iceprincess492

Just think how good it will look in your résumé if you can say that you came into a one star facility and within 2years you have brought it up to a 4 or 5 star facility :-)

I have worked in LTC my entire career - almost 20 years and have been fortunate to never work in a "bad" one. I am now the DON of a very busy SNF and encourage prospective employees or residents to view the nursing home compare website - as I am very proud of our results. My nurses are VERY busy - they have some good days and they also have some bad days. I feel lucky every day to work with such an excellent group of nurses and do my best to assure that they are given the resources necessary to do their jobs. I read a lot of posts on AN and wonder why LTC gets such a bad rap?? Seems to me that the posts from acute care nurses are also for the most part very negative about their work environments and the care that they are able to provide d/t staffing problems. I think there are many good LTC facilities and unfortunately probably and equal amout of not so good ones. However, from my experience there are also many good acute care facilities and a pretty equal amt of not so good ones....Just sayin.

Congrats!!! I love when survey is over and has gone well :)

You are apparently not well informed if you think that nursing homes are making any profit right now. The government has cut the funding so much that many nursing homes will be out of business within a couple of years. If the nursing home industry didn't care about their residents they would not try to run them as financially responsible as possible. If they are out of business then they are unable to care for their residents at all. Your managers want you to look for expired tylenol in the med cart because the surveyors who come to your facility from the State that you live in will look for expired Tylenol. Any citation you receive from your state agency is public information. When people are looking for a nursing home for a loved one they will research on line and choose a nursing home with good surveys. If you have poor surveys you will not get residents which will lead to not getting any reimbursement from the government which will lead to nursing home closing which will lead to residents not getting taken care of. So, as you can see it is all a vicious cycle and you should not assume that your managers do not care about the residents, they are probably acting as responsibly as possible to assure that your residents continue to have a home. Again the managers are more than likely doing what they have to do have a successful Nursing home. The fact that they are still there shows that they do indeed care about their residents because believe me they could could find easier less stressful jobs than they currently have.

I love love love LTC and have spent my whole career (14 years so far) with the same company. Like everyone else has said the best part is the relationships you form with the residents. I work in a wonderful facility and it is like one big family :)

45 min on a good day. 1 hour on a bad day. I love my job and I also love where I live so I don't see anything changing any time soon :)

Isitpossible - the best advice I can give you is be prepared for a roller coaster ride for the first few months. Every day will get a little better as you get more of a routine and get to know the residents better. It is a very difficult job but also very rewarding. Some of the residents you care for will be challenging but it just takes those few residents that are so grateful for the care you give to make it all worth it. It is amazing the first time you realize that you have made a difference in someone's life, even if that difference is helping them die comfortably and helping the family deal with the loss of their loved ones. I was one of those nurses who did not want to work in a nursing home but started out there and loved it. Now I have spent 14 years there - started as a nurse on the floor, MDS nurse, ADON and my current position of DON. I have loved every position - not saying I haven't had bad days but I still wouldn't trade my career for any other. In my opinion the most important things you can do in order to be successful in LTC nursing is to not beat yourself up for mistakes you make while you are learning (because you will make them) just make sure you learn from them. Time management is HUGE - there is alot of work to be done in a short period of time. Don't let people scare you about "putting your license on the line" In reality it is quite difficult to get your license taken away - you pretty much have to be abusive or stealing/taking medications. Remember why you are there...the residents that you are caring for used to be a lot like you are now, and some day you will be a lot like them. Have fun with your residents - they really do become part of your family. If you decide LTC nursing is not for you (and you will know) do everyone a favor and find where your heart truly is. If you are not happy there your residents will notice. Not everyone is cut out for LTC nursing as it is a difficult and thankless job at times. Good Luck to you and as I said I hope you like it as much as I do but if not I hope you find the specialty that makes you truly happy :)

I don't know anything about that company. Just wanted to say congrats on your new job!!! I hope you enjoy LTC nursing as much as I have :)

JZ-RN Thanks for the advice but I prefer to keep my judgement where it is. As long as I am able I will continue to make sure SNF residents are treated with the dignity and respect they deserve. If that means that I'm on a high horse then I hope my horse only continues to get higher. :yelclap: Some day you will realize that the way you really feel about your job is quite clear to the residents you supposedly care for and again I say they do not deserve someone who feels as though they are a "glorified babysitter" caring for them. They deserve a nurse who enjoys caring for them and sees them as something more than a way to pay their bills until something better comes along...

I haven't read the other comments but the only thing I have to say is please find something else to do that will pay your bills. The residents who live in SNF's do not deserve to have nurses who feel like you do caring for them. I have worked in LTC for 14 years and see it as so much more than glorified baby sitting. I wouldn't change the path my career has taken for anything.

That may be the weirdest question I've ever heard:confused:

Just as with any other situation, our responsibility is to educate and educate and educate. Same thing with residents who frequently get up without assistance and repeatedly fall. We can't restrain them we can only educate and explain the consequences of non compliance. Residents have a right to refuse any treatment, medication, diet, etc.... It is our job to keep them as safe as we possibly can regardless of whether or not they are compliant.

I'm sure your facility has a policy against verbal abuse and this should be reported to the DON. The facility has to investigate and send a report to the state within a certain time frame. Abuse in any form should never be tolerated for any reason. If the CNA is unable to care for this resident without becoming verbally abusive she should not be caring for him (or probably anyone).

maybe you could stop pointing out to everyone that you don't know jack for a start. i certainly don't want someone taking care of me that doesn't know jack....as far as what you can do to make things better - improve your attitude and provide the best care you can to your residents and go home at the end of your shift knowing that you did the best you could for them. you say "walk a mile in my shoes" you should take your own advice and realize that you probably don't realize what your managers go through on a daily basis either..... i still stand by my earlier statement...anyone that feels about management as you do should not have that as a career goal.

all i can respond to this post is please please please don't ever become a don - quite honestly the residents and the staff in any facility deserve better. they don't deserve someone who looks at the don position as a "stepping stone" to get experience and bonuses. they deserve someone who actually care about the staff, the residents and the facility that they work in. i think that you need to take a look around you and realize that there are many new nurses who do not view ltc as a stepping stone. there are many new/old nurses who love ltc and give their whole hearts to their residents. my suggestion to you now is to go in to work and turn your notice in because the residents in your care deserve someone who care about them and don't look at them as a place to make some money til something better comes up!!

i probably would not list this position on my resume but if asked on an application or during an interview if you have ever been fired from a position i would definitely tell them. it's amazing how things travel in health care if you are looking in the same geographical area. someone always knows someone who knows someone who knows that you got fired from your last job. as far as the bon is concerned at least in my state the only information employers receive from them is whether your license is active and if you currently or have had in the past any restrictions on your license. good luck in your job hunt :)

i realize this was not addressed to me but as a don in a very busy snf i felt compelled to answer anyway :) first of all you need to realize that the mcr and mcd cuts that you mention were very significant and in order for many facilities to be able to stay in business they have had to make pretty significant cuts in their budgets. think of it like your own home....if you are used to having an income of 4,000 dollars a month and something happens and now you are only receiving 2,000 dollars a month, i'm assuming you would have to make some financial changes to your budget. that is what is happening in ltc right now. secondly, you also need to realize that for profit nursing homes are a business. as with any business if you do not have good profits you cannot produce a good product. the same is true in snf's....in order to be able to pay for high quality staff, equipment, etc....you have to have a profit. i'm pretty sure that the nurses that work in my facility like to get paid every 2 weeks and would be upset if we didn't make enough of a profit to make payroll... lastly the way you feel about ltc/snf's and their management why would you want to become a don? it sounds like you may enjoy another specialty more. ltc is definitely not for everyone.

I graduated in 1996 with BSN. Worked for 1 1/2 years as a psych floor nurse then went to LTC where I worked as MDS Coordinator/ADON for 13 years and now DON for the past 4 months. I have loved every position so far :)

It takes a special person to be a happy and successful SNF nurse. It does not sound like you are cut out for this position. You should find a position in another setting where you are more comfortable. The residents living in a SNF deserve to have someone happy with their job taking care of them.

Our company has always been "color coded", although LPN and RN wear same color. Employees are given one free uniform on hire and then are given a uniform allowance twice a year. We also have a uniform company come in quarterly and they can purchase uniforms and if it is over their allowance amount it can be taken out of their paycheck over a period of time.

Things must be really different in Florida.....In Ohio our State surveys are more involved in SNF's than they are in hospitals. SNF's in Ohio do not "let things like this slip through with little recourse". Some hospitals in my area have nurses that I wouldn't let take care of my residents in my SNF. Unfortunately I have seen many hospital nurses that aren't even close to being on their A game. It is comments like yours that keep this little feud between hospital and nursing home nurses going......

OUr company requires an incident report for any new skin area: bruise, skin tear, pressure or vascular area. If they are admitted with skin problem it is documented but no incident report required

Love it!!!! I have been MDS coordinator with same company for almost 13 years and absolutely love it. My first degree was in business and second in nursing so this position is perfect for me. I am more financially oriented than patient care but fortunately my company appreciates that :) The company that I work for NEVER pulls MDS nurses and we never take on call. They are very aware of the importance of the MDS department and the rest of the building pretty much knows to leave us to our MDS's. Our administrators and DON's attend most MDS training with us. They went to the whole 3 day 3.0 training. They also have attended many RUGS seminars and ADL trainings with us so they are very aware of the importance of every aspect of our positions. I have been very lucky....i have a great position....great administrator....and great company :redpinkhe

Agreed. Report is greatly appreciated. Can't tell you how many weekends I have worked and had patients show up from hospital without us even knowing they are coming :)

I agree with all of the above. You should never accept responsibility for a med cart until the narc's are counted and both nurses sign off that it is correct :)