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That actually sounds like great staffing for a long term care facility.

Me!!! Graduated in 1996. I wish diploma programs were still around. We received such better training and you left nursing school ready for a position as a nurse. I absolutely loved my nursing school. We learned so much and spent so many hours in clinical!!

Being in a middle management nurse manager position is one of the toughest positions there is as a nurse. Try spending a week in their shoes before you judge them so harshly. I'm sure there are "jerks" in every position in every career but not all nurse managers are "jerks"! Most of them try to do the best they can with what they are permitted to do.

OP I could not agree with your post more!! Middle management is the most difficult position I have ever had. You hear complaints from administration/CEO and also from floor staff. Impossible to make everyone happy and nobody understands what you actually do!!! all of your free time is consumed by your job because you are always on call. Sleep in never uninterrupted because there is always something happening that requires your attention. It totally consumes your life and very few people appreciate anything you do. Good Luck to you!! Unfortunately I have no advice and it has been a difficult week so I can't even seem to pull off being a little positive.

Not all SFNs are equal in care. There are good SNFs and bad SNFs just as there are good hospitals and bad hospitals. I get really frustrated when the assumption is made that all SNFs are bad. I have been with the same company for 20 years and DON for the last 6 years. We are a 5 star facility and have had 4 deficiency free surveys. We have a large number of patients that receive excellent PT/OT from our therapists. Myself and my ADON are both wound care certified. The patients in my facility receive excellent care and I'm very proud of that fact. Again I realize that all SNFs are not run the same way. I just feel the need to speak up and defend the nurses who work in LTC. The majority of LTC nurses provide great care to their patients and should be proud of the work that they do and not made to feel that they are inferior to hospital nurses. I think the majority of nurses regardless of setting provide the best care they can. I have the utmost respect for hospital nurses I just wish that respect was reciprocated.

Really??? Because you are sending them back to a SNF they are automatically going to be neglected?? Patients develop pressure ulcers with the best care regardless of where they are - SNF, hospital or home. I have gotten many patients from hospitals with pressure ulcers that developed in the hospital and never once considered they were all being neglected.

I have worked in long term care for 20 years. I am fortunate that I work for a very good company and our facilities are run very well. The only nurses I have ever seen that lost their license was for drug diversion. I'm not sure why many new nurses are fearful of losing their license - it rarely happens. Most states have a website or newsletter that lists nurses who have lost their license and why Take a look at that and it should put your mind at ease.

I think it is different for different companies. At my company BSN is paid the same as ADN.

I like tattoos and actually have one. I chose to get it on my back where it is only seen by people I want to see it. I wouldn't be completely comfortable having one where it could be seen by anyone. I work with great nurses that have tattoos and also some that aren't so great. Same to be said for nurses without tattoos. So I guess what I'm saying is that like everything else in life a tattoo doesn't define your skill as a nurse anymore than having red/black/blonde hair does.

This!!! At least once an hour!

Wait!!! We can afford luxury items?!?! Seriously though the only thing I do differently is I could afford to buy a house and did so and I take one really nice vacation every year. I couldn't have done that on my pre nursing salary.

That doesn't sound possible to me. When I worked night shift I sometimes would go without sleeping before my first night shift but then would come home and crash for pretty much the whole next day before going in again. My husband and I rarely saw each other for more than a couple hours a day when our kids were little but it is what worked for us - we didn't want to have to put our kids in day care. Now that they are older we get our days off together and it is great. To be able to have our children at home with one of us was worth it to us but may be different for others. Good luck in whatever you decide.

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Try being a nurse for a few years and then come back and tell us the "truth".

This happened to a co-worker at my first nursing job and she was reported to the BON She did receive a discipline although I'm not sure what it was since I didn't keep in contact with her.

I guess I have a different view point on this topic. As someone who has been on call there have been many times that I have gone in to cover a shift without having had any sleep. If I work day shift and the night shift calls off because she doesn't feel she had enough sleep I get to go back to work and work night shift. How is this any safer? That puts me at being awake 24 hours or even 32 hours if I have to work the next day shift too.

Going from coworker to manager is a difficult transition. I was friends with many of my coworkers before I became their manager and I had a hard time. Eventually you drift away from the friendship role and assume the manager role. It was very lonely for a while - until I became friends with other managers. Now I make sure to never form a friendship with anyone that I supervise. It makes your work life much easier to maintain the boundaries between yourself and the people you supervise.

I am not where I thought I would be while I was in school. I wanted a hospital job but when I graduated was a tough job market and I ended up in LTC. Since then I am exactly where I wanted to be - the DON of a very good SNF. I'm very lucky to be one of very few people that truly loves my job.

I agree with Elkpark. I didn't see any "venom" in any responses. I volunteered to work as a CNA many times when we were overstated with nurses and short on CNAs. Always made for a much more relaxing shifts. I also spent a lot of years being on call and got called in occasionally to work as CNA and never even considered that it wasn't ok.

Doesn't sound like delegation to me. It sounds like team work.

I have 2 questions. First why would you watch a staff member "physically assault" patients and not stop them? Second question. Why would you lose your job for reporting it. As a supervisor I would think you would be more likely to be terminated for allowing it to continue and NOT reporting it??

This is an easy one. Unrealistic family members!!

I've been an RN for 20 years and LOVE long term care. I have never worked in the hospital so I can't really compare the two but I could not be happier with the specialty I chose. Some people like it and some people hate it. Follow your heart.

Exactly what I was thinking. I feel like anything that you can do with nursing would strongly benefit from getting bedside experience.

I started in a LTC facility on night shift 20 years ago. It was not what I wanted at the time but nursing positions were not very abundant and I needed a job. I LOVED it. I have never left LTC and am currently a DON in a very busy SNF and continue to love it. LTC is definitely not for everyone. It is a difficult but very rewarding job. You will hear a lot of negative things about LTC facilities but try to keep an open mind and decide for yourself. Good luck!!!