savoytruffle

No Elder abuse. Only employee abuse. The best resident care I have ever encountered, actually. I think that's why I hung on so long. Lots of high pressure sales and occupancy stressing, lots of micromanagement and bloated administration.

I was thinking of my exit interview with HR. I won't say anything until I've already created my exit strategy. The ombudsman program for my county currently has no volunteer. It took me three weeks to get a hold of someone in Albany last time I wanted to contact them. I will leave lots of reviews tho. Lots of anonymous reviews that will show up on google searches. A place for mom, glassdoor, indeed, etc. Or maybe not. I don't want any bad Karma! (OK maybe one on Glassdoor)

I am an RN and the Executive Director (ED) of an Alzheimer's Assisted Living Facility. Today we had a big marketing meeting with multiple facilities in our state. There were EDs, community relations directors, outreach professionals, regional operations managers, and the VP of marketing present. Early on into the meeting the VP is stressing occupancy. Fill the beds. No matter what. She said, "let me put it this way. If a resident falls down in front of you, STEP OVER THEM to get to the next lead. In house residents are someone else's problem." Wow. A little while after that gem she says, "I know I have a nurse in the room (me only), but I am going to say this anyway. Never give nursing any forms you have not already made a copy of." Right. Because nurses as a whole are disorganized. Or perhaps we are irresponsible? Or maybe just too stupid to keep track of admission paperwork. There were some very uncomfortable chuckles, and a few hearty laughs. She has the CEO behind her. It's a family owned and operated company. My direct supervisor is the boss's son. I am leaving this company as soon as I can. I will tell everyone I know what the CEO, and VP of marketing really think of their residents and the nurses who care for them. Has anyone else ever encountered such callousness and unprofessional behavior before? I was disgusted. I don't know if anything I say to HR will make a difference. At this point I can only leave with my integrity intact.

She must have been terrified and angry. We have never seen that side of her. Once when she had a UTI and refused to go to the MD we had to call an ambulance and she fought the EMTs. All that info was right in the chart!

Over the weekend the Nursing home still refused to take her. She remains in the hospital while placement is found. I hope she gets settled soon so her family can enjoy Christmas.

I was an MDS program leader for many years. NY is a case mix state. The trainers that I took all of my AANAC courses from used SNF to signify the facility as a whole. Not bed designation for Medicare (rehab) vs Medicaid. All the facilities I worked in had dual certified beds. So if I confused the terms others use for this, I apologize. I do know the regs inside out for what qualifies admission. She was going to a long term care floor. She had private pay funds, not Medicaid. The nursing home screened her in person. They had the records available to them, but did not read the chart. We had a PRI assessment from a neutral third party. The chart contained notes and incident reports of her behaviors. I read charts cover to cover when deciding who can live at my facility. I can't believe they didn't do the same, but they are saying they genuinely did not know she had aggressive behavior and resistance to care.

I got a call that she saw her name on the outside of the room and got upset. She would not allow the nurses to assess her. She was able to over turn a med cart. She went straight out to the ER to be evaluated for the psych emergency center, but being that she has dementia and not a true psych disorder they would not accept her either.

She was going to be placed on a long term care floor. They knew that she was adulatory and had dementia. They knew she was currently living in a secured adult home. The thing that moved her on- she was no longer appropriate for the adult home due to a worsening of her dementia. I do not employ CNAs, only personal care aides. We cannot give a bed bath, change a brief in bed, feed a resident, or provide any physical assist with transfers or ambulation. She was progressively getting more resistant to care, refusing medications, and loosing weight. She needed to be somewhere with more medical oversight. In my home, residents still see their Primary care docs. She would refuse to leave for appointments. We literally could not get her to go to the MD. Her resistance to personal care made her more susceptible to UTIs, which we had a hard time treating because she wouldn't give a urine sample or go to the MD. A few times she ended up in the ER from them. We just couldn't carry on like that anymore. The nursing home evaluated her and accepted her, then twenty minutes after she arrived, dumped her at the ER and abandoned her. It's a very sad situation. Her family is distraught.

Hi there! I currently work as an executive director/ RN administrator at a dementia care adult home. It's not a skilled facility. We are considered more of an assisted living level. NY state regs are very specific about what kind of person I can retain. I have a resident that is exceeding my level of care and has a PRI that places her at a skilled level. (Not a real high skill level, but just outside my license allows). A SNF accepted her and we discharged her. When she arrived to the SNF she became very agitated and I received a call that they sent her to the ED for evaluation and are now refusing to admit her. After offering a bed and accepting a resident, do they have the right to refuse? I have discharged her! Her meds are gone and her apartment was cleaned out by family this morning. I can't knowingly re-admit a resident that has documentation stating she is outside my scope. Has anyone encountered this before?? It seems very unprofessional to me. Please help!!

You don't need a license for this level of admin. (At least where I am in New York). I just recently did the same thing in my community. My ED left for another position, and I applied for hers. I will start as soon as the new DON is settled. I feel that an RN makes a great administrator if you have the drive. Just keep in mind that all departments are working toward the common goal of providing great care, and keep on top of census. It's exciting to venture into a new field after so many years as a nurse.

I like to talk about my motorcycle. And music, books, movies. I had enough of my kids at home. It's nice to talk to people about other things besides my family. Love them to pieces, but I go to work to get away some days. You're young. You may be gabbing it up with the ladies when you have a family later. Small kids really take over your world and leave little time for anything else. Plus, parenting is hard. It leaves you second guessing every decision and action. Sometimes you need to talk over what happened to feel supported by other parents who've been there. Just continue to be polite and professional and supportive and you'll go far in your career.

I think it does. I can't seem to stay out of it. I am really enjoying this new position and jumped in with all I got. It's not without challenges, but I know that I will be stronger for having dealt with them. Thanks for the well wishes!

Not a nursing book, but an excellent leadership book, "the no @sshole rule" by Robert I sutton. It isn't vulgar, and explains why no other word will work in place of that one. It's my favorite. He also wrote "good boss, bad boss".

Just wanted to update this thread. The cubicle became to boring to bear, and the temp contract (thankfully) was not going to be renewed. I am now the DON at an Alzheimer's/dementia assisted living facility. It is challenging and every day is a new adventure. It's been about a month, and so far, I really enjoy it. Thank you for all your kind words and encouragement.

I was 22 when I started school. I ended up pregnant during the first semester. And then again five months after my son was born. I had two babies back to back amid clinicals and exams and stress. It did take me an extra year, but with the help of my family I made it through. If you know you have the support system in place, go for it. Lean on you family and friends. Let them be there for you. After an experience like putting yourself through school and raising babies at the same time you will KNOW with certainty that anything else life throws at you will be cake. Good luck!