's seemed to spend more time spying on and reporting others... I was frequently verbally threatened - outright insubordination threatened to call their union on me (RNs did not have union) I tended to be overly senstitive and they knew they had me and loved pushing my buttons I tried nice cause if the cnas turn on you - you are dead in the water trying to be friendly and get along did not work and my getting tough seemed to come out wrong but when your legs are cut off by lack of management support = end of story A good CNA is priceless! I would run for the alarms and would notice none of the other nurses blinked - they were doing their meds as I should have been Keep documentation of any and everything.. the only thing I should have done was write them up -

I used to work both night and evening shift... I was on the 3-11 We received a new admit - late as usual. We were supposed to have an inservice on respiratory care for this resident - never happened.. Interesting how 'they' expect/assume that a LTC RN has the skills to handle any 'care' without an inservice/referesher/or support. If the poor nurse manages to make it through the night - management takes the experience as - got away with that one - a negative reinforcement >>> that slippery slope to more and more reckless choices - or on the nurse's back garanteed If I knew I could refese this patient - I would have lost my job with threats of repercussions and boy oh boy don't expect a reference or If something happened - as i would be out on that plank ALONE I had been at this LTC/subacute(yeah right) facility for close to 2 years and we never had anyone on a respirator care before...we did not have the equipment on site. This woman was a mess - seemed like a great gaping hole in her neck where what seemed like an ill fitting trach was attached - needing frequent suctioning needed. - argumentative combative.. management was still there at 10pm and was of assistance for admission but scurried away just before 11pm. Luckily the night nurse had prior hospital/respiratory experience boy was she P**$$3@ - too much to safely handle with 44 other unpredictable residents. I know I could not have handled it safely - patient was sent out in the early AM.. This former LTC RN thinks most LTC facilities walk a fine line...

In my experience, Community Colleges in NJ are very hard to get into - They are less expensive than 4 year BSN programs (if you live in county) therefore very competitive. the only problem with the plan of getting Associates RN and then the BSN after getting experience and funding, the NJ job market for nurses.

The law does not require my facility to give me a break...the law does require that I be paid for the hours I work - I was not paid for those half hours Q shift that I worked - The pay is automatically taken out...management counts on employees to not know the law or be too afraid to take action and loose their jobs...

I too have felt the same way - isolated - not a lunch issue as we rarely stoped to eat. My isolation was deepened due to the fact that many of my fellow nurses were contract Filipina's and they spoke to each other in their dialog. Relevant nursing topics were discussed in another language! Not a great learning experience on top of a sense of isolation.

Where I worked in LTC - the nurses did the v/s. We had alot of cardiac meds so we had frequent checks. Not that easy since we had one BP machine for 2 nurses and 45 residents That does not work well In addition the only machine was rarely recalibrated - cost $$$ despite frequent requests r/t bizarre readings, We used wrist cuff pressure or another cvs bp devices These were not legal but more effective and faster than the equipment provided. Our management did not have a background in geriactrics. All of them had a background in Hospital ED and critical care and seemed to think we should be doing vitals q/shift When we had an admit each shift for 7 days did full vitals and ssesment.With our faulty equipment. no matter the diagnosis.Then we have the falls and more V/S neuro, UTI and URI and more V/s Of course bed b gets her bp done and bed A wants hers done too.... auuurrhhh

We need to take profit out of the health industry My insurance company flat out refused to pay for my surgery - approved the spinal surgery then refused to pay. the actual reimbursement was I still pay for insurance - what is a person to do - You tell me... We need to spend more time finding out what is going on in the world - look it up -The world can be more fun and less scary if we try to stay informed keep an open mind - find information to support your ideas - read something that you don't agree with... We have a wonderful tool the internet "google it" The article below states that the Health reform bill was actually built upon Republican ideals but being 'partisan' not one republician voted for it. http://voices.washingtonpost.com/postpartisan/2010/03/why_democrats_are_fighting_for.html "We have committed the fatal sin ... of becoming cynical and arrogant with respect to decisions affecting the lives of hundreds of millions of people." -US General Lee Butler, on maintaining a nuclear orificenal "The most costly of all follies is to believe passionately in the palpably not true. It is the chief occupation of mankind." -H. L. Mencken

auuugghhhhI'm hooked:lol2:

Breaks - whats that? Appparantly I have taken one half hour each shift even when working alone overight Never punched out - never took a break Now the cnas... They rush around afterthe resident's dinner putting everyone to bed and ALL sit down and eat their dinner together and there is no moving them management is not there and DOES NOTHING to enforce staggered breaks.

One of the activities people who of course only works the day shift Flatly denies that SUNDOWNERS exists HA!