I'm reading the "New Grad perfect job thread" and I keep seeing the NGs say that LTC is a "deal breaker - no way I'm going to apply to an LTC job".
Why? If I were a NG having difficulty finding a job, I certainly wouldn't have that attitude. LTC is a WONDERFUL way to learn time management and multi-tasking skills. Hell, I have almost six years of nursing experience, and if someone offered me a job in LTC working 8-5, I'd take it in a heartbeat. LTC is a great way of opening up for administrative/management opportunities as well (lots of ADON and DON positions around).
I'm confused about the attitude, and wondering if someone could explain it to me, because surely there must be something I'm missing.
How are things going to improve when the govt tied nurses hands in nursing homes by calling them "supervisors" and then say they are ineligible to unionize and safely speak up about patient care, staffing issues,etc. Instead they turn around and try to arrest and prosecute the nurses for the negligence created by the bad working conditions and staffing ratios they don't have any real control over. It's easier to scapegoat the nurses as bad, rather than demand safe staffing ratios and provide the funds to do this!
I don't see nursing homes choosing fair and safe staffing ratios on their own because they are trying to cut corners to save money and this is not going to change! Money pressures are going to keep increasing so more staffing cuts will probably be in the picture.
To those who work there, God bless you, you are stronger than I am. I do like elderly people, but I can't handle demented and violent patients, psyche, whether young or old.
Again to those who have a special ability to calm these patients that's wonderful, but I'm not one of them. Nursing is stressful enough to me without adding the psychotic, dementia, violent, bipolar, schizophrenics and drug/alcohol detox patients to the mix.
Sometimes I come to work and I swear I feel like I'm trapped in an insane asylum! I was very busy the last week, but I didn't have any psyche patients for a change so it was much easier and less stressful!
How are things going to improve when the govt tied nurses hands in nursing homes by calling them "supervisors" and then say they are ineligible to unionize and safely speak up about patient care, staffing issues,etc.
OT, but helpful info.
The last time my state's Nurse Practice Act was revised, it was revised to specifically state that non-management nurses are NOT supervisors, even if they delegate tasks.
Check your state's NPA to see if there's anything in it to that effect.
When PPS (Prospective Payment System) became the basis for Medicare payments back in the 90s, it really messed up reimbursement...it needed to be redone d/t all of the fraud (buying wheelchairs when renting for temporary use would be enough, getting ultra deluxe products when 'good' got the job done without any ill effects on the patient, etc), but it was/is a lousy system and nursing homes were stuck. They got rehab patients who only "paid" 250.00 a day (what Medicare paid the facility- regardless of how much care they need- it doesn't matter- if they only qualify for a certain category, that's all they get reimbursed for). But their therapy alone (for the facilities that outsource rehab) was 300.00 per day- that leaves a negative $50/day....and nursing, CNAs, dietary, housekeeping, office staff, maintenance, electric and water bills, etc had zippo going to them. SO, many went bankrupt.
It's not all about nursing homes hoarding money (some do- some companies are "for profit"- and it's a huge difference when working for those- they buy the cheapest stuff they can get away with; "not for profits" focus more on the patients; "non profits" just hope to stay alive ). It's a lot about reimbursement, whether or not people want to believe it. The folks on Medicaid retired ages ago- and their pension checks/SS checks are sometimes only a couple hundred dollars a month- literally (I've helped the payment processor open the envelopes). Medicaid pays a daily rate for the rest. The resident gets to keep about 70bucks (may be a bit higher now- but it's nowhere near what their check is).
Just throwing this out there- maybe nobody cares. But it does make a difference in how nursing homes function :)
LTCs generally do the best they can. The residents deserve better- and for those who are able to pay for more care, they get it...but the vast majority of people in nursing homes 1)don't want to be there, 2)don't deserve 'second' best, and 3) are doing the best they can- brain disorders dictate their behavior- they can't help it.... it gets frustrating to take care of them, but if they had to see themselves the way they were (per family reports) they'd be humiliated.
All of the unions in the world won't pry a dime from the government to make conditions better for the patients- and that's who matters....
Specializes in LTC/REHAB/GEROPSYCH/WOUND CARE/ICU.
Working in Nursing homes /LTC have the pros and cons. I did work in a skilled nursing home/LTC for quite a number of years and currently , I am both an employee in a LTC ( as part-time)and hospital. My skills and time management has improved because I first started with long term care, managing different patients with a higher RN-PT ratio. Learning is subjective and is not limited to where you are situated whether you are in a hospital or in a long term care. It is how much you are determined to learn and how much initiative as well as enthusiasm you are willing to put into it. Yup! you are prone to mistakes because of the ratio but that makes you more aware that you need to raise your standards and there is zero tolerance for medication error / or judgement mistakes. There are always your managers and DONs and ADONs who will help you. All you need to do is ask for help when you need it. Yeah, Hospitals also provides us opportunities for education and I agree that there are more stringent rules in the hospital than in a LTC. I would say, whatever I learned from my LTC experience has helped me in a lot of ways working in a fast paced setting in a hospital.
). It's a lot about reimbursement, whether or not people want to believe it. The folks on Medicaid retired ages ago- and their pension checks/SS checks are sometimes only a couple hundred dollars a month- literally (I've helped the payment processor open the envelopes). Medicaid pays a daily rate for the rest. The resident gets to keep about 70bucks (may be a bit higher now- but it's nowhere near what their check is).
brandy1017, ASN, RN
2,910 Posts
How are things going to improve when the govt tied nurses hands in nursing homes by calling them "supervisors" and then say they are ineligible to unionize and safely speak up about patient care, staffing issues,etc. Instead they turn around and try to arrest and prosecute the nurses for the negligence created by the bad working conditions and staffing ratios they don't have any real control over. It's easier to scapegoat the nurses as bad, rather than demand safe staffing ratios and provide the funds to do this!
I don't see nursing homes choosing fair and safe staffing ratios on their own because they are trying to cut corners to save money and this is not going to change! Money pressures are going to keep increasing so more staffing cuts will probably be in the picture.
To those who work there, God bless you, you are stronger than I am. I do like elderly people, but I can't handle demented and violent patients, psyche, whether young or old.
Again to those who have a special ability to calm these patients that's wonderful, but I'm not one of them. Nursing is stressful enough to me without adding the psychotic, dementia, violent, bipolar, schizophrenics and drug/alcohol detox patients to the mix.
Sometimes I come to work and I swear I feel like I'm trapped in an insane asylum! I was very busy the last week, but I didn't have any psyche patients for a change so it was much easier and less stressful!