Sixtyseven

Because we are tired.

What I have seen in my 20 plus years of nursing is that the men are consistently promoted to management positions over women with more experience. No sooner do they have their RN than management starts eyeing them. Women in management fawn over them. However, I have seen that gay men fare no better than female nurses in moving up the ladder.

I think that "management" nurses just become lazy and also jaded - they just give up because the staffing will never improve as long as LTC facilities are run by corporations whose main concern is the bottom line.

Really? You want to judge all LTC nurses from your experience with your own facility's unit? Of course we check BGs and of course we give O2. I might mention the times residents were sent to hospital and returned with Stage IIIs because maybe hospital nurses did not know about turning, etc. Basic nursing.

It's interesting but sad to hear that things are the same in the UK. Perhaps the problem lies in the fact that historically nurses have primarily been women - and women and women's work have always undervalued. Nurses are bullied more than respected.

Clarification: The prescribers are not making more money by ordering liquid meds - the liquids cost the resident or his/her insurance company more. Some insurers do not cover the liquids if the med can be crushed.

The liquids cost more. Also, many times the docs order meds that should not be crushed, however, the resident needs crushed - but the nurse taking the order does not recognize that, so either meds end up given crushed that should not be....or the resident is given a whole pill he/she cannot swallow - until finally someone notifies doc of the problem.....

Applesauce seems to be a rare commodity in LTC. I have used juice thickened up pudding consistency.

Of course do it! It is great experience that will give you confidence and insight into the nursing profession. You will understand and appreciate the responsibilities of everyone on the nursing team and it will make you a better manager. If time is limited, do it part time. Have a great summer!

The CNA's are the heroes of LTC. They are the ones who let you know when a resident is having problems. They are the ones who give and give and give. Without the CNA's we nurses could not survive LTC. Let alone the residents. Just wanted to say that.

Oh, how common that situation is. Your choice - leave your resident in pain or catch hell from an angry doc (who has the right to be angry). These kinds of errors became more frequent when the LTC's discontinued unit secretaries who were an immense help to the nurses in keeping everything up to date.

I worked in LTC 20 plus years. The problem is, the owners (corporation) will staff to the minimum state requirement. The minimum state requirement is far from adequate for the acuity of care most residents now need. The scheduler will fill the schedule with any name to make it look good, even with names of people who no longer work in the facility. Then there are the call-outs. What you end up with is an impossible situation for staff and a win-win for the corporation who save dollars by working with less staff. If the workers complain about staffing, the corporate powers that be point to the state minimum and say "we are above the state requirements". Poor old grandma and grandpa do not understand why they have to wait so long to be cared for! So they and their families become angry and the anger is directed at staff. I am so glad to be out of it now.

It sounds as though your facility lacks organization. I worked in a similar facility, much time wasted searching for supplies, etc. I would say that if it is your opinion that your resident needs the hospital, but the doctor or NP disagrees, I would cover myself by notifying the DON (regardless of time of day or night) and I would advise the family of the resident's condition and how the doctor has decided to treat this (without criticizing doctor's orders). This would give the family (or DON) opportunity to override the doctor's decision. I would also talk to the resident, if he or she is cognitively able, to see what his/her wishes would be. If a resident or family state they prefer hospitalization, no doctor should argue with that.

This is all about corporate America - people who sit at desks from 9 to 5 and take hour long lunch breaks, and earn 3-4-5 times what any nurse earns and make decisions about staffing based on their "numbers". They do not care about the human toll or the care and they certainly do not care about nurses. They go home at 5 o'clock on Friday to enjoy their "much deserved" weekend.

Of course, nothing is simple. This is Nursing. The question was whether it is the nurse's duty to bring this to the doctor's attention. The facility says it is, and is there another way to get an order from a doctor other than contacting the doc? My point is that we can maintain professional demeanor with the doc by just asking.