"Nursing homes" giving nurses a bad rap

Nurses General Nursing

Published

Hi,

Im a nursing student and I'm putting my 2 cents in. I think if the public had a better idea of what nurses do, they would support us and not only insist upon but demand better patient care. Too many dont realize that the nurses are the ones on the front line and advocating for the patient. Too many people have only encountered nurses when they had their tonsills taken out or when someone in their family needed a C-Section. When my family or my friends families think of nurses, they think of "nursing" homes.

You know, I'm sure each and every one of you know what I'm talking about. You walk in and are almost knocked over by the smell of urine. You walk down the hall to your loved one's room and try not to look at the pitifull old people lined up and down the hall with their heads hung over, waiting for their morning meds. "It will make them more comfortable" is the reason for this soon to be dead parade. You find your loved one totally incoherent and with unexplained bruises and you wonder what happend to your grandpa(ma) that was so full of life just a month ago.

Your family may of put them there in good faith, believing that after a temporary family mishap, your loved one would come to live within the family once again or you may assume that this is the place for your loved one to live out his or her golden years (and give you a much needed rest). Unfortunately, your grandpa(ma) only lives a few months after being admitted and you can't understand why. Also your grandparents of your freinds that are in similar "homes" end up only living a few months as well. Soon the community begins to talk and you realize that, this is how nursing homes work. Once someone is admitted, they drug them untill they lose their will to live and just die. It's really a wharehouse for old people waiting to die to make room for the next wave of old people. They must make a half way decent profit as their turn around time is usually 3-4 months at most.

So when most mid-westerners (at least the ones I have come into contact with) think about nurses, they think about "nurs"ing homes and how it only takes a minimal amount of effort to oversee a group of old people and give out meds.

I must agree with Heather on this one, tenderheart35, I would find a new on-line name for myself. I can tell by your post that you are also in sad need of Gerontological Nursing 101. Allow me to improve your education:

There are a few things one must consider in this population. First and foremost, we tend to get the views of the family when we talk of perceived quality of nursing home care. Families tend to see things through the dark sunglasses of guilt. Many members of today's nursing home resident population raised families with varying numbers of children. I myself have always found it amazing that this generation of older adults could care for 5 children, yet 5 children cannot care for one parent. At any rate, the resident's opinion about the care they receive tends to go unaccounted for.

Insofar as your concern about 'strange people dressing and undressing you!!!!' this is no experience that no other patient has ever had. In fact, this older adult generation is more familiar with the healthcare environment then our generation [remember 6 weeks for a gallbladder removal?--or the doctor put a patient in the hospital for a month for tests?] I am sure have had their clothes off for a nurse once or twice before. It's all in the way the professional nurse handles it [protecting the patient's dignity].

Another fallacy is that all old people hate going to nursing homes. Several studies on activation/integration patterns have demonstrated that community dwelling older adults have had higher levels of social isolation and subsequent depression than elders of similar health/socioeconomic/educational status who dwell in nursing homes. For many of these people, placement in the long term care setting has been associated with a re-establishment of a peer network, peace of mind knowing that their healthcare needs are being met, and satisfaction from the support that they receive from a nursing staff. Kind of a far cry from the black hole of Calcutta that you make it sound, isn't it?

The next incorrect thing that you said was "....of course on the flip side yes nursing homes are the best thing the healthcare field has come up with for the care for the elderly..." Actually, the concept of aging in place is by far the best practice. Unfortunately appallingly bad reimbursement mechanisms and a lack of a community support system often preclude this option.

The student who wrote the original post that made all of the true-to-heart Gerontological Nurses respond frames his/her inquiry in an antagonistic manner, assuming that the pariah of the nursing profession had to be the nursing home.

Can long-term care facilities be improved? YOU BET. But they won't be improved by the ignorance and crass comments of students or 'seasoned' nurses who couldn't even spell Gerontological Nursing if their lives depended upon it.

It is in my humble opinion that you should learn more about the subject matter you are attempting to be antagonistic about before you make heinous statements like your post, which only serve to make you sound like an idiot.

Cheers!

I'm confused as where to start.....

The original post disturbed me, yet also, hit home with me.

I've been in the health field since 1990, and started at the bottom. I worked for a hospital as a unit clerk, a CNA, and then an RN.

As a student nurse, I watched and cared for my grandfather while he died of Cancer. It was heart wrenching...I was a student nurse at the time. When he was in the hospital, I sat on the edge of his bed holding his hand, and this is what he said...."Honey, when you become a nurse...please...never treat any of your patients with less than the utmost respect!!!" My heart went out to him...and it wasn't because his oncology nurses weren't good to him...it was because, it was a new diagnosis...he was about to lose everything, and he expected more...My grandfather was 64 when he died, and he was the best man I've ever known!!!

My nursing career believe it or not, started on an oncology/hospice unit. It was very therapeutic for me, and I will never forget our "frequent fliers" as we, as nurses, called our patients. Because you would see your patients into remission, only to get them back again when the cancer reappeared. This helped me get through my feelings and emotions after losing my grandfather to Cancer. And, the families are priceless in this situation! I found that including the families in all aspects of care assisted them in dealing with the issues they were facing in regards to losing someone they loved with all their hearts.

Then, when the hospital re-engineered, I went into LTC. It was a county owned nursing home, and I was the charge nurse on a 52 bed sub-acute unit. I thoroughly enjoyed that job!!! However, when talks of unionization swept through, I'd had enough!

I went to another corporate owned LTC facility. I worked there and enjoyed all positions held at this facility....which were Charge Nurse, ADON, and DON....which was in Illinois.....then, my husband and I chose to move to Florida.....so, I transferred within the Corporation I worked for...however, I was not so happy within the Corp. here in Florida.

So, once again, I left and went to a Rehabilitation Center, where our residents range in age from 2 years to 100 years. We have 4 different units, 2 sub-acute units, 1 behavioral unit, and a LTC unit....however the majority of our residents are elderly....this is my current place of employment, where I am the weekend Supervisor from 7a-7p.

However, since I've left Il, my grandmother has been placed in the facility that I held above all others in our area, and has not received the best of care. Being a nurse, I can appreciate all the responsibility that goes into caring for a person, however there are some things that are inexcusable. For example.....my grandmother was re-admitted to the nursing home with an order to straight cath q8h........after 13 days, she had been straight-cathed a total of 1 time!!!!

Is that a slam on all nursing homes??? Or all nursing home nurses??? ABSOLUTELY NOT!!!!

My mother calls me every day with news and lab results, etc....and I tell her what she should do in my granny's best interest....

Of course, I told her to get her to a different nursing home! I've even offered to take care of granny myself, however granny doesn't want to leave all her friends and family in IL or to burden my family, even though, we wouldn't consider it a burden!!!! Family is family, and most of us in the general public, even us nurses, know or seem to think that no one can care better for our family than us!!! We, as nurses have to realize that and understand where our family members are coming from!!! My mother is not a nurse, or even a CNA, but has provided my granny with better care in the nursing home than some of their employees. Being a past employee of this facility does not make me proud, however, everything in life is a choice! We have since moved granny to a private pay SNF. This is her third nursing home, and if this doesn't work, I will fly granny to Florida, with her consent of course, quit my job and take care of her myself.

Now...........this is my vent time.......

In defense of the nursing student that started this nightmare.....

where I went to nursing school......we had to follow 2 patients during our clinical time...(a huge farce regarding the reality of nursing)...and this is the same in regards to our CNA's....

Then we get thrown into the real world.....in the hospital i had anywhere between 8-15 oncology/hospice patients....and in LTC anywhere between 25-55 patients. This is very difficult to handle when nurses no matter where they go.....seem to get no orientation but are thrown on a med cart and let go....This is probably one of my biggest complaints as a nurse. I actually changed that in my facility where i was a DON, however since transferring to Florida, I have not seen the same.

The two jobs that I've held in Florida, I've gotten approximately 6 hours of orientation. That says a lot since Florida is one of the states leading in law suits....

Staffing is astounding in all states, and it is depressing. We need more nurses/cnas, and as another previous writer stated.....everyone else in the LTC team to step up......

I've had the misfortune of dealing with abuse cases, negative agency staff members, poor management, and just about everything else this industry feeds us......and the people we care for. However, I've also seen the good side of this industry....where my nurses go to our deceased funerals, cry along with the family when we lose a resident, laugh along with the family and resident during their b-day parties, etc..........I've seen CNA's who will go out and purchase Bath and Bodyworks products just so there residents feel pampered, etc....

This industry has many caring and loving individuals.......and we have some that are in it for just the paycheck, and trust me.........I've come across many......but, it takes a lot of hard work, and confidence in yourself to take on the responsibility of someone else's loved one. And, we need to just weed out the bad seeds....

I've been in this business from both sides.......the RN who loves her job, residents, and what she does.....to the granddaughter of a grandpa dying of cancer, a granny in the nursing home post-stroke, to a granny-in-law with Alzheimer's.....

I've thought many of times, that i'm underpaid.....overworked.....and unappreciated!!! As, I'm sure you all here have!!!

But, I'm here for the first time to post, and to pat all of you on the back and say HEY!!! We are all in this together...no matter where we are from....WE ARE ALL NURSES!!!!!!!!! When we see something wrong.....we correct it.....When we see our residents not getting proper care.....we ensure that they get proper care....When we see another nurse burning out.....we do all that we can to save that nurse!!! We need to hang in there together and improve the care of our patients and residents......

And one last note before I step down from my podium......TO THE ER NURSE!!!! THANK YOU!!!! You are an exception to the rule when it comes to my geriatric patients................

I totally appreciated your comments and stories about our geriatric clients when they enter your ER. They are loving, and quick to give you a pat on the back, when most others aren't....

and that is why most of us here are in LTC!!!

One last note..............Nursing is one of the least appreciated professions.....if you see someone going out of there way, no matter who they are, or what position they hold.......please let them know that you've noticed what they've done to improve another's quality of life!!!!!!!!!!!!! It may be something little, but it will mean the world if you have noticed!!!!!

Tenderheart35,

If the original post is more acurate of a resident in a nursing home, tell me why 60% of the population of the facility I just finished surveying has been there at least 4 years on the average? The longest resident has been there 15 years by choice. I worked in a facilities where the average length of stay was 3 & 1/2 years.

I agree there are facilities who need to improve the quality of the care they provide. Have YOU tried to figure out what is causing the problem? I worked in a facility where the Surveying agency was in every other month on complaints of care issues. Many of the complaints had to do with issues that resulted from a lack of staffing not the care provided. The cause of the staffing problems came from an administrator who was not supportive of the staff. didn't trust the staff, and didn't understand the care requirements of the residents. This person had never worked as a CNA or a Nurse and didn't understand. How can one expect someone to provide quailty care when they don't understand what it takes to care for those entrusted to them? This facility is now under a new administrator.

Maybe the people posting replies to this are the fortunate ones to have worked or are still working in the facilities that do provide good care. If that's the case, where are those who don't? And what does that say about the care they, themselves provide?

i give my props to nursing home cna's and lpn's. u ppl have it rough. not only r u underpaid, but ur usually understaffed, which more times than not leads to neglect, in one way or another. u can't possibly have 1 nurse taking care of 20-30 ppl without ONE of them not getting the proper care they need.

which brings me to why i work in an afh. we have 5 clients, 4 workers, 2 shifts (not counting the nite shift which my boss who owns the home gets). normally all of our residents have some form of dementia/alzheimers, although right now we have one who is there because of strokes. not only is the one-on-one care better in a private home such as the one i work at, but the end-of-life stage tends to last longer in these atmospheres. and maybe, as one former poster put it, they don't live as long when they can't remember family and therein their family stops coming by to see them. i wouldn't want to live like that either.

i have seen ppl come into our home and go from being a bed-ridden alzheimer's patient with very little life left in them, to being an alzheimer's paitient that can walk and talk and feed themselves again. it's all about proper medication and proper therapy. u can't very well live 'normal' when ur drugged to the point of comatose. (i'm not saying all nursing homes do this to their residents, but we've all seen this before, so u can stop freaking out now).

no offense, but i will NEVER suggest to anyone i know that is dealing with someone in their life as they reach the end stage to put them in a nursing home. the care in a nursing home compared to a private home is crap, u just can't compare the two, no matter HOW great the nursing home is in the state.

Hi,

Im a nursing student and I'm putting my 2 cents in. I think if the public had a better idea of what nurses do, they would support us and not only insist upon but demand better patient care. Too many dont realize that the nurses are the ones on the front line and advocating for the patient. Too many people have only encountered nurses when they had their tonsills taken out or when someone in their family needed a C-Section. When my family or my friends families think of nurses, they think of "nursing" homes.

You know, I'm sure each and every one of you know what I'm talking about. You walk in and are almost knocked over by the smell of urine. You walk down the hall to your loved one's room and try not to look at the pitifull old people lined up and down the hall with their heads hung over, waiting for their morning meds. "It will make them more comfortable" is the reason for this soon to be dead parade. You find your loved one totally incoherent and with unexplained bruises and you wonder what happend to your grandpa(ma) that was so full of life just a month ago.

Your family may of put them there in good faith, believing that after a temporary family mishap, your loved one would come to live within the family once again or you may assume that this is the place for your loved one to live out his or her golden years (and give you a much needed rest). Unfortunately, your grandpa(ma) only lives a few months after being admitted and you can't understand why. Also your grandparents of your freinds that are in similar "homes" end up only living a few months as well. Soon the community begins to talk and you realize that, this is how nursing homes work. Once someone is admitted, they drug them untill they lose their will to live and just die. It's really a wharehouse for old people waiting to die to make room for the next wave of old people. They must make a half way decent profit as their turn around time is usually 3-4 months at most.

So when most mid-westerners (at least the ones I have come into contact with) think about nurses, they think about "nurs"ing homes and how it only takes a minimal amount of effort to oversee a group of old people and give out meds.

You sound like a person who´s heart is in the right place. However you also sound like the millions of people who have a very exagerated idea of what "modern medicine" can accomplish. Studies have shown that the most money spent on health care, for most people, is in the last two weeks of life. This of course mainly applies to astonomical ICU costs, however the point is that there IS an end to life. Remember that with all of our hight tech treatments and drugs the mortality rate today is exactally the same as it was in 200 BC, 100%, everybody dies. In the modern world it is dificult for many to accept this, modern medicine is suppose to prevent this from happining.

No one likes to think about going into a "nursing home". Therefore most people only go when is is not possible for them to live in their own home, or they have become so difficult and so much work to take care of that the family can no longer manage this. This usually occurs when a person is nearing the end. A nursing home is not a rehabilation center nor is it a hospital. You make a vey good point when you mention the smells, and the bruses. Someday when you work in a nursing home, as an RN, you will find that it is all you can do to give out the meds, and if fact I think the only RNs who realistacally can keep up with the "med pass" work load in a nursing home are those with very good memories for colors and shapes of pill and for faces of old people. It is just not possible to read the name of every pill and think about its actions, interactions, side effects and ect, in regard to someone who is on ten or fifteen pills a day, when you have twenty or more others to give pills to. My hat is off to all the nurses who can do this and who can remain and stick it out day after day. The "heart" of a nursing home, however are the CNAs. They are the ones who dress and undress the patients, who know the patients my name and by habits, likes and dislikes. A good CNA is worth their weight in gold as far as I am concerned. But does their pay reflect their worth? The pay is not bad compared with a convience clerk for example, BUT, a convence clerk or worker on a job site is expected to work fast and get a lot acclomplished in a shift. The owners of nursing homes expect the same of the personnel they hire. Nursing homes must turn a profit for their owners, or the owners cannot stay in business. Caring for people is not the same as building a wall or checking out groceries, BUT, you see more people per shift on job sites, or as checkers at Wall Mart than per shift at the local nursing home. The health care costs in this country are already over 15% of the GNP. More and more people live longer, they have bodies that are useless due to a life of inactivity, obesity, alcoholism, smoking, and the list goes on. I am not saying that it is a good thing, the condition of most nursing homes. I am just saying that the end of life is the end of life. This fact, especially in the US, is not accepted. Also, when you complain about something, you shoud have suggestions for a solution, any suggestions? Sick and old people are the "cash cows" of todays society. It is a digusting thought, but all of us in the so called "health care" (perhaps it shoud be better called the "illness intervention") field have spent years of our life getting certified and licenced so that businessmen who are smarter and much more realalistic that we "health care providers" ever were, can make a fortune of of us and our patients. If you don´t want to play along, then do what a lot of nurses do, take the vow of poverty (so to speak), make a living with underpaied or part time work, and get into something like yoga, dance, tai chi, or other type of health and fittness activity and help encourge people to move more, consume less and try to stay healthy.

at first i became very upset at your post, then i felt pity that you have such limited knowledge, yet choose to speak so harshly about things which you obviously do not understand. i hope once you become a nurse, you will not make snap decisions without first assessing and gaining all the facts, it could cost someone their life!!!!! things are not always what they seem and you do have much to learn. i am a ltc nurse and i do this proudly. i cannot tell you the amount of joy my job gives to me and i in return, pray daily that i provide joy to the lives of those i care for. what you fail to understand is that we work under very difficult circumstances and make sacrifices daily so that the people we care for receive the care and love they deserve. i frequently work 10 hour days with no break from my unit. if i get the chance to eat, it's while i am doing my mounds of paperwork that the state requires. personally, i'd much rather be out on the unit, holding hands, bringing smiles, and offering that little extra attention that many of my residents need. i sit by countless beds of those that are dying, holding their hands and praying i am there when they die, so they do not have to leave this world alone. i have prayed many prayers that the end will come quickly and painlessly. i have cried many tears with families, as they all understand that their family has become our family. it seems to me that you are repulsed by the elderly but please keep in mind, you are not old yet, you know not what your future holds. these are individuals, not items to be discarded. none of these people would have chosen to become this way. when i look into the eyes of my residents, i look beyond their contracted limbs, their drooling mouths, their inability to feed themselves, or toilet themselves. what i see is a person that at one time, held a job, raised a family, lived life to it's fullest and due to circumstances beyond their control, it was all taken away, leaving many of them with only memories, and some without even those to look back on. and not everyone comes into a facility to die, but to get better, so they can go home and continue to live. we provide extensive therapy, we help them learn to walk again after a cva, we help them relearn the things that you may take for granted, like washing their faces and brushing their teeth. we give them every oppurtunity to continue to live their lives but if they cannot, then we care for them, lovingly and devotedly, until their time to move into the next life comes. then we are there to help them die with dignity. i hope you have read all the posts here, for they were written by people that know what they are talking about. at times, medications are necessary. would you rather we let them live in a nightmare that they cannot awaken from. often times dementia and alzheimer's place these folks into a never ending nightmare, from which they cannot awaken. my own grandmother was an alzheimer's resident. i watched her cry and plead with god to take her home. she was constantly screaming and crying, trying to protect the children that were in danger. this came from years of devoted service and care to handicapped children. now, in her dementia, they were in danger and it was her job to help them but she could not and she was terrified for them. she was constantly screaming for someone to help her protect them. should we have stood by and let her live this nightmare day in and day out, or should we have given her the medication that let her mind rest???? what would you have done? many times residents are drugged up, but it's only until we find the right medication to ease their situations. then we titrate the drugs to the least needed amount to provide the best quality of life. as for folks being lined up in wheelchairs.....should we leave them in their beds to become infested with bedsores and get pnuemonia and die, or should we try to help them maintain the quality of their skin integrity, promote mental stimulation and let them see another human being, instead of being hidden away and alone. these are human beings, not monsters and they should not be hidden as though they are freaks of nature. yes my dear, you have much to learn, most of which is compassion. do not speak harshly of what i do until you walk in my shoes. try caring for residents without enough staff. try watching your staff work like dogs to provide mininal care and feeling guilty because they couldn't sit by a bedside and hold a hand. yes there are times when the smell of urine and feces hangs in the air. we do not work in a flower shop!! does it always smell pleasant in the home of someone with a baby. it's nature, what goes in must come out and as a nurse you had better learn to deal with these smells because they are there, no matter what filed you work in, unless you sit behind a desk all day. please learn to look beyond the illness and see the person, you are looking at someone who has been where you are, but never thought it would happen to them. and always remember, "there but for the grace of god, go i."

wow! could not have put it any better.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Great posts on this thread. Don't have anything to add. :)

I'm sorry the op has such bad experiences with nursing homes. I think the op is generalizing his/her feelings onto the whole midwest, and I don't think it's like that.

The op rasies some valid concerns, because if this type of prejudice and stereotyping is out there, and internalized by nursing students, it's sad. :stone

I too could not pass this by without putting in my two cents. First of all long term care residents can have very active lives in the facility. It isn't their home but they are safe, well fed, properly medicated, they are bathed, shaved, they get constant wound care, and incontinence care. My residents interact with the activities staff, the volunteers, the nurses and aides, and visitors and most live far longer than three months unless they have a terminal illness. The nurses and aides that I work with bust there butts to care for our residents. If we didn't care with every ounce of our beings we wouldn't stay at the nursing homes, no one is getting rich working in long term care. My only complaint working in long term care is that the residents want to visit with their relatives and they like to get away from the facility sometimes even if it is just a short trip to the local park. I am sorry that you feel so strongly against long term care nursing but you can volunteer at the facility or become a CNA, every little bit helps.

Specializes in Utilization Management.

I'm curious. If the OP joined in 2001 and has only one post to his/her credit, might we then assume that the OP is no longer here to see these recent responses?

Why blame the nurses in LTC? Its not their fault that they are short staffed and overwhelmed with completing the tasks for their shift. Its not their fault they have substandard equipment or no equipment at all. I always here people blaming LTC Nurses. I think they do a pretty damn good job for the situation and environment they are in. Instead of picking on the staff, evaluate thier situation. Poor staffing, poor equipment, poor supplies, and poor support. I personally get sick of hearing about LTC Nurse this and LTC Nurse that.....Spend some time looking into their situation/environment that they have to work in. You never see this exploited in the news.

LTC Nurses are special.......i honor them for what they do. Its in my opinion one of the most difficult fields to work in. Not so much because geriatric patients are harder to take care of, but the fact you are shafted in the equipment, supplies, and stafffing areas. Think about it. IF you work in ICU, Med Surg and so forth.....You have unlimited access to supplies. This is far from true for a LTC Nurse.

Had to put in my bit about nursing in aged care and some thing that effects us all - getting old and the inevitable (for those who survive long enough) the last phases of our life.

I have been nursing for over 36 years and am still in there!

Started in aged care (geriatrics) progressed through psych, mental handicap, general, acute, paediatrics and now finally back to aged care.

I have just read all of this "Old Thread" and I feel for M2BchgoRN. I was there once too like so many of you who have put in your experienced words of wisdom, opinions, advice and general observations.

Yes some of the primitive homes I started nursing in - in the UK did smell. Working there also after a short while you smelt too!

I love my nursing job. I look forward to going to work even. I need them and they need me - or someone to look after them and give them some love and even more important now - give them your time.

Thanks for the incredible input to this thread. It was worth taking the time to read.

Mister Chris :specs: :balloons: :Melody: :balloons: :Melody: :balloons: :Melody:

When i was in nursing school a couple of years ago, I did not want to working in ltc because i thought of it as depressing and have heard all the " bad things" that go on there.My own family didn't want me to work in ltc because they thought of it as abuse and begged me never to put them into those "nursing homes". Well I graduated and started working in yep a nursing home. Come to my facility and ask my patients how they feel about living here. Most of them will tell you that it was their OWN CHOICE to move there from the assisted living place behind our facility. I don't think there is a nurse in our facility that has not laughed or cried with our residents, we sing songs and dance with them and most importantly give them the best care we can give them because they know they cannot give it to themselves. I love my residents and will probably never leave this facility because of the feeling i get when i walk onto the floor at 2pm, I hear laughter and i recieve smiles and i have been thanked for being there that night because i truly believe they know that they are in the best place for them. My family has changed their minds after coming into my ltc facility and seeing that things are different, and even my own young children ask me weekly when can they go back to see all those nice "old" people that i "make all better" and my daughter has already asked when can she work there! Please reconsider what you think of ltc facilities because it will be the most fullfilling and rewarding thing you could ever do.

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