"Nursing Home Mentality"

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I need to vent on some things that are bothering me. My RN supervisor recently used the phrase "well, thats the nursing home mentality". It took all I had not to snap back at her, as I have been in long term care since 1994. I started as a CNA and am currently an LPN with goals to return for my RN within the year.

My current facility is new. It is under hospital authority. Over half of the staff, including management, is from the acute setting. This line of health care is new to them and I completely understand that. I work nights, however I am THE rare breed in my facility. I have found everything from orders not completed, DNR's not followed up on, and missed treatments. I have done the monthly changeover paperwork for the past three months. I have tried to help the CNA's by devising a bath schedule, made a list for required vital signs rather than making them get vitals on all patients, helped weed out unnecessary documentation, mentioned ideas to cut costs...What is the definition of "nursing home mentality"? :confused:

My co-workers have questioned how I can stay busy all night, asked me if I take speed before I come to work, and reassured me the DON isn't gonna pop in during my shift ("just sit down"). But these are the same co-workers that come to me for my paperwork every day. One of the day shift nurses mentioned that I should be on days. My response was "but then who would do all of this at night?":banghead: Other departments make comments like, "I know you didn't work this past week-end because the O2 tubing wasn't changed". But no one informs the other nurses that it needs to be changed. I told some people the other night that my back hurts...from everybody walking on me!

Maybe I'm asking for it, maybe I'm doing too much, but that IS my nursing home mentality!

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Specializes in Med Surg, ER, ICU, LTC, DRUG & ETOH.

I worked as RN house supervisor at a nsg home and know exactly what she means by her statement. Yes, there are wonderful nurses like you out there but there are a lot more just like the ones you have described that you are working with. Mentality /reality is most people who run these homes don't care who gets dumped on and who just skates thru as long as they don't have to come in and help out.So , what happens is that mistakes are made, people are neglected, and good nurses finally get enough that they leave nsg homes, which is what I did. Sad, yes, but neccessary at times unless you want to stay a doormat from now on doing most of the work, while the jokes are drawing a paycheck too,

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I don't want to sound rude or upset anyone, but she is an acute care nurse. Most of the nurses I work with are from acute care...so what does that say about their 'acute care mentality'?

My point is that in their hospital, the lab would report to the MD, the pharmacy would get clarification from the MD. In my experience in LTC, all of those things fall on our shoulders. We don't have all of those luxuries in our facility. The aides were mad when they found out that they had to empty garbage out of patients rooms.

These employees were not given proper orientation as to what it takes to succeed in LTC. And that falls on management!

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Specializes in Med Surg, ER, ICU, LTC, DRUG & ETOH.

I don't easily take offense lol, and did not intend to sound like I'm picking on long term care nurses. As, I've said there are a lot of great nurses out there as well as people who are there to do the least they can do for their paycheck. Sorry to say, they are everywhere, acute care, ER , everywhere !:bluecry1:

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CTM985, I agree with your post. However, I would like to point out that some of the nurses that you think are just not doing their jobs up to standard, they may be so beaten down by the "Management by Intimidation" and the fear and loathing shown by many LTC managers for LPN's that they are fearful of instituting new procedures for all of the paperwork, scared of even cleaning up the desk area. For instance, in my facility, a 54 bed combo LTC and sub-acute, management has stopped accepting elderly who may turn into LTC. Instead we were getting people straight from ICU with trachs, IV, caths, tube feeds etc, w/o warning, w/o the screening docs that would have prepared us. My last admit came in w/o warning, no docs provided by our management, needed O2, neb, tube feed, iv set up with meds, suction. We had nothing ready for him. His b/p was 70/40 o2 80%ra, AP 164, resp 30, ragged, congested, needed suction. I sent him to the ER where he was admitted to CCU. This was at 7p on a Fri. I wrote a memo that made some organization suggestions re: new admits such as keeping the chart available to nursing, not locked in Directors office, ways to expediate ordering supplies that we anticipate, For my efforts i was suspended, written up for overstepping my bounds as I am just an LPN. I was the 4th person in 1 month suspended for ridiculous reasons. Turns out that my wonderful fellow nurses have instituted my suggestions on their own. I thought I was being helpful, silly me. My backround was 30 years running business, BS in Business. I will never make a suggestion again, just pour my meds, do tx, document and look for another jobASAP.

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Specializes in acute care and geriatric.

CTM985- you just keep doing your job, ignore the others who are in essence abusing their position and patients by neglecting their responsibilities, I promise you that in the end good work will get noticed, and better things are waiting for you. You can not in all good consciousness neglect your job just because others do and encourage you to. You are not being stepped all over just because you take your committments seriously. However that being said, you have to get along with others so try to be pleasant about things and try not to sound judgmental when talking about others. Don't worry mnmgmnt knows who's getting the job done. But if you do it with a sour face or nasty comments you are negating all the good

I AM NOT IMPLYING THAT YOU BRING ATTITUDE TO WORK WITH YOU, just pointing out some good advise. IGNORE the supervisor who said "well thats the nursing home mentality" she knows she is wrong. Stick to the mantra that you are just trying to do your job and help your patients. Do this and stay positive. Dont let em get to you and bring you down. If they are telling you that they can tell you worked cause the work got done that means that they are noticing. Don't blow it by having a poor attitude.

I applaud your efforts, wish you all the luck in getting your RN, YOu will make a helluva RN!!!

LPNMAURA, I am so sorry that you had that terrible experience. The mngmnt should be ashamed. They had no cause for suspending you, it is still a free country one where you should be able to express ideas freely- they could have ignored the letter if it was not to their liking.

Sorry!

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CTM985, I agree with your post. However, I would like to point out that some of the nurses that you think are just not doing their jobs up to standard, they may be so beaten down by the "Management by Intimidation" and the fear and loathing shown by many LTC managers for LPN's that they are fearful of instituting new procedures for all of the paperwork, scared of even cleaning up the desk area. For instance, in my facility, a 54 bed combo LTC and sub-acute, management has stopped accepting elderly who may turn into LTC. Instead we were getting people straight from ICU with trachs, IV, caths, tube feeds etc, w/o warning, w/o the screening docs that would have prepared us. My last admit came in w/o warning, no docs provided by our management, needed O2, neb, tube feed, iv set up with meds, suction. We had nothing ready for him. His b/p was 70/40 o2 80%ra, AP 164, resp 30, ragged, congested, needed suction. I sent him to the ER where he was admitted to CCU. This was at 7p on a Fri. I wrote a memo that made some organization suggestions re: new admits such as keeping the chart available to nursing, not locked in Directors office, ways to expediate ordering supplies that we anticipate, For my efforts i was suspended, written up for overstepping my bounds as I am just an LPN. I was the 4th person in 1 month suspended for ridiculous reasons. Turns out that my wonderful fellow nurses have instituted my suggestions on their own. I thought I was being helpful, silly me. My backround was 30 years running business, BS in Business. I will never make a suggestion again, just pour my meds, do tx, document and look for another jobASAP.

what part of your "bounds" did you overstep.....i am not seeing an issue here, except from your perpesctive....i would think they would be pleased to have your degree of education and willingness to give input.....oh i forgot if it isnt THEIR idea, it isnt any good....

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Specializes in LTC,Hospice/palliative care,acute care.
I need to vent on some things that are bothering me. My RN supervisor recently used the phrase "well, thats the nursing home mentality". It took all I had not to snap back at her, as I have been in long term care since 1994. I started as a CNA and am currently an LPN with goals to return for my RN within the year.

My current facility is new. It is under hospital authority. Over half of the staff, including management, is from the acute setting. This line of health care is new to them and I completely understand that.!

They are making a common mistake-many nurses think they know everything they need to know when they go from acute to LTC-they learn the hard way...When the citations start flying they will learn....
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