What is it with the nurses in LTC?

banditrn · May 12, 2007

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.

You may not be a 'rocket scientist', but you sound like a smart cookie!! :) Don't lose your fight and drive - we need you!

hecete · May 13, 2007

hey,

there's nothing wrong with us ltc nurses. i haven't eaten or dismembered anyone lately!!!! i've worked the skilled unit for over 2 yrs. this facility will take a brand new grad. and stick her on the skilled unit,just to make sure the hall has a nurse. most are under the impression they just have to pass meds. we do not have a m.d. in the facility. you have to try to get in touch with them, so you better have some damn good assessment skills, cause you're on your own. we take everything, trachs, pegs, piccs, central lines of any kind. you better have a clue of what you're doing. i don't think it's fair to put a new grad. on a skilled floor without some kind of training. i had a newbie on the other hall, she was over her head from day 1. we have some pretty unstable folks here, you need to know what to look for or they're a code. she lasted about a week before being trans. to the long term unit. i told staffing they didn't do her any favors, and thought it was wrong. she just laughed!!!!!!!:angryfire

ejsmom · May 16, 2007

I've been in your shoes. I didn't come across one nice/decent nurse during my clinicals, so when students come to our facility I leap the extra mile for them. With that being said, I have run into students that think that they know it all, spend hours behind the nurse's station, don't want to get involved w/ anything hands on, and do not give very good care. :nono: We also have students that come in and are wonderful, both LPN,RN and even resp techs. I have 31 resis to pass meds to, do treatments, review labs, call mds, take orders, reassure family members, and thats before noon, on a full bladder and an empty stomach.... yeah sometimes I get testy and I'm pretty nice. Just go in and do the best that you can do and be a sponge! Ask questions and offer your help because there is always something that you can help with while learning at the same time! Hang in there!!!

llamagirl25 · May 19, 2007

I have worked in LTC for 20 years. I have been at the same place doing the same job for the last 7years. I work on an Advanced Alzheimer's Unit. I know when I have students, I may not be on my best behavior but I explain to them what is going on and why I'm upset, rude, etc. Trust me, this unit can get very crazy. Fights, falls, arguments, staff issues, etc. I do know I can get rude with staff that work on the snf and come to my unit and act like they know better than I what is best for my residents. (Even if they are an RN!!

SuesquatchRN, BSN, RN · May 20, 2007

We had CNA students on the floor last week and I thought I would have to kill them all, along with our ADON, who is their clinical instructor.

We have a very demented woman who sits at the nurses' station and lays claim to everything placed on the desk. When denied the chart or bibs or whatever she has grabbed she becomes quite profane. And it can be hysterical, but not under all circumstances.

I'm trying to chart. The students and actual aides keep walking back and forth between me and the chart rack, sometimes bumping into me, and then, when Demented Resident is confused and overwhelmed by all of the new people and lets loose with a stream of profanity they all start cracking up, with ADON leading the chorus of cackles. Charge Nurse is on the phone trying to discuss orders through the din, I've completely lost concentration because of the racket, and I finally had to explode, "Has it occurred to all of you that you are upsetting {demented resident}? Please go to the dining room for a little while."

Oy.

BigB · May 20, 2007

hey,
there's nothing wrong with us ltc nurses. i haven't eaten or dismembered anyone lately!!!! i've worked the skilled unit for over 2 yrs. this facility will take a brand new grad. and stick her on the skilled unit,just to make sure the hall has a nurse. most are under the impression they just have to pass meds. we do not have a m.d. in the facility. you have to try to get in touch with them, so you better have some damn good assessment skills, cause you're on your own. we take everything, trachs, pegs, piccs, central lines of any kind. you better have a clue of what you're doing. i don't think it's fair to put a new grad. on a skilled floor without some kind of training. i had a newbie on the other hall, she was over her head from day 1. we have some pretty unstable folks here, you need to know what to look for or they're a code. she lasted about a week before being trans. to the long term unit. i told staffing they didn't do her any favors, and thought it was wrong. she just laughed!!!!!!!:angryfire

i recieved similar treatment. brand new grad and i was put on "hell unit" with 47 -48 patients. they said, "don't worry you can handle it." the nurse that was on the unit before me quit in frustration after a few weeks. i left for the same reason months later.

nightmare, RN · May 20, 2007

We had CNA students on the floor last week and I thought I would have to kill them all, along with our ADON, who is their clinical instructor.
We have a very demented woman who sits at the nurses' station and lays claim to everything placed on the desk. When denied the chart or bibs or whatever she has grabbed she becomes quite profane. And it can be hysterical, but not under all circumstances.
I'm trying to chart. The students and actual aides keep walking back and forth between me and the chart rack, sometimes bumping into me, and then, when Demented Resident is confused and overwhelmed by all of the new people and lets loose with a stream of profanity they all start cracking up, with ADON leading the chorus of cackles. Charge Nurse is on the phone trying to discuss orders through the din, I've completely lost concentration because of the racket, and I finally had to explode, "Has it occurred to all of you that you are upsetting {demented resident}? Please go to the dining room for a little while."
Oy.

That kind of mentality that uses the demented residents as their own personal entertainment,provoking demented behavior, really annoys me and there has been more than one very surprised carer who's been blasted down the corridor for that kind of moronic behavior.:angryfire :angryfire

h2ogoddess · May 20, 2007

I have been in LTC for more than 35yrs. Students used to help and do care.

Seems to me the last several years they are there to sit at the nurses station and , yes , get in the way. I have orders to take off , phone calls,family concerns, and of course the residents that have questions. Also order supplies for the unit and audits. AND I am only the Unit Clerk. The Charge Nurse on my unit is so busy , I truly some days don't see her often. And yes I do answer call bells when I can.

PAPER WORK--well let me tell you there is a mountain of it and I think everyday there is a new piece to deal with,

So if I get crabby with you and tell you to leave the nurses station, just know I have much to get done and the MD and PA are on their and they also need a place to sit and and work!!

Yep, I am not always the most nice person but get out of the way and let me get the job done I am there to do.

nightmare, RN · May 20, 2007

I'm not sure how it is in USA but here students ,instead of being part of the working team,are now "observers" now some of them want to get stuck in ,hands on from day one but I have met a few who will quite happily stand and watch while you struggle with a task and some who have even declined to help when asked!:angryfire

TrudyRN · May 20, 2007

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.

too bad the patient didn't vomit on her instead. Maybe she'd have found that more appropriate.

I seriously hope someone c/o about that surveyor to her boss. She was quite lacking in her comprehension of "inappropriate sexual behavior". :trout:

TrudyRN · May 20, 2007

I have been in LTC for more than 35yrs. Students used to help and do care.
Seems to me the last several years they are there to sit at the nurses station and , yes , get in the way. I have orders to take off , phone calls,family concerns, and of course the residents that have questions. Also order supplies for the unit and audits. AND I am only the Unit Clerk. The Charge Nurse on my unit is so busy , I truly some days don't see her often. And yes I do answer call bells when I can.
PAPER WORK--well let me tell you there is a mountain of it and I think everyday there is a new piece to deal with,
So if I get crabby with you and tell you to leave the nurses station, just know I have much to get done and the MD and PA are on their and they also need a place to sit and and work!!
Yep, I am not always the most nice person but get out of the way and let me get the job done I am there to do.

Just talk to the students nicely and maybe even get 1 or 2 of them to work with you. They should not be in the N. Station to begin with but, if they are, put them to work. I'd ask their Instructor what they are supposed to be doing. BTW, where is the Instructor?? Why is it the students are just clogging up the Station? Someone really needs to educate these students and their Instructor! Just be nice about it. I see this a lot. People are afraid to speak nicely to someone who is annoying them but they don't mind getting angry at them. :idea:

h2ogoddess · May 20, 2007

:uhoh3:

Just talk to the students nicely and maybe even get 1 or 2 of them to work with you. They should not be in the N. Station to begin with but, if they are, put them to work. I'd ask their Instructor what they are supposed to be doing. BTW, where is the Instructor?? Why is it the students are just clogging up the Station? Someone really needs to educate these students and their Instructor! Just be nice about it. I see this a lot. People are afraid to speak nicely to someone who is annoying them but they don't mind getting angry at them.

I have been nice not only with students but co-workers that are just hanging out in NS, They look at me like I have 2-heads.

I have no idea where the instructor is--oh wait--she is there also -just chatting about eveything and anything (nothing much to do with nursing-yes I am there and I do hear it),

Makes my job so confusing and harder than it needs to be most days. :uhoh3: