Peepershops

WAY over your head! Long term care is a specialty, just like psychiatry. DON is not a job to "learn as you go." You need to have a good working knowledge of long term care nursing and regulatory compliance before even thinking about accepting that position. Start off working as a per diem nurse in a nursing home first to see if it's something you'd like and to get the basics down. I'd be surprised if you were hired as the DON with no long term care experience. But I've worked for big companies and stranger things have happened!

If she does implement her "Wall of Shame" she won't have any staff working there. Let's see if she can keep HERSELF off her own "Wall of Shame" when she's having to work shifts AND be DON! What a loser and a poor excuse for a manager!

This is sexual abuse and needs to be reported to the state agency. And the RN who said that nothing can be done needs to be reported to the state board of nursing. She is a mandated reporter. Shame on her! There should be a state number posted within the facility in several different places that ANY person can call to report abuse of any kind or other poor quality of care issues. Your girlfriend needs to use the number as she is also a mandated reporter. This behavior is wrong, dementia or not.

I've been a nurse for 40 years. I did my time on the floors and on holidays/weekends/rotating shifts. I'm in management 8-4 Monday thru Friday. It's nice to get paid for what I know instead of how fast I can run or how many shifts I pick up.

They may have taken your picture but they are not able to use it as evidence against you because it was without your permission. These family members are clearly bullies and use picture taking as a scare tactic. It sounds like you get no support from Administration. There are many good SNF's out there, please don't hate all of us for the poor judgement of one building. Polish up your resume, do some research on Nursing Home Compare on the CMS website, and find yourself a good place who will appreciate your efforts and give you support.

I took the exam in October and passed. It was a pass/fail scoring system. All computerized, I had 4 hours to take the exam and finished in 2 1/2. I downloaded the study guide from ANCC when I applied. I do believe you have to answer so many questions correctly in order to pass. The study guide and materials you receive when you apply for the exam will give you all that information. I first took the practice test at the end of the study guide to see where my weaknesses were. Then I went through the study guide and concentrated on those areas. I skipped over the sections I was confident about. I did a little studying every night over the 2 months before the exam-no more than half hour at a time. It was well worth it.

I am leaving LTC after 40 years for a lot of the same reasons. It's been a good career but even I, with my Mary Poppins attitude, can't do it anymore.

After 40 years in nursing, 95% of which have been in LTC, I've decided to give up being a DON and full time work. It wasn't a hard decision-my heart is just not in it anymore. Unstable staffing patterns, lack of support, buildings being bought and sold faster than I can keep up with, just to name a few things. On the top of the list, are the ever-changing rules and regulations the dictate the care that must be provided in a nursing home. Most recently, circular letters at the state level mandating that nursing homes have Narcan available and that nursing home staff are trained to recognize signs and symptoms of overdose and be prepared to administer the Narcan. Nursing homes and skilled nursing facilities will now be expected to train staff to care for those with substance abuse disorders, leaving the nursing home even more vulnerable to serious citations during surveys. The next group on the list are those who are aging in prison who are now too old or sick to be considered a danger to society any longer. The push is on for these folks to be placed in long term care facilities for the remainder of their lives. I became a nurse to care for the sick and elderly but this is pushing it for me. I think the mixing of these 3 very diverse populations is a recipe for disaster, at least from a Director of Nurses' perspective. I heard from my state Ombudsman yesterday that it has already had disastrous results in larger cities where its already happening. I've done my time, I've made a good reputation for myself and have had a good career. It's time for me to step away and maybe do some consulting on the side. But I will still be watching and keeping up with what happens.

If you go into labor in the middle of the night with no instructions on which nurse to call, I would call the DON. It is her/his ultimate responsibility to assure the facility is staffed. I can't tell you how many times I've gotten called as a DON to come into work on the night shift because some agency nurse didn't show up or there was a call off and nobody wanted to work. It is your DON's responsibility. I'd have the conversation with her first since you seem to have gotten nowhere with the schedule.

You are a mandated reporter. If you do not report this to the police, your license could be in jeopardy. I wouldn't put my license on the line for this obviously incompetent idiot who doesn't care about your license or his own. And the poor residents! In my building, a person who is accused of alleged abuse is suspended IMMEDIATELY pending investigation. The investigation is kept confidential and reported to the state agency. DPH regulations state that if you report an allegation of abuse to the DON or Administrator and nothing is done about it, it is your responsibility to then take it above their heads, including notifying DPH and/or the police yourself.

I have told many people that if I didn't have only two years left before retirement, I would change careers altogether. I've been at this for 40 years and have seen many changes but none which have made me so tired and discouraged as those that make our healthcare system what it is today.

You need to remember that you are a NURSE, not a JUDGE. When we become nurses, we vow to do it with compassion for ALL, regardless of what the ailment, self-inflicted or not. It reminds me of a story of 2 patients. Both had broken limbs from falling accidents. One was 70 years old, the other was a 46 year old alcoholic. When it came time to review the referral for admission, the admissions nurse wanted to deny the 46 year old. "Why?" I asked. She replied, "Because he's a drunk who fell off a ladder-he shouldn't have been on the ladder in the first place." So I asked, "So does that mean he shouldn't be allowed to have rehab for his broken leg?" I got no answer back. We took the patient and he was a model citizen who completed his rehab and went home. Don't let your mind question whether or not a patient deserves care or not. Treat all patients the same, with compassion and dignity. It's also not wrong to set limits with manipulators and demanding patients. You can politely but firmly let them know that your job is not to be manipulated or run ragged. That you will provide care and meds as necessary but that you won't be used and abused. Hope this helps-I know it's hard to keep sight of why you became a nurse when these difficult situations arise.

This is clearly a "Sensitivity Training" to show staff what it's like to be on the receiving end of care. Making someone wait to use the bathroom, putting patients on guerneys in the hallways, exposed to those walking by are just a couple of reasons NOT to go to an emergency room. I've been a nurse for a very long time and I get it-there is not enough staff for 1:1 care for every patient but when you have to use the bathroom, 5 minutes can seem like 5 hours. When you can't see or hear very well, it seems the whole world is ignoring you. I think sensitivity training is a good thing. Those who actually try to get something out of it will learn something, those that don't, will never have the sensitivity and compassion enough to continue in the nursing field.

You didn't say how long you were at the LTC facility but it's not good advice to leave it off your resume, unless it was less than a month. Otherwise, you'll be finding yourself explaining the gap between jobs and why you were out of work for so long. Better to say that it wasn't a good fit for you personally and/or professionally.

Negotiating a raise means knowing your own self-worth. It sounds to me like they know the value you bring to their business. You've made some good points about how you've changed some processes around to improve client outcomes. I would start with those things-make a list of how things were, what you did to improve the process, and what the outcomes were. Think about how the clients have had a positive impact because of the changes you've made. Never settle for less than 10% and present yourself with confidence. They know how lucky they are to have you, it is YOU who needs to be convinced of the same go for what you deserve!