fireflies_for_me

Amen to that. I work with OMTs at my facility, and do so gurdgingly. I had a 4.0 GPA when entering the nursing program and walked out of it with a 3.2 and that was studying every night and having 20 hour study groups almost every day of the weekend! I worked hard to earn my license, and am working harder to earn my ADN. But the facts are the facts. LTC owners rarely staff according to need. I have been the only nurse on the weekends, in a facility that has 50 residents where I had no OMT. It is six of one half a dozen of the other. I work so short that I can't provide quality care, or I work with an OMT where I can't guarentee quality care. I hear a lot of comments about standing up and doing something about it, but other than the media, I haven't seen a lot of suggestions on just how to go about doing that. As I posted before, I have written to my state legistators and received no response. If anyone here has some viable solutions to this problem, I'd certainly be willing to see what they are. I too, would love to be able to go to my work place knowing that it I will be able to provide the best care possible to the residents that I am there to serve. And no, I would not place my parents in any longterm care facility. I am afraid they are stuck with me. I have worked in enough LTC to know that there aren't any available that I would trust with my family because of the very problems that are addressed here.

If it were only that simple. I worked once in a facility where on my THREE halls I had 63 residents. The medication aid made a serious error with medications giving "Anna" Lanna's" medication for several days in a row which included digoxin. Anna almost died because of it. The problem is that NO, most administration will NOT hire a nurse to relpace a med aid. Instead, I took care of 16 skilled care patients, 8 people with very serious dementia, one gentleman who had alcohol induced dementia and continuously urinated in my waste basket, a woman dying of brain cancer, another with an end stage dx of COPD and MRSA in both lungs, A man with dementia who kept attemping to sexually assult the female residents (he shared this behavior with my 51 year old alcohol induced dementia patient), and the list goes on. I don't bend over and take it from anyone. I voiced my concerns in a professional way. Hell, I even had a few fits about it and eventually left that job. But the reality is, at least in Iowa, there is no nurse to patient ratio for longterm care. You get what you get and it is pretty much the same every where. Ocassionally, you run across a place where the owners genuinely seem to care about the resident and their well being, but those are few and far between. So you go to work and pray none of the nurses call in and that you do no harm by your actions because you are so overwhelmed with your work load. And yes, you may even pray that a med aid is there, dispite your misgivings about them, becaue you so badly need the extra help. I have written my state legislature about this problem on two seperate occasions and not even gotten so much as a response.

Oops... I just realized the new nurse was offering opinion to the veteran! I hope that I didn't offend Carly

I think that initial use of peroxide is fine depending upon what type of wound it is. The problem with peroxide is that it destroys new tissue formation so it shouldn't be used as a treatment of the wound after the initial cleansing. Carly

I would like to thank all who have responded to this post. I did not write the MDS coordinator up for her actions. I did, however, pull her aside and talk to her about it today. She hadn't even realized that she seemed so insensitive and after talking to me she apologized to the resident. I believe she was genuinely sorry for her attitude toward the new resident's condition. And for the record, this is the ONLY time she has come into an admission assessment since I have worked at this facility. I think it would be wonderful if she attended them all as then she would have a better concept of the patient's needs, but she relies on the nurses assessment to develop her care plans. As to me, I feel a bit better today. This situation has deffinately effected me in a profound way though. I am finding myself thinking introspectivly this day and assessing my life and my goals. I do not want to be so sad in my own life at her age as to feel the need to end it all. Maybe it was my wake up call to make my life what I want it to be... Again, thank you all for your thoughtful posts and your advice... Carly

I am an LPN working in longterm care. I love what I do for a living. I am currently working on my RN (at 42 years of age...lol). Today was one of the most difficult days, emotionally, for me as a nurse. This morning I admitted an elderly woman to the facility that I work for. Nothing unusual about that except for her reason for admission. I really want to be able to discuss this without it becoming a HIPPA violation so of course, I will not use name, age, or location in this post. She came to us from the hospital having had exploratory surgery done in effort to determine the extent of internal damage caused by a self inflicted gunshot wound to the chest. She had attempted to shoot herself through the heart, however, the bullet ricocheted and traveled around her rib cage and exited through her back. Now, I am sure ther are a lot of nurses here who see this kind of thing regularly, and perhaps have even become somewhat acclimated to it... but it is not something that comes through longterm care doors often. I have helped, during my career as a nurse, many, many people to leave this world with as much comfort and dignity as I could possibly provide. But never have I seen such anguish in another person as what I saw in this woman today, and frankly I am having a very difficult time dealing with it. Then to top it off, my MDS coordinator hears about it and knocks on the door while I am doing her admission assessment. I called out that we were occupied but she came in anyway just as I was removing the dressing on my patients chest to measure the wound site. She said OH! OH! OH! I want to see this! If you could have seen the look of sheer humiliation on my patient's face it, I believe you would have been as sickened as I was by that behavior. Her actions took my patient from being a woman in crisis to being a gunshot wound in an instant. I asked her to leave the room and apologized to my new patient. Unfortunately that was all that I could do. I could use some advice here from anyone willing to offer it. I am usually able to maintain a professional attitude about work, but I must admit that this one had me in tears all of the way home. Thanks for listening, Carly