What's It All About, ALFie?--Help and Support for Assisted Living Nurses

Specialties Geriatric

Published

It's not independent living........and it's not a nursing home. It's not a secured Alzheimer's facility.........yet it does house some Alzheimer's patients. It's definitely NOT a 'retirement community'..........but some tenants who still drive, live active lives, and manage their own affairs come here for the meals and housekeeping service.

What is it? Why, assisted living, of course! ;)

And as anyone who works in this relatively new field knows, ALF nursing has its own unique challenges. We care for residents with a wide range of conditions and abilities, from the independent 65-year-old retiree who does his or her own thing to the blind 95-year-old diabetic who needs daily glucose monitoring insulin injections. We serve as supervisors, administrators, confessors, staff developers, mentors, companions, receptionists, marketers, counselors, even chief cooks and bottle washers from time to time. And we are guided in our practices by a set of regulations that vary by state, are often muddled and contradictory, and WIDE open to interpretation by state and federal surveyors.

This thread, then, is for us---the bold, the brave, the confused---who go to our "cushy 9-5 desk jobs" every day (any of you fill in as NOC shift med aide lately? I have;) ) and put our careers on the line to assure quality care for each and every resident in our communities. Please feel free to ask for or offer support; share ideas that have (or have NOT) worked in your community; or even just vent!

Welcome!!

Specializes in Telemetry, Orthop/Surg, ER,StepDown.

PHEWWWWWWW!!!! holy buhhhjeebus! I love my job because of the residents, but i'm tryig to put chaos into order at the moment. I'm dealing with an ass of a marketing guy that was hired with me who now thinks he 's the ED. had the unmittigating gaul to tell me that i should straighten up my office after i had been there from nine thirty the following morning and it was now four pm the next day. three hours of sleep in the empty unit was not enough to think he was amusing. Anyways, i just received a call from the pharm that is coming into to do an audit. I'm scared crapless. I haven't had a chance to audit the charts, i had to do the new month mars which only half come from our pharm the otherw are through kaiser which refuses to send me mars. I noticed that they weren't signing their mars at all, and had to put up a sign that siad, ifr you don't sign august and september mars by 9/2 you will be written up. One girl said, but can't you give us some time....and I looked at her and said, honey..you've had all of august. they don't count narcs each shift, which i found out as I randomly pulled a narc sheet and counted the narc. oNE WAS MISSING!! holy hell batman! my head nearly spun as i reenacted linda blair in excorsist. Come to find out the offgoig med tech had pre packaged a scheduled vicodin....:eek: needless to say that will not be happening again. Any suggestions for my upcoming audit? i'm trying to make a checklist to go in each of the residents chart as well as checklist for the med room. Then i might start thinking about streamlining the horrendous way other things are done. This place has not had someone at the helm in the patient care department in over a year, and so I spend basically all my time trying to fix things. Any help would be appreciated...oh look, here's another phone call about someone calling in!!!!!!:devil:

I'm so sorry, clinicalteach, but your post made me LOL. I almost took what looked like the job of my dreams, too, until I was told about the 24/7 call. No way, Jose. I live 2 miles from the facility and could see myself being there 24/7. (Hi, Kids. Remember me? I'm your mom. What? You graduated?) Your scenario makes me itch to come in and help. I'm a fixer type. But I also know about regs and do not appreciate being blamed for others' mistakes. Who had the job before you? That person should be hung by his/her toenails until they fall off.

One suggestion I might make is if you've already put thoughts together for change, put them on paper to show you've already identified huge problems and intend to take care of them. Also put together a quick education plan and schedule.

Good luck and keep us posted.

Specializes in Telemetry, Orthop/Surg, ER,StepDown.
I'm so sorry, clinicalteach, but your post made me LOL. I almost took what looked like the job of my dreams, too, until I was told about the 24/7 call. No way, Jose. I live 2 miles from the facility and could see myself being there 24/7. (Hi, Kids. Remember me? I'm your mom. What? You graduated?) Your scenario makes me itch to come in and help. I'm a fixer type. But I also know about regs and do not appreciate being blamed for others' mistakes. Who had the job before you? That person should be hung by his/her toenails until they fall off.

One suggestion I might make is if you've already put thoughts together for change, put them on paper to show you've already identified huge problems and intend to take care of them. Also put together a quick education plan and schedule.

Good luck and keep us posted.

LOL..go ahead and chortle! its what i'm doing to keep from crying. Excellent suggestion which i'm about to do once the phone stops ringing from work :uhoh3:

Specializes in Telemetry, Orthop/Surg, ER,StepDown.

well, i've had about hmmm..no days without doing something for work. I clocked 85 hours and still feel like I couldn't get anything done Friday when I left. I was almost in tears. my ED is gone every day at 2-4pm . I have a subversive business office manager who is stirring the **** with my staff about staffing , she's sending out emails cc'ing everyone questioning my increases in care points . The marketing guy quit, so now i have to go out and do some of that. The are slashing budget but i have to somehow find a way to train people to replace the ones that need to go and I'm just frreaking tired! I love my residents! I just want the time to get organized, get my med room really going without constant workload added. I have a staff that was never held accountable for anything before hand. I've had ot lock up gloves because they aren't able to let anyone know that hey! we're running out of gloves, we might need some until the morning where they tell me, welll...we had one box yesterday...?????? My medtechs look at me blankly when i ask them how come they don't do certain things like count the narcs with the oncoming shift. I have to threaten write ups for freaking EVERYTHING! THERE HAS GOT TO BE AN EASIER WAY THAN THIS! any help would be appreciated! i could be good at this job, but they are making it virtually impossible. Its driving me to drink, but not letting me have any time to actually consume!

Specializes in LTC, assisted living, med-surg, psych.
well, i've had about hmmm..no days without doing something for work. I clocked 85 hours and still feel like I couldn't get anything done Friday when I left. I was almost in tears. my ED is gone every day at 2-4pm . I have a subversive business office manager who is stirring the **** with my staff about staffing , she's sending out emails cc'ing everyone questioning my increases in care points . The marketing guy quit, so now i have to go out and do some of that. The are slashing budget but i have to somehow find a way to train people to replace the ones that need to go and I'm just frreaking tired! I love my residents! I just want the time to get organized, get my med room really going without constant workload added. I have a staff that was never held accountable for anything before hand. I've had ot lock up gloves because they aren't able to let anyone know that hey! we're running out of gloves, we might need some until the morning where they tell me, welll...we had one box yesterday...?????? My medtechs look at me blankly when i ask them how come they don't do certain things like count the narcs with the oncoming shift. I have to threaten write ups for freaking EVERYTHING! THERE HAS GOT TO BE AN EASIER WAY THAN THIS! any help would be appreciated! i could be good at this job, but they are making it virtually impossible. Its driving me to drink, but not letting me have any time to actually consume!

Ohhhh, brother........sounds like one of my old AL jobs. Seems that the inmates are running the asylum and things have gotten completely out of control. What you need are some reinforcements---e.g., a regional nurse director who can come in and help you straighten out your staff and pass on to your boss's boss that he/she needs to deal with the BOM and the lack of a marketing director. You are a NURSE, not a salesperson, and you have much too much to do as it is---it is an unwise use of valuable nursing time to be in the dining room serving lunch with a napkin over your arm, or making sales pitches all over town. :devil:

Specializes in Behavioral Health, ALF.

Has anyone taken the National Certification for Alzheimer's Care? Jusst wondering how it was. There is no particular text to study for it, just a suggested reading list. It leaves me wondering how much to read. Thanks.

Specializes in Behavioral Health, ALF.

Got my certificate, test was fairly easy, although I read 5 or 6 books on the subject.

Specializes in OB/GYN/Neonatal/Office/Geriatric.

Wow, just read all these posts. Thought I was the only one stressed by their job in ALF/SCALF. I feel stretched beyond measure. Residents? what residents? I don't have time for residents anymore. Too much other STUFF. It is a lonely job as well. Only one of me so no one to vent to who truly "gets it". Bless you all who have traveled this road. Just wish I could clone myself somedays.

I have applied for a Resident Care Director position at a facility that is just being built. I applied about a month ago and was surprised when they called because it had been so long.

I have been an LPN for 23 years and the majority if that time has been in either home health or hospice care. I realize that this is a management position and I have done home health case management and also the volunteer and bereavement coordinator at hospice. So does that reflect as management experience, at least sort of?

She he asked me about my management experience and scheduling. I know these things do not compare to scheduling for a facility but I am aware of the responsibilities and truly believe I am up for the task.

I am not sure of the potential salary either. In home health I make very well as an LPN but there is no where to move up the ladder so to speak and I am at a point in my life that I want to make an upward move.

Any advice would be appreciated

Specializes in ICU, CM, Geriatrics, Management.

Good luck, MM!

Gotta tell ya my least favorite management function is scheduling. I'd be looking to unload that to someone else real quick! ;>)

You really should research nursing salaries in your area to see if ALF wages are competitive..........Here, where hospital jobs pay new hires an average of $25 an hour and nursing homes around $21/hr. (that's before shift differentials, certifications, or experience), ALFs pay around $20-22/hr. It's not great, but you will almost always be the best-paid staff member in your building.....even the administrator earns less in a lot of places.

Vivalasviejas what state is this?

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

I'm in Oregon. But I posted this over nine years ago, so the quoted wages no longer apply. My last ALF job paid over $61,000K a year...not bad for this area.

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