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

Nurses General Nursing

Published

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.

Specializes in ICU, telemetry, LTAC.

Marla, my heart goes out to you. I think the whole bulletin board fulla nurses, posters and lurkers alike, did a happy dance when you found this job.

I'm glad that you put in for something, anything else, just to keep a line open. I'll tentatively list stuff that you might or might not wanna consider, knowing what people do with advice. :-)

1. House supervisor, itty bitty hospital. You can come to mine if you want.

2. Education

3. Public health, although it's hard to get state jobs, they have good benefits and decent hours

4. Education

I'd love to see someone like you teaching nursing. It's always apparent to students which teachers actually care about whether or not they succeed.

Anyway, putting out a prayer for ya.

Specializes in Utilization Management.
Meanwhile, I just filed an application for an opening with the Client Care Monitoring Unit---as a state surveyor.;) The pay is decent, the benefits are far superior to what I have now, and I'm certainly qualified. I also think I'd make a pretty good one, with my knowledge of so many facets of LTC and the desire to improve the care elderly and disabled people receive in facilities.

So yes, I'm thinking of going over to The Dark Side.........I've actually thought about it for years, and what the heck, it might just be the right job for me.

Of course, I still think I'm IN the 'right job'.........I'm simply not sure how long I can hang on to it. Best to keep my options open, in any case.

I've worked LTC and left due to management shennanigans.

Frankly, I'm glad there's a Dark Side. I've actually come to welcome their visits to facilities I've worked in. The reason is that they're basically interested in the same things I'm interested in -- keeping it sane and safe for those under our care.

I remember how awful the living conditions were for the elderly before there was regulation in the industry. Believe me, if it wasn't for that regulation and the constant threat of legislation hanging over their heads, a lot of facilities would've gone up in smoke long ago, taking those dear residents with them. Who could forget that horrifying string of nursing home fires back in the '70s that compelled the nursing home industry to begin self-regulating and improving the standards of safety?

I have come to believe at this point that working for the State would be a move that is highly in the interest of the elderly. An inspection does show a lot about a facility, and even if it means that a facility has to straighten up only once a year, for a period of time waiting for the survey and a short period after, the residents have it a little better.

Yes, I know it's very stressful on the staff, and we have all noted with irony the difference in before and after the survey in staffing and supplies, but still, if I had the right amount of experience, it's a job that I feel is necessary and ultimately benefits the individual as well as keeping the entire system base in a mode of improvement.

I guess what I'm saying is, you shouldn't feel conflicted about going after a job like that. I wouldn't.

As far as leaving those residents: how better to fight for their rights as paying clients of a facility than to make that facility toe the line with the implementation of laws that are already on the books?

Aw, Marla. :icon_hug:

Your residents are lucky to have you in their corner.

If the residents don't feel comfortable complaining about their issues, what about enlisting the help of their families. The relatives can be the ones threatening mass desertion and getting management to consider how that might affect the bottom line. They could also file grievances with the state ombudsman or other authorities.

Planning an exit strategy seems wise, if for no other reason than that you'll be stronger if you're not worried about what comes next.

Keep meticulous records of the various day-to-day insults and injuries, the ways the residents are short-changed, the good employees who have walked away, etc. This might be wishful thinking, but someone somewhere might find this litany interesting. Keep track of the good things, too, if there are any, so it looks more objective.

If push comes to shove, let the residents know you are putting in your notice. Maybe it should be longer than two weeks as you are management. That also allows a little extra time for folks to decide to make a stand. If admin saw that some of them (residents and workers) really did intend to bolt along with you, they might understand that this could really cost them big in the long run.

If the worst happens and you have to leave, at least you will know your did your best.

Choosing your battles wisely doesn't mean you're losing your "fight." It means you're protecting it as the precious asset it is.

If I were ever going into battle, I'd want you on my side.

You are your daughter's mother. That's for sure.

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

Miranda, that means the world to me.:heartbeat:bowingpur

As always, you've managed to articulate exactly what I needed at this moment in time. Thank you ever so much!!

Also, I appreciate the thoughts of everyone who has posted here. Your kind words and advice are helping me a great deal more than you know. Bless each and every one of you.:bow:

Good state surveyors are worth their weight in gold.

VivaLasViejas--

I do hope you get the state surveyors job. I think that you will be a good one. The place you are a manager at sounds pretty toxic to me, and it's probably time to move on.

..."I just filed an application for an opening with the Client Care Monitoring Unit---as a state surveyor.;) The pay is decent, the benefits are far superior to what I have now, and I'm certainly qualified. I also think I'd make a pretty good one, with my knowledge of so many facets of LTC and the desire to improve the care elderly and disabled people receive in facilities.So yes, I'm thinking of going over to The Dark Side.........I've actually thought about it for years, and what the heck, it might just be the right job for me.

I wish you the best of luck with Client Care Monitoring Unit...I left there when my son was ill, and I was having back problems at the time, but would have left anyway, as many good people have. One experienced surveyor, who is a great advocate for seniors, very sharp, talented, and a real sweet person, recently left. This is a person that always gave of her time and helped to train many of the surveyors. She shared resources and was committed to excellence. Although she was protected by Whistleblower Laws, and had no disciplinary actions against her, her reputation was irreparably damaged by false allegations made against her by management. She successfully defended herself, and then quit. It was ridiculous, to say the least, that allegations were made against her in the first place because she was honest to a fault.

The supervisor was unethical and asked her to downgrade her findings because he said he was tired of answering questions about her findings, and didn't have the backbone to support his staff. Staff didn't trust him, and with good reason. He called himself "Teflon Man" and said that nothing stuck to him. He was delusional in his thinking that his unethical actions and erroneous decisions were above reproach. Needless to say, she steadfastly refused to downgrade her findings, her investigation skills were rock solid, and so ultimately the investigation was not changed. Reporting her supervisor's ethics violations was difficult, but necessary. Also, the feds sided with her, and basically said that her supervisor was a real knucklehead.

In addition to my fellow surveyor's ill treatment by management, I was appalled at what happened while I was there. It was like banging my head repeatedly against a brick wall. Ouch! :banghead: I thought it would be so much better than the corporate stuff that goes on, but, I am sorry to say that it wasn't. Some surveyors are on real power trips and think they're nursing home cops. Some are real bullies, both to facility staff and to their fellow surveyors. Reaching consensus with some of these folks is akin to a root canal with no novocaine. Other surveyors are lazy, burned out, don't give a damn, and/or ignore blatant abuse. Supervisors reward quantity of surveys completed, not quality of findings, and don't consistently protect frail older adults. There is lots of turnover in staff because, unfortunately Client Care Monitoring Unit harbors some dysfunction of its own.

It is unlike any other job you've had, in that you travel and stay in hotels with people you may or may not like. Here's a peek...one surveyor was found asleep during a survey by a facility nurse (how embarrassing for her fellow surveyors) in a building where abuse was discovered. Another surveyor, who consistently (daily) had alcohol on his breath, REFUSED to investigate possible abuse, although surveyors are bound by their mandatory reporter status to investigate (as well as personal ethics, pride in a job well done, and just doing the right thing). Supervisors drop report findings because they don't have any nursing or medical background, don't understand the significance of the findings, or don't want to do the work it takes to support their surveyors' findings.

One supervisor had no understanding of MRSA. Another supervisor had no understanding of Norovirus. Supervisors didn't always exercise good judgement, and frankly, some were just evil. One supervisor thought it was fine for a resident who wanted showers, not to receive any showers in 30 days, and didn't consider rape to be immediate jeopardy. One surveyor made very loud derrogatory racial remarks to an administrator and disciminatory remarks regarding the person's sexual orientation to one of the BEST LPNs ever, and yet the surveyor's supervisor did absolutely nothing about it. The same supervisor sent a team of people to survey a building, which was not even close to being due for survey. When her decision was questioned, her rationale was that she said she was thinking of putting her mother-in-law there. Talk about a waste of taxpayer's money!

So, things are not as rosy as they seem. I hate to be a downer, but thought you should know. Forewarned is forearmed. Because, as you said, you're going to the dark side. You just didn't realize just how dark it is. Yes the pay and benefits are OK, but not worth working with people who are all too willing to look the other way and ignore abuse and neglect so they can spend more time shopping, which is just so wrong!

Specializes in Geriatrics, Med-Surg..

I hope this all works out for you. Your facility is lucky to have you. I think I would love to work for someone like yourself. Maybe when they can't get any staff anymore, the light will come on. Wishing only the best for you.

Thank you, linzz. I appreciate the support.:saint: It's funny that the surveyor I mentioned in the post was told by her supervisor (and his supervisor, of which he was a real brown-noser) that she wasn't "management material." A lame excuse they both used to keep from promoting such a talented woman. It turns out her bad boss was really threatened by her and harbored petty jealousy because of her impressive qualifications and experience.

The former surveyor was immediately offered several much higher paying management jobs within a few days, and her wise new supervisor promoted her in the first 2 weeks. He told her that she will be rapidly promoted because is very bright and she does excellent work! :cool:

So, yeah, I'd say that her evil former supervisor (and his supervisor too) are clueless as well as unethical. It is their loss! With the way they drive good people away, their survey teams will be making big mistakes which will reflect very badly for them.

It is wonderful to know that good people like her are eventually rewarded for their honesty and integrity, and comforting to know that she is in a place where she is treasured and valued as she should've been all along.:redpinkhe

I also agree with ingelein's post as well....good state surveyors ARE worth their weight in gold. That statement couldn't be more true!

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

Kiki, where IS that place where good people are rewarded and valued?

Oh, yeah, I forgot: it's called HEAVEN.:p

I appreciate your perspective on the "dark side" of being a surveyor. It goes to prove that mean, petty, tyrannical, unethical, uncaring, rotten, lazy, and nasty people are everywhere........and too many of them are in positions of power.

Thank you!

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