I'm an LPN, finishing my RN. I have had so many nurses/doctors/instructors etc tell me lately that I MUST work a few years in a hospital, that LTC isn't real nursing, I'll lose my skills, "You're too smart to work in a nursing home," you'll never get a job anywhere else, your whole day is figuring out how to make them poop. I can see where they're coming from, really I can.
I love coming to work every day. I know those 32 dementia residents like the back of my hand. I know how to soothe them. I figure out when they're hungry/tired/have to pee/in pain when all they can tell me is "AAAAAHHHHHH!!!!" I have time to sit under the table with a lady and help her clean the floor with her sock. I have time to sit with an anxious resident who is screaming, not from pain, but from fear and confusion, and stroke her hair while she falls asleep. I have time for that macho man to "help" move the furniture around. The man who can't remember he can't walk sits behind the nurses' station with me while I chart and eats bacon and eggs so he won't fall. I have time to give a bath now and then. I have time to have popcorn fights with them. I argue, sweet talk, and get feisty with doctors, pharmacies, case workers, administrators and others to make sure my residents get what they need. Like my med surg instructor said, "A monkey can start an IV. A monkey can do procedures. That's not nursing." And that makes sense.
I may want to move on some day. I'm still very young. But for now, I'm where God wants me. And I'm blissfully happy.
Specializes in Gerontology, Med surg, Home Health.
Why do I do this? So far this week I've been threatened with 4 lawsuits, called names by family members and even had someone threaten to blow up half the building. Yikes.
Specializes in LTC, home health, critical care, pulmonary nursing.
Why do I do this? So far this week I've been threatened with 4 lawsuits, called names by family members and even had someone threaten to blow up half the building. Yikes.
Specializes in Director of Nursing Long Term/Subacute.
Sounds like you have some irrate family members. Get to the bottom of each problem--take it one by one.
Just like there is a source to every odor--there is a cause of every problem. Take each one one at a time and try to see where all of this is coming from.
Are you a DON?
You do what you do because you care about the residents. Right?
Their family does too--but they feel hopeless and helpless in these situations. Sometimes they just feel pure guilt. And unfortunately you take the brunt of it.
Take time to listen to them and write down their concerns. When someone comes to you with a problem have pen and paper in hand and write down their major concerns. That way they feel like you are doing something to help them.
After they finish complaining and you have the high points written down--read it back to them to make sure you have it all clear.
Then look into their issues and followup.
If you do this enough--especially with the ones that are always complaining--the problems will become less and less.
Specializes in Director of Nursing Long Term/Subacute.
oh and the one threathening to blow up half the buidling needs to be reported to the authorities. I would call the police and make a report. Were there any witnesses to the threat?
Specializes in Gerontology, Med surg, Home Health.
The cause of the problem is simple: the families involved think they finally have some power in life. They love to threaten with calling the DPH or suing because they think that means we will be wary of them and not make them follow the same rules as everyone else. I think we should screen the family members as well as the patients before we accept them in the building.
Awww honey, welcome to LTC nursing. I had no intention of staying in LTC 12 years ago while working as an LPN pursuing my RN. (and was first a CNA) Even had an instructor say that LTC was for nurses who couldn't cut it in "real" nursing. The best thing you can do is decide for YOU what nursing means to YOU. Yes, med surg skills are invaluable, but so much more is learned in LTC than you think or is commonly believed. Plus, LTC can be as educational as you want it to be. You can be like a lot of nurses and simply get an order for a consult for every new problem, or really dig into their history, new meds, etc. and figure out what may be going on with them. Research their labs, etc. You can lose a lot in LTC, if you choose to. But here's what I've gained as an RN in LTC for 12 years:
1) Assessment skills that I truly believe would rival any doctor- have you ever actually watched them when they visit? They don't even listen, much less do a thorough physical? I've diagnosed my own families issues long before their doctors did. Do you know how many disease processes you get to watch firsthand in LTC? Verses a few days of an acute exacerbation on a med surg floor?
2) Excellent medication knowledge- Short of Viagara, don't think there's a med I haven't given in LTC, and even that one was ordered once!
3) Untouchable organizational skills- I can do a med pass and treatments for 30 patients on a day shift, chart on 15 med A patients, arrange transport, assess 2 acute patients, and do 2 admissions in a 8 hour shift! And still get a lunch!
4) Even technical skills- IV's, blood draws, g tubes, j tubes, NG tubes, PICC lines (including discontinuing) , TLC's, wound care, implanted ports, pain control, trachs, prosthetics. Can't think of much I haven't done.
5) Lab knowledge- After enough years of CBC's, CMP's, BMP's, HgbAIC's, U/A's, PT/INR, yada yada yada, you get to really understand labs.
Again, you can learn as much as you want to. Maybe LTC isn't for you long term (no pun intended), but if it is, the first lesson you need to learn is to care less what others think. If it was your mom in a facility, would you want a highly competent, caring nurse, or one who "couldn't cut it in real nursing"? Please! Do what you love, and you will love what you do!
the cause of the problem is simple: the families involved think they finally have some power in life. they love to threaten with calling the dph or suing because they think that means we will be wary of them and not make them follow the same rules as everyone else. i think we should screen the family members as well as the patients before we accept them in the building.
cape cod....amen!!! i keep telling our hospital assessment nurse that she needs to assess the families more so than the pts!!!! i can handle just about any pt, but the family members drive me to drink. you are so right. threats, demands.....the doctors are scared to say "no" to unrealistic families. it's not the docs who direct care anymore, it's the families. some are wonderful, but more and more aren't. they look up every med on the internet and suddenly their loved one has that side effect. they demand the newest, most expensive meds. they don't understand why their 92 year old mom with advanced dementia isn't bouncing back from her broken hip and doesn't want to eat. they want us to withhold pain meds because "that must be why she's so tired"....etc, etc, etc. *sigh* oh, and then there's trying to explain a medicare cut, which is part of my job, too......
i'm a little toasty right now. the only reason i'm continuing to do mds', write care plans and run the cp and pps meetings, medicare d approvals, hmo approvals, keep the cmi up, etc is because of the flexibility it gives me while in school. i love ltc pts, but i'm not sure i can handle much more of the families....
3) Untouchable organizational skills- I can do a med pass and treatments for 30 patients on a day shift, chart on 15 med A patients, arrange transport, assess 2 acute patients, and do 2 admissions in a 8 hour shift! And still get a lunch!
Wow! That's incredible. I just started as an LPN 2 weeks ago and am just slowly learning how to do my med pass, I sure look forward to the day I can pull that off!!
I'm an LPN, finishing my RN. I have had so many nurses/doctors/instructors etc tell me lately that I MUST work a few years in a hospital, that LTC isn't real nursing, I'll lose my skills, "You're too smart to work in a nursing home," you'll never get a job anywhere else, your whole day is figuring out how to make them poop. I can see where they're coming from, really I can.
I love coming to work every day. I know those 32 dementia residents like the back of my hand. I know how to soothe them. I figure out when they're hungry/tired/have to pee/in pain when all they can tell me is "AAAAAHHHHHH!!!!" I have time to sit under the table with a lady and help her clean the floor with her sock. I have time to sit with an anxious resident who is screaming, not from pain, but from fear and confusion, and stroke her hair while she falls asleep. I have time for that macho man to "help" move the furniture around. The man who can't remember he can't walk sits behind the nurses' station with me while I chart and eats bacon and eggs so he won't fall. I have time to give a bath now and then. I have time to have popcorn fights with them. I argue, sweet talk, and get feisty with doctors, pharmacies, case workers, administrators and others to make sure my residents get what they need. Like my med surg instructor said, "A monkey can start an IV. A monkey can do procedures. That's not nursing." And that makes sense.
I may want to move on some day. I'm still very young. But for now, I'm where God wants me. And I'm blissfully happy.
That's so great that you love where you're at and what you're doing! A nurse is a nurse and we all have different areas that we love and those we run from. But, it's great to hear such an inspiring story- it is really a breath of fresh air! Your should post your story on the "First Year of Nursing" board- that thing is bleak!!
Wow! That's incredible. I just started as an LPN 2 weeks ago and am just slowly learning how to do my med pass, I sure look forward to the day I can pull that off!!
Don't worry, it will happen. I too started as a CNA. I still remember my 1st night. I worked 3-11, I was still doing my 4pm med pass at 10:30. It slowly got better over time, and now 12 years later, I'm finally "getting it" , lol. Of course I still have those days. The ones we all have. Where everything that can go wrong goes wrong, and you don't even get to stop to pee , much less take a break. But you WILL get the hang of it, promise. If it makes you feel better, I didn't even realize my first deceased patient was dead. I went in to change her duragesic patch, turned her over, put it on her upper back, and rolled her back over before realizing "Hey, she's a little cool". Yep, she was gone. And had been for a little while it appeared. Yet I slapped a brand new patch on her :icon_roll I also had a hard time transitioning from the CNA mindset. Everytime I'd have a patient get acutely ill, I'd want to run and tell the other nurse I was working with! Took awhile to realize I was the nurse, and needed to handle it. Just wanted you to know, we've all been new, and you'll find your niche!
Don't worry, it will happen. I too started as a CNA. I still remember my 1st night. I worked 3-11, I was still doing my 4pm med pass at 10:30. . If it makes you feel better, I didn't even realize my first deceased patient was dead. I went in to change her duragesic patch, turned her over, put it on her upper back, and rolled her back over before realizing "Hey, she's a little cool". Yep, she was gone. And had been for a little while it appeared. Yet I slapped a brand new patch on her :icon_roll I also had a hard time transitioning from the CNA mindset. Everytime I'd have a patient get acutely ill, I'd want to run and tell the other nurse I was working with! Took awhile to realize I was the nurse, and needed to handle it. Just wanted you to know, we've all been new, and you'll find your niche!
Wow! That is pretty bad! Thanks for the encouragement- I really needed it. :rcgtku:
Wow! That's incredible. I just started as an LPN 2 weeks ago and am just slowly learning how to do my med pass, I sure look forward to the day I can pull that off!!
I just started as an LPN 2 weeks ago and am just slowly learning how to do my med pass, I sure look forward to the day I can pull that off!!
It slowly got better over time, and now 12 years later, I'm finally "getting it" , lol. Of course I still have those days. The ones we all have. Where everything that can go wrong goes wrong, and you don't even get to stop to pee 
, much less take a break. But you WILL get the hang of it, promise. If it makes you feel better, I didn't even realize my first deceased patient was dead. I went in to change her duragesic patch, turned her over, put it on her upper back, and rolled her back over before realizing "Hey, she's a little cool". Yep, she was gone. And had been for a little while it appeared. Yet I slapped a brand new patch on her :icon_roll I also had a hard time transitioning from the CNA mindset. Everytime I'd have a patient get acutely ill, I'd want to run and tell the other nurse I was working with! Took awhile to realize I was the nurse, and needed to handle it. Just wanted you to know, we've all been new, and you'll find your niche!
CapeCodMermaid, RN
6,092 Posts
Why do I do this? So far this week I've been threatened with 4 lawsuits, called names by family members and even had someone threaten to blow up half the building. Yikes.