Staff Leaving In Droves! Residents Revolting! Administration Ignoring All! HELP!

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Specializes in LTC, assisted living, med-surg, psych.

I love my job.

No, I really DO love my job, and watching my facility fall apart at the seams is breaking my heart. This is the best place I've ever worked for, a place I'd planned to retire from someday. But in the past six months, it has deteriorated from a facility that couldn't pass a state survey but cared deeply about both residents AND staff, to a building that passed survey with flying colors but has lost its soul.............not to mention a good number of staff members.

Yesterday, my assistant handed me her keys and walked off the job at 0930, despite my practically begging her not to throw away 2 1/2 years of good work, as well as losing the ability to use us as a reference in the future. She is not the first to do this; three other staff members have quit without notice in recent months, and I'm afraid she will not be the last. Then yesterday afternoon I received another two-weeks' notice from another extremely reliable aide who's been with us for over a year, and I've gotten the heads-up from still ANOTHER long-term employee that she's going to turn in her two weeks' notice as soon as she finds another job.:crying2:

Now, I've been a manager in long-term care for a number of years, and I know how this industry chews up people and spits them out systematically. These days, anyone who stays at one facility for more than a year or two is a grizzled veteran, so high is the turnover. I know the problem is industry-wide. So why does this bother me so much?

It's because our little assisted living facility used to be special. It had a heart and a soul, and many employees stayed for several years because of that. But ever since our "lazy" and "incompetent" administrator left, and we got one who is a go-getter but seems to think people are as disposable as Kleenex, it's all gone to you-know-where in the proverbial bushel basket............and I'm beginning to have second thoughts about staying myself.

Oh, it's not that she and I don't get along. In fact, we're good friends, and I can say just about anything to her. The trouble is, she's been there six months and still doesn't know the residents well, knows the staff even less, and doesn't seem to think there's anything wrong with that. She dismisses various staff members as "silly young kids with no work ethic" and various residents as "troublemakers". Of course, in a facility our size everybody knows everybody else's business only slightly better than their own, and this stuff gets around. Since I do all of the service plan conferences, I get to hear time and time again how angry and restless the residents are; they confide in me things that really should be taken up with the administrator, but they don't feel comfortable enough with her to do so.

Now I hear the residents are planning a sort of revolt---they are going to take their concerns to the VP of Operations, and then up the line to the board of directors. I don't blame them a bit. They're being charged an enormous amount of money for services they aren't getting because we're chronically understaffed, and I'm angry FOR them. Trouble is, I'm the DNS, responsible for staffing as well as quality of care, and having been middle management for some time, I know exactly where the blame is going to land. I've been kicked to the curb before for far less. My job will be on the line, even though neither the staff nor the residents are angry with me---every single staff member we've lost has told me, "It's not you, it's ______ (the administrator who preaches confidentiality and then yells at them in front of other staff and residents)". The residents come by my office to chat, and often they say "Don't YOU ever leave---if you do, I'm moving out".

So, I'm at a loss as to what to do. Sure, I could be all wet about my head being on the chopping block, but happy endings usually only happen in the movies.........my experience of things has been rather different. I guess what I'm asking is, should I start planning an exit strategy now, and look for a new job from a position of strength, or do I wait it out and take the chance of being 50 years old and forced to start all over again in a profession that is not kind to older women?

It feels a lot like the choice between the lady or the tiger: guess wrong, and you've had it. The heck of it is, I don't WANT to leave, either way..........I love my residents, and I love the fact that I've built a good many connections and friendships through this job. I could go to work at either of the two local nursing homes tomorrow if I wanted---both administrators and DNS's know me well and would hire me in a heartbeat---but I know I don't want to do that again. I keep thinking of the headaches this job creates: the 24/7 phone, the staffing issues, the scheduling, etc. and some days I'd kill to have a job where I could just do my eight hours and go home and not think about work again until my next shift. But then I see in my mind's eye the faces of residents, who trust me with their very lives, and I know I can't just walk away from them.

Sorry so long, but I really need some perspectives on this. Thanks in advance for any help you all can offer.

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Specializes in RETIRED Cath Lab/Cardiology/Radiology.

I have no clue what professional advice to offer.

Change in mgmt, resulting in change in mgmt perspective and ways, was one huge reason I (and many others) left my former position after 21 yr.

Will keep you in my prayers.

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Wow, so sorry this is happening to you.It seems as if no facility is immune to these types of problems, what do you think would improve things, make the residents happy, make the staff stay?Is it understaffing and budget issues, just like in most LTC facilities? I think we are seeing the tip of the big baby boomer iceberg , what in the world will happen to our age group?

It is tough for an older nurse, you have good experience and you are probably very marketable, but I know how hard it is to start all over again at our age.I hope things work out for you.Wish I had good advice.

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Sorry about that new manager. What she is doing is what passes for managment these days. Start making your resume. Two thumbs up to your residents for taking things up the ladder, I get a kick out of that.

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what's making all the aides leave?

i imagine it's along the lines of being overworked, underappreciated?

maybe you should share the input from the residents, w/the vp of operations.

or, share your personal observations w/the administrator?

honestly, if i saw everyone leaving, and knowing why they were doing so, i would hope the admin would be concerned.

if she is not, i would plan to leave.

right now, you're a sitting duck. (albeit, a very loved duck:heartbeat)

you have nothing to lose by stepping up to the plate and speaking on behalf of those who have spoken w/you.

i find it worrisome that everyone is running from this place...

and think it would call for some proactive allegiance.

if tptb turn a deaf ear, then it's time to move on.

hugs to you, my dear friend.

you can and will do this.

take a stand, one way or the other.

go ahead marla.

time to kick some butt.

leslie

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Specializes in LTC, assisted living, med-surg, psych.
Sorry about that new manager. What she is doing is what passes for manament these days. Start making your resume. Two thumbs up to your residents for taking things up the ladder, I get a kick out of that.

I feel the same way. These people may be elderly and frail, but they are NOT stupid, and they are sick and tired of promises and talk and management B.S. while nothing ever changes. Ever now and again I'll start quoting the "company line" during a service plan conference, and it floors me when they call me on it because they know as well as I do that I'm not speaking from my own point of reference, and they won't let me get away with it. I'm glad of it, for otherwise I'd be considered a sellout and distrusted the way the administrator and VP of Operations are, and then I'd have to question my own integrity.

Actually, that last statement is only half right. Indeed, I question myself pretty often as to whether I'm being ethical and honest, especially when I find myself repeating some corporate mantra about what this year's seven percent rent increase is being used for, when I don't have the foggiest notion (it sure didn't go toward staff salaries---all we received was a 3% COLA). These people have a right to know what they're paying for, and yet when they met with the management company and the board of directors a few months ago, they were told that, among other things, their nurse was being underpaid by about $10,000 a year according to community standards, and part of the increase was intended to boost the RN's salary. The residents were OK with that, and the unrest died down.

Until one day when the gentleman who is the president of the Resident Council asked me casually about whether my raise had taken effect yet, and commented that he was pleased the rent increase was going toward something good. Well, I was flabbergasted, and before I could shut my face, the words were out: "WHAT raise?" For one thing, I was embarrassed that my salary had been discussed in a public meeting with residents and families, and for another, 10K was a HUGE increase that would have certainly been appreciated, but (IMO) better spent on staff wages. But over the months since that first came out, I have come to suspect that both the residents and the board THINK I received that increase, but to this day I haven't seen a dime of it........only the three percent COLA that everyone else got.

Oddly enough, I don't even really care about the money. I work for a nonprofit organization, and it's understood that salaries are low by industry standards. But at this stage of my life the kids are grown and we don't need as much; we are comfortable if not wealthy, and anyway I don't do this for the money, But I am mortified that some of the residents think I'm earning this huge salary thanks to their rent increases, and they're still not getting all the services they want.:mad:

Now I hear from the office manager, who takes the minutes for the board meetings, that the salary hike that never happened is being talked about once again. I'll believe it when I see it...........but I don't think I will. And worse yet, these poor staff members are still struggling along on $8.76 and $9.15 an hour, PLUS being treated like disposable diapers. They need the money so much more than I do, and I know the residents wouldn't begrudge them, especially if it helped stabilize the staffing even a little bit. But I seriously doubt ANY of us are going to benefit here..........least of all the residents :(

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Specializes in ICU/ER.

I am so sorry for you and HATE to hear stories like these. You described what was a wonderful environment now turning toxic.

How frustrating for you. What will happen if you join the residents in voicing their complaints to the Operations mgr. $$ talks. We all know this, if they and their families are serious about maybe leaving, I think that would get some mgmt folks attention.

What about helping the residents come up with a list of very specific problems and then you work on a list of very specific answer's to those problems and address them together.

I really truly wish you the best, and hope you keep us updated.

I believe change needs to happen in ALC/LTC and maybe you will be the inspiration it will take for others to step in and make those changes.

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Specializes in LTC, assisted living, med-surg, psych.
I am so sorry for you and HATE to hear stories like these. You described what was a wonderful environment now turning toxic.

How frustrating for you. What will happen if you join the residents in voicing their complaints to the Operations mgr. $$ talks. We all know this, if they and their families are serious about maybe leaving, I think that would get some mgmt folks attention.

What about helping the residents come up with a list of very specific problems and then you work on a list of very specific answer's to those problems and address them together.

I really truly wish you the best, and hope you keep us updated.

I believe change needs to happen in ALC/LTC and maybe you will be the inspiration it will take for others to step in and make those changes.

Thank you for this post.:heartbeat

I know I've never been good at being a "sheeple"---never been one to just shut up and follow the crowd. My mother used to say I came into the world a month late, a glass of beer in one hand and a cigarette in the other, and yelling "All right, I'm in charge here!!" I've ALWAYS questioned authority. And yet here I am, a few months away from the half-century mark, still with a lot of life left in me...........but I'm also getting tired and somewhat jaded, and at this point in my life I think I'd like more peace and joy and less stress.

I'm not sure I want to be an "inspiration" anymore. It's too hard on the blood pressure, too fraught with demands that can't be satisfied, no matter how hard I work.

I don't mean to be a downer. It's just that I'm no longer sure that I'm fit for the battle, no longer sure of where I belong or even if I want to stay in nursing. But then, I don't know what else I could do that pays anywhere near enough to continue living in the manner to which I've become accustomed.......nursing is really all I know how to do. And I'm good at it, or so people tell me.

Thanks to all of you, and please keep the advice coming!

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Specializes in Peds (previous psyc/SA briefly).

You can do it!

That's what I say, anyway.

You're the manager, right? I say, line up your other jobs and then take a stand! 50 is nothing - you're feeling old because the people above you are screwing up! My mom is a 69 year old working nurse, so I look to her for inspiration on that one... I say throw over some chairs, advocate, raise some shackles and let the chips fall where they may.

Of course... that's on paper.

In real life, I don't know if I'd be that brave. Or energetic. Or convicted. But I'd hope to.

So I guess at the end, I can only just offer some empathy. It sounds like an awful situation to be in - and I'm really sorry that you're in it. :(

I'm pretty sure by your posts though that you'll figure out the right way to go... you know your stuff and you know your heart - and any facility should be so so glad to have you.

Best,

Kristen

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

My impression is that it's time to hope for the best, plan for the worst.

It may also be time to think about presenting some accurate information where it needs to go, for example about the salary increase. If the board is under the impression that you got that, then they need to know that you didn't, and that you think it needs to go to the other staff, anyway. I don't think it's your ethics and honesty that is in question, here.

Formulate an exit strategy, then work on getting the place back to where it needs to be.

As Leslie put it, time to kick butt.

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Specializes in Community Health, Med-Surg, Home Health.

You sound like a GEM to work for, and I am sorry this is happening to you. I have avoided long term care because of the other types of nurse managers floating around, and somehow, I suspect that if I had met and worked under you, I would have been happy. If you ever come to the NY area, and are in the position to hire, seek me out.

I wish I had answers for you. I do think, though, that self preservation is the law of the land. If you get screwed in the process, then, who will take care of YOU?

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Specializes in LTC, assisted living, med-surg, psych.
You sound like a GEM to work for, and I am sorry this is happening to you. I have avoided long term care because of the other types of nurse managers floating around, and somehow, I suspect that if I had met and worked under you, I would have been happy. If you ever come to the NY area, and are in the position to hire, seek me out.

I wish I had answers for you. I do think, though, that self preservation is the law of the land. If you get screwed in the process, then, who will take care of YOU?

Believe me, if I've absorbed any wisdom from fifteen years in health care, it's how to cover my own assets. :uhoh21: I learned long ago that nobody will look out for me but ME.

I appreciate your kind words, pagandeva.:bowingpur I'm far from perfect as a boss, but I do try to make my staff feel good about themselves and the work they do, and I bend over backward to be fair. Maybe I'm too easygoing, because sometimes I get taken advantage of; still, I'd rather let someone get away with a minor infraction of the rules than have them leave in the middle of a shift because they've been berated in front of other staff and residents........:madface:

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