work

[mumredrose]

Has anyone ever worked in a long term care facility? As an RN, I am thinking that this isn't a fit for me. I have been discharged from two places. Complaints about me from staff are that I am rushed. The work load is high not to mentiont the nurse to resident ratio. I hope I can find my fit in the world of nursing.

[maire]

I have worked in LTC and yes, it is too much. I think you need to work on night shift where the workload is more manageable. Once you have mastered your time management skills on night shift, perhaps you could move to PM or day shift and be better able to rush through the job like everyone wants you to. Since there are so few jobs available out there you really should consider trying night shift. Or, you can always go to home health and work with one patient at a time. That is about as laid back and stress-free as one can get in nursing. Good luck.

[dodaive]

Hello MumRedRose I first worked in a SNF in 1991 as a CNA and felt the same way as you do. Two years later I enjoyed the work very much and found it very rewarding. You have lots of choices, what do you enjoy most about Nursing? There is quite a lot to learn about people in a SNF.

[oldntiredRN]

Dear mumredrose; I too have been in your shoes. I am an RN and tried LTC 2 times and had the same thing happened to me- discharged and complaints from the staff and too rushed. I am an old RN( have always been an RN, was never a nurses aid or LPN), my 30 yrs of experience has been all hospital- medical surgical units, oncology units, sameday surgery unit/endoscopy unit, most recently( last 7 yrs) stepdown, some ICU/CCU, telemetry, and cardiac stpdown-medical and surgical) except for the 8 months I tried to transition out of the hospital mental illnes/chaos wile still doing the above hospital positions. I thought the LTC failures were my fault- I tried it first as a eve.nursing supervisor- but 2 LPN's on the subacute unit did not appreciate me much-I found med transcription errors, one was the doc wrote for the patient to have a monclonal antibiody for his MS, the LPN mis took the med for an Atibiotic( avelox vs.avenox) because she being a subacute nurse did know the other existed and it was the nursing supervisor's responsibility to do the admission H&P. I tried to explain the who, what whnen where and why but she didn't appreciate it and went to the DON who wasn't familiar with the med either, the second discharge- I figured- O.K, this LTC problem is my fault let me start from the ground -up, I went as staff nurse- lasted 3 months- discharged at the end of my probation period- I was too slow on my med pass(it was rubbed in my face that I was a "Hospital nurse ONLY 5=6 patients!! now you have 30", the games and enjoyment at my falling on my face were unbelievable, and done by LPN's who boasted/ tooted (out thier ... butts) they were in school doing prereq's to be RN's so they could get into the hospitals!! and scrutinized my documentation. It's very interesting that in both places never a critique on my admissions!!! I loved the residents- especially the ones with dementia, I enjoyed dealing with the families- that was a major critical thinking, problem solving part of the job that the LTC staff hates- and these staffers think they are going to make it in a hospital? I don't think it's that it is not a good fit- It is however the midset that runs (administration) and controls(LPN's and CNA's) these LTC facilities. until that changes we, RN's are not welcome. I'm sorry to say that these DON's are not much more than promoted LPN's and have very limited knowlege of current nursing, they have been able to hide and escape the drastic changes that have taken place in nursing practice- medications/ pharmacodynamics(they don't even know what that is) evidenced based practice( another foreign word to them) critical thinking has eluded them, never developed- they missed the opportunites to practice it- family issues, don't encourage staf to learn new meds. equipement( I had to go in an hook up a CPM machine, they didn't know what it was; TPN in this facility was a disaster, tubing changes, why?? couldn't figure out why an 89 yr old was bleeding profusely- never looked at is recent labs or reviewed his current med list and connected the dots- he was HITT just kept changing dressings on his old peg site and doing it VERY frequently like it was normal!! I had to send him out to the ER, couldn't figure that a new young 38 yr old admission from a hospital, who was vented from respiratory failure/asthma was screaming with leg pain and had one leg bigger than the other-to them she was a drug seeker. for what asthma! I had to send her out to the ER, she had a DVT and needed a thrombectomy; and then hide the fact from me that a demented pateint had pulled out her PICC line@4:30PM, I see her going out with the squad@10:30PM and asked the fool question "where's she going and why?" In the other facility I watched a CNA answer a demented resident's call bell and make pig noises @her over the intercom- this resident is the aunt of the socialworker there and the doc kept uping her Xanax because this resident was paniky, crying and begging to go home. What abuse and cruelty. I reported it to the DON and she stated"I doubt that ever happened!!" This is a county run LTC facilty where my tax dollars are going, I live in NJ so that's a whole lotta tax dollars!! What did i get- terminated @ the end of my probation period- not fast enough, didn't document on Thanksgiving- why? because I wasn't working that day, It was my day off, I guess I wasn't documenting- this is the mentality of those who run these places. This crack head DON with her Miss america hairdo will collect a state/county pension,because she has been there as DON for 30 yrs, with my tax dollars. I really like LTC and the challenges, would love to do it permenantly- I can see a lot of potential for nursing and family education and is not near as stressful compared to a cardiacstep down which I have had enough of. I don't think it's you- I think it's your title- RN. and it is a shame- this population is a very vulnerable population- in many ways( emotionally, physically, mentally, socially, ECONOMICALLY), and deserve to have the best- lots of eager competent RN's young, new and old, experienced!! But the established and curent status quo will not have it.!! it makes them look bad- incompetent, insecure, lacking in knowledege and perception for the scope of the bigger picture.

[dodaive]

Hello old Tired RN
As I see it the idea behind the difference between RN and LVN has to do the two opposing ways to use one's brain. One being worker bee mentality, cranking out as many tasks as possible. The other being the ability to have an conceptual understanding of patient care, and utilize this understanding to make good decisions and put it into practice.. A nurse that is good at one of these will very often find fault with the nurse that is good at the other form of intelligence. In Reality both are needed.

[Gona_bea_nurse]

I'd rather be unemployed forever then ever work a nursing home, but thas just me.

[oldntiredRN]

I look at it this way- What is the point of chasing RN's out of LTC? LTC is hard, never ending heavy work. Look at how vulnerable this population is- do they just get to enjoy the sounds of pig noises over the intercom for the rest of their life because one slime ball CNA has control of the bully population, I wasn't the only one who saw her do this, there was an LPN sitting right next to her- how did she respond- laughter!! While this old woman was crying"please come and help me" so the brainiac nurse manager(an RN) asks the doc in the AM to increase her Xanax, this resident was on other antipsychotics also. so we keep increasing the xanax, have her neice come to.see her until the woman stops breathing,just callit a day and more importantly, just for the entertainment of 2 staffers. Did it ever occure to the LPN as she sat there and was amused by this senario that respiratory arrest was a good possibility? does she even know the side effects of xanax especially in an elderly. And there is no excuse for the DON- an RN who probably has not done patient care since the Mod Squad was on TV. Her and her Patty Duke hair do. This is the danger of no new knowledge being infused into these places- the same sesspool of stale knowledge keeps circling. I bet they don't even know Xanax (is a benzo) and is the only withdrawal a person can die from- because of seizures. But Miss lovely Rita- the DON would just make sure her hair was all in place. And with my tax dollars paying these imbesil's salary and pension, this facility is county run: $700/month property tax and going up, 7% sales tax every time I go to the check out and $8,000/yr in state withholding tax. I guess they did have to start making up documentation errors to get me out of there- afraid of what I was going to tell my new found freinds at the state dept of health. So i guess I would like to know what are these county employeed LTC staffers good at? In my years, I can't honestly say that the LPN's have made a good case for themselves- they have cut their own throats- by insidents such as this, they do this in the hospitals also- they get into that danger zone where they feel they know as much as the RN because they have watched the RN's do things- and take it up on themselves to do it too, or they interpret situations, don't have all the facts and take it upon themselves to make clinical judgement- that is not their scope of practice. You put them into LTC, they get themselves into trouble, you put them in the hospital and they get into trouble, I suspect you put them in clinics and they get into trouble there too. They over step the limits of their license. Some CNA's do this also but not as much. This is where the RN starts to panick- what else did that person do- that I don't know about. it's the resident or the patient that gets harmed, not the RN, not the LPN, not the CNA- then I had both groups say after something does occur, Oh, sorry I didn't mean it!" Well sorry doesn't undo the damage your ego just did. and that's all it is - one impulsive fleeting ego moments to cause serious harm. Just wanted to try on the RN shoes for one second to see how it felt. This is why I'm old and tired and want no more to do with the whole damn mess.

[oldntiredRN]

To mumredrose: How long have you been an RN? If your new at it. Don't quit after a few hard knocks. and don't take the slime buckets to seriously yet- get a few years under your belt, try other areas of nurseing what ever you can get, then decide. For me after 30 years- it's the same bat time, same bat channel. the nurse managers are as usless as you know what on a bull- they can't get out from under the bed sheets with the money people to do their job- Leadership. they're spending our tax dollars filing BON complaints over pee poor documentation issues and visions of impaired nurses dancing in their heads- so every nurse who forgets to sign out her/his meds( WE HAVE ALL DONE IT) gets to meet the state employeed(tax dollar supported)BON. maybe the nurse managers get to dressup in judge robes for the occassion- yipe! It's Halloween@ the state house. look at your next property tax bill- that's April fools!. or nursings version of Dancing with the (BON) Stars.

[Penny_Cillin]

Hello old Tired RN
As I see it the idea behind the difference between RN and LVN has to do the two opposing ways to use one's brain. One being worker bee mentality, cranking out as many tasks as possible. The other being the ability to have an conceptual understanding of patient care, and utilize this understanding to make good decisions and put it into practice.. A nurse that is good at one of these will very often find fault with the nurse that is good at the other form of intelligence. In Reality both are needed.

Excellent post.

[oldntiredRN]

Do My eyes deceive me? There's that nursing shortage scam again! Tell me some one isn't feeding false info to the Bureau of Labor statistics.
The Top 10 Hardest Jobs to Fill
By John Rossheim, Monster Senior Contributing Writer

The economy is sputtering, and companies say they will make nothing but perfect-10 hires. Meanwhile, Baby Boomers are retiring by the millions -- and everyone wants to be a millionaire, not a wage earner. Where does all this leave employers and workers in their never-ending struggle to tip the balance in the American labor market?

From the perspective of an annual survey commissioned by staffing firm Manpower, these dynamics yield a number of occupations for which openings are hard to fill. Among white-collar jobs, the following positions make Manpower’s 10 Hardest Jobs to Fill list: sales reps, nurses, technicians, restaurant/hotel workers, managers/executives, doctors/other clinical practitioners, engineers and customer service reps. And on the blue-collar side, skilled tradespeople and drivers make the top 10.

But labor-market power has shifted toward employers with the soft economy. In the prerecession year of 2007, Manpower’s survey of 2,000 US firms showed that 41 percent of employers reported difficulties filling positions; however, the 2010 tally found only about a third of that percentage of companies -- 14 percent -- reported recruitment was a struggle.

And many experts, especially labor advocates, take issue with the Manpower study’s conclusion that all these occupations are in shortage. “Our starting point at EPI is where most economists would start: If you don’t have low unemployment and rising wages, you don’t have a shortage,” says Ross Eisenbrey, vice president of the Economic Policy Institute (EPI).

So if you work in one of these occupations -- or want to -- what’s the real story? Let’s take a look at the survey results and get some perspective on what the shortages really mean.

White-Collar Occupations Blow in the Winds of Economic Change

With fuel prices spiking and oil and natural gas exploration heating up, demand for petroleum engineers is rising. Offshoring notwithstanding, “engineering is going to be around for awhile,” says Melanie Holmes, a vice president at Manpower North America. “Oil companies have employees averaging in their late 40s.”

Eisenbrey says EPI data shows labor shortages in a number of white-collar niches, from healthcare workers to librarians, farm managers, engineering managers and environmental scientists.

Some Blue-Collar Jobs Go Unfilled Even as Their Numbers Drop

Even after decades of manufacturing decline, employment of machinists is expected to drop another 5 percent between 2008 and 2018, according to the BLS.

“We’re at the very beginning of that decline; we haven’t necessarily gotten there yet,” says Holmes. “Even if machinists are declining, applicants are in short supply. Kids are not getting excited about going to tech and vocational schools.”

Labor advocates paint a different picture. “Employers are still not willing to pay what’s required,” says Eisenbrey. “It’s a shortage only at the rate that employers want to pay.”

The skilled trades rank high among blue-collar jobs that are hard to fill, according to the Manpower survey. Carpenters, welders, plumbers, electricians and masons are in demand, the survey says.

But Eisenbrey questions the validity of these conclusions. “It doesn’t make sense that jobs for construction workers and laborers are hard to fill,” he says. “Wages are declining in most of these occupations." While the Associated General Contractors of America reports that 40,000 new construction jobs -- many due to stimulus projects -- were added between February and April 2010, that's a far cry from the more than 2 million construction jobs lost over the previous three years.

Even in our digital age, stuff still needs to get from here to there, whether the trip is across the warehouse floor or around the world. That’s why jobs for laborers such as freight, stock and materials handlers are projected to increase by almost 250,000 positions from 2004 to 2014, according to the BLS. Many of these jobs require few skills but pay $12 to $15 an hour, about double the federal minimum wage, which rose to $7.25 per hour on July 24, 2009.
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[marizandres]

For me, it's really fine to work in a nursing home but we do need lots of patience though.