What is it with the nurses in LTC?

txspadequeenRN, BSN, RN · May 2, 2007

listen up op cause this is reality!!!!!

it's a prerequisite. they actually ask you on the application "are you rude, b1tchy, and unwilling to help?" you even get paid extra if you walk around with a perpetual scowl on your face!
serioulsy, be careful about judging everyone based on 2 facilities. i would ask how you'd feel if you knew they were sitting around the nurses desk after you left asking why all nursing students were clueless and obnoxious?
but i know they weren't b/c they were too busy taking care of 40 patients. do you know how many meds 40 patients take in an 8 hour period? they get at least 5 a piece, and i have some on 25 a piece. 2 med passes. you're talking at least 200 meds in 8 hours! then of course they have wounds, and the tx nurse (if you have one) had to take a cart so you're doing your own. then, mr. smith hits mr. jones with the fire extinguisher he pulled off the wall. scared poor ms. harris so bad she fell and broke her hip. all this about time the state surveyors walked in and wanted to know where your msds manuals were. you can't answer her just yet b/c your dementia patient just walked out the back door and alarms are going off. before you can get her back inside, ms. little's daughter is screaming at you because her mom has on blue slacks instead of black slacks. and you're only 3 hours into your 8 hour shift. (well, actually it'll be more like 10 hours, b/c you want be able to document on your 10 medicare patients, and 5 patients on abt until your relief gets there and takes your keys)
i wish you luck on your geri clinicals. truly i do. just know the world doesn't stop when you walk in the door.

txspadequeenRN, BSN, RN · May 2, 2007

this sounds just about right ....something i would expect from the state...

nevermind the state's not caring part...they'd probably cite you for giving someone a hug. my facility got cited once because one of the demented women walked up to a surveyor and hugged her. the surveyor cited us because we didn't have an "inappropriate sexual behavior" care plan. harumph! nothing inappropriate about a hug....but i digress.

txspadequeenRN, BSN, RN · May 2, 2007

honey, you have a lot to learn and you should be prepared for a jolting reality check upon graduation....everywhere is understaffed not just ltc...your experience is very limited and maybe you should wait until you have been the nurse on the other side before you generalize about ltc nurses not caring...nursing school does not allow you to experience the full potential of the situation..wait until you get out and have all this responsibly yourself. i bet you will be singing a different tune...lol...

thank you all for replying to my post! your feedback is much appreciated. for those that had a somewhat negative response, i apologize for striking a cord in you. my purpose for posting that thread was to find out why the conditions are such that, "in my experience" ltc facilities are so understaffed. i will tell you that the place i am doing my clinicals at now is atrocious! the patients are such sweet people, and i just feel soooo sorry for them! i really hope that this facility is the exception to the rule. furthermore, the nurses there do paperwork and are completely uncaring towards the residents. i understand that students can be annoying, i myself would get annoyed, it's more than that in this particular case. it's a deeper rooted, "i hate my job," sort of thing. okay, let the bashing begin, but first i want to say that i am a very good student and a very considerate person, i hope that i never get to a point in my career or in my life that i stop doing what's right because it isn't convenient for me. we are all in this together and should live our lives accordingly. peace and love.

linzz · May 2, 2007

Just like the former poster said, txpadequeen921, there is reality shock and it will be a big one as school doesn't prepare for the real world of nursing. I also think a lot of us hate our jobs, we don't hate nursing, just hate nursing the way the facilities want it done. The nurses look unhappy because they are sick of too many patients to be cared for in too little time.

dolldoctor · May 7, 2007

we don't hate nursing, just hate nursing the way the facilities want it done. The nurses look unhappy because they are sick of too many patients to be cared for in too little time.

I've worked in LTC as a CNA for several years. I'm waiting to take my PNCLEX and I've been accepted into a ASN program, starting in Mid-March and will finish the end of December.

I'm 49 this year and almost ready for LTC myself, as a resident . After working many years in the corporate world, and with our kids all grown, I decided to live my dream and become a nurse. At any rate, I guess I don't understand why any professional would be a slave to the facilities way of doing things if it is not a safe environment for the professional to practise or in the best interest of the patients/residents.

I did some research on staffing issues for CNA's a while back and I found that only when health care professionals make a loud collective noise to their state reps and the news media, staffing mandates may be possible.

If you look at the LTC facility registrar at, I think, elderabuse.com it's clear that facilites are getting dinged for the same issues and most all are things that are happening due to staffing issues. Too many patients to only a few staff.

I'm far from being a rocket scientist but we should be outraged enough to do something and force our states into creating safe staffing mandates. By them not doing that and leaving "adequate staffing" interpretation up to facilities, of course the facilities are going to run lean for the almighty dollar. It's criminal for states to allow that and for us to allow it to happen. Not to mention the tax payers dollars that are being spent in government subsudized health care.

With the elder boom that is just beginning, if we don't do something now, I really wonder what will happen a little down the road?

The media is always looking for a story and politicians are always looking for a popular cause. This topic is popular because we are all going to be geriatric material some day. Our patients can no longer advocate for themselves and we are all they have. And, it is doubtful that big corporations are going to be generous to take money out of their own pockets to make things safer for nurses to practise or for their patients. Corporations have shareholders to make happy.

Just a few thoughts.

adrienurse, LPN · May 7, 2007

I didn't do anything wrong

adrienurse, LPN · May 7, 2007

I am usually pleasant toward the students who complete their clinical rotations at my facility. However, here are things that you should not do, because it will really piss off some LTC nurses.
1. Do not sit at the nurses station, because it forces me to have to find a chair to sit in. After all, I need to stand for 16 hours. You get to go home in less than 8 hours.
2. Do not tell me you're going to do something, if you do not plan to follow through. I cannot stand when a student tells me they'll pass all my meds, then they stop after 2 patients.
3. Do not verbally accost the nurse who is not doing a procedure "by the book." The imaginary textbook world of nursing is adequately supplied, and filled with unlimited time. The real world has time constraints and inadequate supplies.
4. Do not waltz into the building acting as if you know more about these patients than the very nurses who have worked with them for several years.
5. Realize that many LTC nurses are treated badly by nurse managers. It's a trickle down effect: if your nurses are being ridiculed, they might take out their frustrations on you by ridiculing you, the student. Many LTCs suffer from poor leadership.

:yeahthat:

'specially the one about the chairs. For goodness sake, I need to sit down to do my job -- if you're not working get out of my chair.

adrienurse, LPN · May 7, 2007

"Furthermore, the nurses there do paperwork and are completely uncaring towards the residents. "

Ahh paperwork is a legal requirement of the job.

SuesquatchRN, BSN, RN · May 8, 2007

At any rate, I guess I don't understand why any professional would be a slave to the facilities way of doing things if it is not a safe environment for the professional to practise or in the best interest of the patients/residents.

Because you can not invoke change in a vacuum and all your advocating and agitating will do is piss off the other personnel and, ultimately, get you fired.

dolldoctor · May 8, 2007

[GVIDEO]Because you can not invoke change in a vacuum and all your advocating and agitating will do is piss off the other personnel and, ultimately, get you fired.[/GVIDEO]

You are exactly right!! I noticed the "vaccum" effect right away! In fact, I've been really shocked at that type of mentality during my experience as a CNA in LTC and during my student clinical rotations.

Please understand, I'm not suggesting agitating and advocating in front of other personnel - in many cases they are the vaccum. I am suggesting that health care professionals that want to create change, need to become change agents and it won't work within the system itself, I can clearly see that. I feel that it needs to come from legislature and media and that can be done on the "QT" without rattling the cages of owners and administrators who don't want to work through changes.

An evil thought . . .if more working staff were added, admin would have to take pay cuts or corporate earnings/investment returns would have to be a less.

The bottom line as I see it, I can't see how LTC can keep going on the way it is when year after year a lot of state findings reflect the same type of issues that most likely could be solved with better higher staffing ratios.

I'm so glad you brought up the idea of making the powers that be mad, because I noticed that right away when I started working up an actual time study for the care of each patient and it showed that a CNA would actually have to work 12 hours with no breaks or lunch to complete the work correctly that had to be done in a 7.5 hour shift. It was kind of funny because the procedures that are in place that specify how we are to care for patients require time that is not available when the patient to working staff ratio isn't right. Mathematically it does not compute and we wonder why during state audits facilities get sited?

I think the state of MA has state mandated staffing ratios and it would be interesting to see what nurses and CNA staff have to say about how things are working out there.

I'm from the mid-west and our staffing mandates simply say, "adequate staff for patient care" and then it is left up to the institution to decide what "adequate staff for patient care" is. Most of the time it is pretty lean, although when it gets close to state audit time they do a little better and after state leaves it goes right back to the usual.

As for most of the nurses that I encountered during my experience as a CNA and student nurse, most were good nurses and most were caring. There were a few really lazy ones but that happens in any profession. I did see some that had lowered there standards just to be able to survive in the type of work environment that owners and administrators had created.

Also, an observation from my own clinical experience was that everything listed for a student nurse not to do is exactly right:) I noticed our nurses didn't appreciate it if students were sitting in their chairs at all. Some of the students in our class surely didn't take their clinical rotations seriously. I had a really nice experience but I applied myself and learned from every nurse by observing and asking questions.

jjjoy, LPN · May 8, 2007

3. Do not verbally accost the nurse who is not doing a procedure "by the book." The imaginary textbook world of nursing is adequately supplied, and filled with unlimited time. The real world has time constraints and inadequate supplies.

No student, or anyone for that matter, should verbally accost another when a polite question or critique would suffice. However, I feel I must defend students who politely question non-textbook procedures. As nurses, students will need to think for themselves, which means that they shouldn't just blindly accept what others are doing. The practicing nurse ought to be able to explain why their variation is still safe. Some nurses just don't have the time to explain. Others haven't thought about it in a long time, in which case the student's questions can help them review their techniques and habits. In general, I think nurses need a more reasonable workload. With more time for the practicing nurses, the presence of student nurses wouldn't threaten to make a usually hectic day ever more hectic.

nightmare, RN · May 8, 2007

I like to fire questions at students[EVIL][/EVIL]Like "well you are in uni you should be well up on the latest practices" I have even learned a this or two from some of them.