dolldoctor

Your state reps would be a great place to start and the news media as well. News people are always looking for a story and if you help the media and do a lot of research and work for them . . . you can get the message out. Also - Michael Moore just did the documentary "Sicko" and I bet a sequel might spark his interest. The LTC topic touches all of us and we are all paying for many people in LTC - especially when they run out of personal funds long before they die. Staffing mandates need to be initiated by the state and not the kind that just say "adequate staff to patient ratio" - those leave the definition of "adequate" up to owners and admin people that are there to make the most amount of money in the least amount of time and keep overhead as low as possible.

Not wanting to appear ignorant - but, can you let other people chart for you? I would be scared to death to let somebody else do my charting.

Congratulations for being a fine, caring and compassionate person! My patients in LTC knew about my goal to become a nurse too and they constantly encouraged me. You will never have any regrets for caring for your patients with kindness. "For the grace of God go I". Everyone you take care of could be you someday and in a time in our world where so many don't know what the "Golden Rule" is - (treat others like you would like to be treated), you know doubt are a breath of fresh air!:1luvu:

New LPN grad here and accepted into the ADN RN program. Starting in March 08 and graduating December 08. The program I'm in is a nursing career advancement program. You have to become a CNA, then LPN then if you make it . . . RN. I must have worked at a horrible long term care facility, but I must say . . . at one facility, I never saw a nurse or a med tech do anything but pass meds and a little charting. The other facility I worked at, only one nurse would ever do anything to help - she did that when a patient had thrown themselves on the floor and he was such a big man one CNA couldn't lift him from the floor, especially with him fighting against being placed back into his bed or a chair. I understand that med pass, treatments and documentation are a priority for the nurse and must be done, but I saw a lot of setting around and chatting going on when nurses could have been doing a little more to help with patient care. I decided that I would be a nurse that would do more, however I know it is a fine line to walk, because some lazy nurses will not like that (it could make them look bad) and I also don't want staff to come to expect me to do their work for them, but I really can not see not answering a few call lights and doing what I can when I do have time to help. Also, I plan to make a point to check patient rooms to make sure things like HOB is not left down on tube feed patients and that call lights are in reach, dirty diapers are not left in rooms, etc. If I can set a good example for other prospective nursing students and provide a higher quality of patient care, I will.

I accidentally passed our required exam to get into the lpn/rn program - it was the TEAS test. We are allowed to take the test 3 times - if you don't pass it by then - you can't get into the program. I passed the test on my first try but got a text message from a classmate yesterday that said 7 of the girls in our lpn class that took the TEAS test did not pass it. I found the test had nothing to do to evaluate nursing skills at all. It was just a general academic assessment test. Had I not passed, I was going to enroll in Excelsior and take their distance ed courses. According to the program chair - general education assessment tests are good indicators as to whether or not a candidate will pass the NCLEX. From what I understand, the program chairs want their school NCLEX pass rates to be high, so this is why they use the assessment exams for entrance exams.:smackingf

I'm wondering if the trend will be for hospitals to hire people in off the street, train them to be CNA and/or "Patient Care Partners" ? Instead of hiring LPNs and just have the RNs coordinate patient care with them? It would sure be cheaper for hospitals to do that and they could say they don't have a patient care crisis because they would have people on the floor. Hmmmmmmmmmmmm?

Physical and Emotional abuse here. No drugs or alcohol - abusing gave them their highs! So, answer is yes. I knew early on that I wanted to help people and be kind to others and certainly do know harm!

Nursewendy2000, Thank you for your post. I find it very helpful. I've worked as a CNA in long term care while in a Nursing Career Advancement program. I'm now a new grad LPN and will be starting my ADN bridge in March 08 and finishing December 08. I really like working in LTC. My husband would prefer I work in a hospital but I want more routine on a daily basis and would like to come to know my patients/residents, which I think LTC would afford me the opportunity to do. Also, people can not be hospitalized all the time and in LTC I feel that you really do have the opportunity to put more nursing skills to use. At any rate, I appreciate your insightful post.:balloons:

I've had fx ribs before from a MVA. Lord almighty!!!! OUCH!!!!! I can't even imagine the pain of having compressions done to me at that time!!! And what if the fx ribs puncture the lung? Geezie Peezie!! Seems to me that code would go south in a hurry. I'm going to advocate living each minute like it is your last. Always be grateful for the time you have had and then being able to face the end with as much dignity as possible.

Extremely well said!

I for one remain chronically amazed that civilization (and I use that term loosely) have not come to terms with the idea that we are all living to die. Death is as much a part of life as birth and living yet we just can't seem to wrap our minds around it and embrace it. My mother-in-law finally passed recently. She refused to sign a DNR and left the decision making to be left up to the kids, which were a 3 to 2 vote. The 2 that wanted mom to have a full code, were not as educated as the other 3 and also were the ones that did not want to do any of the daily home maintenance work to help take care of her. The whole thing was a mess. Mom accidently died late one night. I'm pretty sure she was a "slow code", thank God!! The slow code may be unethical and or illegal, but because we do not have laws in place that require all patients to make a clear decision in writing, the slow code helped everyone make the best decision. The end result would have still been the same, keeping her alive would not have solved her health issues, it would have just prolonged the situation.

[GVIDEO]Because you can not invoke change in a vacuum and all your advocating and agitating will do is piss off the other personnel and, ultimately, get you fired.[/GVIDEO] You are exactly right!! I noticed the "vaccum" effect right away! In fact, I've been really shocked at that type of mentality during my experience as a CNA in LTC and during my student clinical rotations. Please understand, I'm not suggesting agitating and advocating in front of other personnel - in many cases they are the vaccum. I am suggesting that health care professionals that want to create change, need to become change agents and it won't work within the system itself, I can clearly see that. I feel that it needs to come from legislature and media and that can be done on the "QT" without rattling the cages of owners and administrators who don't want to work through changes. An evil thought . . .if more working staff were added, admin would have to take pay cuts or corporate earnings/investment returns would have to be a less. The bottom line as I see it, I can't see how LTC can keep going on the way it is when year after year a lot of state findings reflect the same type of issues that most likely could be solved with better higher staffing ratios. I'm so glad you brought up the idea of making the powers that be mad, because I noticed that right away when I started working up an actual time study for the care of each patient and it showed that a CNA would actually have to work 12 hours with no breaks or lunch to complete the work correctly that had to be done in a 7.5 hour shift. It was kind of funny because the procedures that are in place that specify how we are to care for patients require time that is not available when the patient to working staff ratio isn't right. Mathematically it does not compute and we wonder why during state audits facilities get sited? I think the state of MA has state mandated staffing ratios and it would be interesting to see what nurses and CNA staff have to say about how things are working out there. I'm from the mid-west and our staffing mandates simply say, "adequate staff for patient care" and then it is left up to the institution to decide what "adequate staff for patient care" is. Most of the time it is pretty lean, although when it gets close to state audit time they do a little better and after state leaves it goes right back to the usual. As for most of the nurses that I encountered during my experience as a CNA and student nurse, most were good nurses and most were caring. There were a few really lazy ones but that happens in any profession. I did see some that had lowered there standards just to be able to survive in the type of work environment that owners and administrators had created. Also, an observation from my own clinical experience was that everything listed for a student nurse not to do is exactly right:) I noticed our nurses didn't appreciate it if students were sitting in their chairs at all. Some of the students in our class surely didn't take their clinical rotations seriously. I had a really nice experience but I applied myself and learned from every nurse by observing and asking questions.

I've worked in LTC as a CNA for several years. I'm waiting to take my PNCLEX and I've been accepted into a ASN program, starting in Mid-March and will finish the end of December. I'm 49 this year and almost ready for LTC myself, as a resident . After working many years in the corporate world, and with our kids all grown, I decided to live my dream and become a nurse. At any rate, I guess I don't understand why any professional would be a slave to the facilities way of doing things if it is not a safe environment for the professional to practise or in the best interest of the patients/residents. I did some research on staffing issues for CNA's a while back and I found that only when health care professionals make a loud collective noise to their state reps and the news media, staffing mandates may be possible. If you look at the LTC facility registrar at, I think, elderabuse.com it's clear that facilites are getting dinged for the same issues and most all are things that are happening due to staffing issues. Too many patients to only a few staff. I'm far from being a rocket scientist but we should be outraged enough to do something and force our states into creating safe staffing mandates. By them not doing that and leaving "adequate staffing" interpretation up to facilities, of course the facilities are going to run lean for the almighty dollar. It's criminal for states to allow that and for us to allow it to happen. Not to mention the tax payers dollars that are being spent in government subsudized health care. With the elder boom that is just beginning, if we don't do something now, I really wonder what will happen a little down the road? The media is always looking for a story and politicians are always looking for a popular cause. This topic is popular because we are all going to be geriatric material some day. Our patients can no longer advocate for themselves and we are all they have. And, it is doubtful that big corporations are going to be generous to take money out of their own pockets to make things safer for nurses to practise or for their patients. Corporations have shareholders to make happy. Just a few thoughts.