kcochrane

Another RN that chooses to work in LTC. Working as a LPN in LTC gave me the organizations skills to be successful in the hospital when I did finally receive my RN. Although I am grateful for the experience of being in the hospital and getting the acute experience I needed, I have no desire to return. I love LTC and the residents. LTC is not your typical "old people" type atmosphere anymore. I draw blood, start IVs, work with vents/trachs and basically deal with what most might cause subacute residents. It is not for the lazy or unorganized. I find in my area the pay is about the same as if I was back in the hospital in leadership. To dismiss LTC as something less than desirable may deter many that would actually love that type of care. Don't get me wrong its hard work and you never seem to have enough time, but its rewarding and you learn something new everyday.

Although I'm not against unions, I have not found them to be beneficial in my area. The county nursing home belongs to the county union and the pay for RNs was dismal. At least $8-10/hour less than any other nursing home. $22/hr for staff nurse, $25.75/hr for supervisors. I loved working there but it just wasn't financially feasible. The only plus I found was that you have some protection from being fired without fair representation. My current facility pays well, good benefits and the vice president must review all terminations to make sure they were fair. The union here is only for CNAs and LPNs.

Wow, just wow. I've had managers as you describe throughout my years in different jobs and I've had managers quite the opposite. The problem is most good managers will burn out after awhile. Trying to make the upper management happy as well as advocate for your staff is a stressful. I've put my neck on the line more than once for my staff. I have to be careful how far I push because getting fired will not help my staff in the long run. Trying to explain to higher ups something logical that is known from working in the trenches is like banging your head on the wall at times. And I was just on a cart last Friday passing medications.

Guess it depends on the charge nurse. When I was charge in acute care I took on a partial patient load along with my charge nurse duties. There was no way that the nurses I was in charge of could have done their assignment and taken care of what I needed to do as charge. Some charge nurses will not and prefer to just do the minimum. This exists everywhere at all levels. It is hard at times for others to see what charge, supervisors and managers in general do. Until I became a nurse manager I had no idea. I would love to help out more on my floor, but I have my own tasks and someone I answer to when I don't get my work done. Like Klone pointed out, doctors do answer to the CMO.

One more other thing. So let’s say we have alarms for this sort of issue. What happens when it malfunctions? Who is to blame then? Relying on technology to parent is a bad idea. And as much as I can understand it as an extra check you know as well as I do that many will use it as the only check.

Me too. I raised five children while working two jobs and trying to go to school...and involved in a bad marriage. I'm sorry I just don't get it and never will. Now we need safeguards to help parent? Call me judgemental all day, I'm ok with that.

I guess I'm different. I don't want people to think I'm contagious when I cough. I always tell them its because I smoke.

Exactly. The deadliest school massacre was in Bath, MI. Andrew Kehoe, who was seeking revenge for losing an election set up bombs that he could set off himself at the school. This was in 1927. Michigan's Bath School massacre remains deadliest of its kind... I don't own a gun, probably never will, but I support the our 2nd amendment. The point is that if someone decides to go on a rampage, they will find a way - with or with guns. We need to address the issues that cause people to go in this direction.

That appears to be part of the problem, the MD calling someone a nurse that isn't. Wonder how they would like the shoe on the other foot. I'll call myself a doctor.

These are in most cases LPNs. The admins before me thought that policing each other would work. It isn't. So as a nurse manager it's falling on me to decide on how to proceed. Checking the MARs every night before I leave is just one other audit I don't need, but will probably have to do. "Holes" or failure to chart won't go away with eMARs, but the nurse will be made aware of the omissions at the end of the shift that need to be fixed. I'm sure reports can be run in minutes that I can use to discipline as opposed to hours combing through paper charts.

Yes it is an eternal battle with no end in sight. Every LTC facility I worked with seemd to have this issue. I was in the habit of double checking my MARs at the end of the night. But I realize sometimes it is just too busy to have time. The solution here is to make the next shift check for "holes". That is a problem when the next shift comes in late, the previous shift is still passing meds or any other staffing issue. Just not a good solution. As a nurse manager I could check the MARs myself and probably will have too.

Lol. That relieved some stress for today. Thanks JKL33.

Hi, We have an ongoing problem with holes in our paper MARs. Anyone have any solution(s) they've used to help with this issue. We've tried making the nurses check each other MARs at the end of the shift, but it hasn't worked well. I know this issue will go away once we get electronic MARs, but that may not be for another year. Thanks!

It is going to hurt and I think we all understand that here. Overtime it will get better, but it doesn't feel like that to you now. A couple years ago I felt like you. Didn't want to get up out of bed. Nothing brought me joy, but I went to work everyday and that kept my mind off of it for a few minutes at a time. I know if the midst of it I realized someone better was out there. And he was. I am now married to the love of my life. Go to school, get your nursing license so that no matter what happens you can take care of yourself. This will allow you to find someone you want, not someone you need. Believe me we all know that pain you are feeling, like your heart will break in two. One day at a time right now. Hugs to you.

As a nurse manager in LTC if there is a call in I have to be able to get on a cart. I also help out with patient care. I needed to have experience in order to answer clinical questions. Mind you the paperwork keeps me from helping as much as I would like.