I have always loved working in my small LTC facility, but it is starting to get to me these days. It seems our patients are soo sick and we just don't have enough time to care for them properly. What happened to a "home like environment"? These patients don't get to choose when the want to be showered, day or evening, or even at 5am! When I asked how the staff would like to be woken at 5am to be showered, or how would they like it if it was their mother, father, I was told to "wash people that can't complain???" WTH??
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
In my opinion if CNAs were screened more carefully, were started at a minimum of $10/hr (by the same token pay LPNs a minimum of $20/hr), and patient # was determined on the basis of acuity, we wouldn't have the short-staffing we do today and there would be better care.
I was recently hired onto my first nursing job for a wage of slightly under $18 hourly. This LTC facility offers no health insurance or retirement plan. I actually would think about sticking with this job for the long-term if the employer offered benefits, but I only plan to gain a year of experience before moving on to a job that offers the fringe benefits that are designed to attract and retain employees.
The nursing home where I'm employed uses paperless, computerized charting. And believe me when I say that the facility is small, understaffed, and stingy. However, I wish I could go back to the days of written 'defensive' charting on paper.
I agree, we have computer charting and I swear, by the time I get through all the options and finally get to the screen you want or need, I could have hand written the note or doctors' order 3 times over!!!! Then, we still have to print it out and place a copy in the chart. Crazy. I thought computer charting meant we put everything IN the computer, I didn't realize we had to take it all back out again. So much for a paperless society. It's the weirdest system I've ever seen.
I find it sad that the nurses who care the most are often the ones that end up leaving LTC for other nursing options. It's a vicious cycle, conditions aren't great, nurses leave, the load gets heavier for the remaining nurses... As a CNA, I have had the privilege of working under some very knowledgable and compassionate nurses. And LTC so desparately needs those nurses.
you just hit the nail on the head!!!!!i agree completely....i am a nurse that cares so much and get so frustrated....i feel that my LTC career has been successful and i have made a difference but not w/o the feeling of frustration every day!. i am looking into other nursing options and it hurts me b/c i love my geriatric patients and there are some good aides/nurses that love those patients !!!
:offtopic: this may be off topic a bit, but in regards to showers.....we have 5 wings,with 12 rooms per wing. we have our showers "split" into rooms 1 & 7 on day shift monday, 2 & 8 on tues., 3 & 8 on wed., 4 & 9 on thurs., 5 & 10 on friday, and rooms 6 and 12 on saturday. for 3-11, i believe we start on 4 & 6 moday afternoon, on down the line. would this sort of schedule help any? let the rezzies know the schedule ahead of time?
Nursing homes are the epitome of exploitive capitalism, slashing costs to the bare minimum and taking advantage of the fact that people can't complain. I don't blame you for leaving.
"The DON is terrible. I get 'snapped' at for working overtime (there is usually a reason for doing so), and she has written up other nurses for it. "
I empathize and sympathize for I've been there! An 8-hr shift was NEVER shorter than 9hrs for me! Pretty much the same for the other nurses I worked with when I worked LTC.
"And why are nsg homes so against using computers for charting, admission paperwork, etc?"
My guess is that computers are expensive, thus that much less profit earned if they put out money for them AND if ever one "broke down", then there would be an expense to get someone in to diagnose/fix the problem. I agree that computers sure would be heaven-sent in those facilities!!
"Not to mention, all the equipment that doesn't work, the short staffing..."
In my opinion if CNAs were screened more carefully, were started at a minimum of $10/hr (by the same token pay LPNs a minimum of $20/hr), and patient # was determined on the basis of acuity, we wouldn't have the short-staffing we do today and there would be better care.
If you leave...you will come back!!! If long term care is truly in your blood you will be back. I have done this and am back in LTC. I have worked in numerous states in LTC and in 1 state that I was DON at I fought and battled corporate to get us "up to speed," the hospitals are computerized so why aren't we?" Finally, I got what I wanted. And ate lots of crow!!!! We had nurses that were almost retirement age and refused to learn the computer. The system was SOOOO nice! and I could log into my computer in th emorning and see all orders that had been written, read nurses notes, etc. without having to go check all the charts. Except for 3 of the nurses who refused to learn the system. What do you do? I wrote them up then I was in trouble as they had been team players for years!!!! Is it fair to spend the time to train new employess and hold eveyone else accountable for using the computer? No. Alo, the facility I am at now (DON) I recieved a call from the owner today...y is there so much overtime??? Well I said, welcome to my world. For starters, 3/4's of the staff have recieved their income tax so its time to call out!! After they have blown their money they'll be begging for overtime. And have you seen the cutbacks with medicare and the Gov. Why is LTC the ones that are suffering???? While medicaid/care usuallly pays evey 14 days the other is running 3 months behind. So when my beds where full 3 months ago, but cnesus is down now, we have not received the benefits of 3 months ago. This is where the issues arise, why can't we have new equipment??? The cna's are mad because we fuss at overtime. I had to tell the cna's, figure up 30 minutes overtime for 12 employees(not all, only 12) calculate time and a half, times the 12, times 5 days, times 4 weeks, you get the picture. Then they were a little less hostile about the subject. But he main issue is with new staff. When the staff who are supposed to orienting tell the new hire, I'm so tired of working short, you won't stay because you have to work over, our euipment sucks!!! How are we supposed to retain staff this way??? Y not, this is a great facility! We have our issues but so does everyone else, we're so glad to have you here, if you need any help just let me know?!? I think our main issue is often times we do not know how to treat new employees. We are too busy playing woe is me. Lets all work to change this as we are the family to many ouf our residents. Lets show them that we want the best for them and we are able to choose only the best workers and team players. Just a thought! Later, Tracy
That is an interesting point about using computers. I worked for a home health agency, and my supervisor totally opposed the use of computers, and she was at least 10 years younger than I am. She said she just did'nt like them.
I have worked in LTC for 21 years, 5 years as CNA and 16 years as LPN. Yes i get frustrated when working short and inappropriately placed residents and demanding families, beds not working etc. However i dont see myself anywhere else. I have had lots of people tell me, you need to work in hospital, well i like the family atmosphere of LTC much more and I think there are probably short staffing in hospitals too. I have been told " when you stop caring about them, it is time to leave." I hope that I never stop caring. I have also had people tell me, " It takes special person to work in LTC" maybe it is true, however I like what I do and that helps alot.
The nursing home I work for was brought by a corporation last year and they are bringing us to the 21st century. We have computers. CNA's will go to documenting on Palm Pilots, mandatory inservices can be done on the computer, new beds are rolling in, nurses will eventually be performing electronic charting and we will be a lift free facility.
Prior to this, checks were bouncing, bills were not paid, department managers were bringing in their own supplies. Some would say why? Well we love working at this facility. We love our residents and we believed in a higher power that knows our hearts and has rewarded us for our labour of love.
Things were so bad at one time that we had a "House Blessing" where staff that wanted to participate could. We went to the four corners of the facility where some staff read a bible verse, some read a poem, some spoke from their heart and we all had a good time doing it.
But it starts from the top. You have to have a knowledgeable DON, who is able to handle corporation, administrator and families. One who is not afraid to get her hands dirty, genuinely cares about the care residents receive and respects her staff as well as educates them instead of always writing them up.
Don't give up if you love LTC.
On bad days, go find that pleasantly confused resident that loves to talk but it is hard for you to follow becase she will talk about 5 topics in two minutes and none of them from your standpoint are connected. Take her lead for the conversation. This affords you to leave your reality and jump into hers for those minutes you talk to her. She will appreciate that you took the time and you would have had what I call a therapuetic leave of your reality for the moment. Try it!
I can understand completly what you're talking about.. no electric beds unless they can be classified as "skilled".. short staffing.. inadequate supplies.. (if you're lucky enough to have any), and yes.. management walks out the door at 5pm on Friday and never seem to think about the place until Monday at 8am.
Marketing has taken place over patient care, and profit seems to be the law of the land.. not caring.
An 8-hr shift was NEVER shorter than 9hrs for me! Pretty much the same for the other nurses I worked with when I worked LTC.
TheCommuter, BSN, RN
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