Friday, May 05, 2006

Why I Hate Nursing Homes

Ok, I should have entitled this post "Why I Hate Nursing Homes, with a Side of Dr B's Top 10" but it wouldn't quite fit.

Was in medical last night. We sometimes call medical Green. The jokes about Green and long and distinguished. Its fairly common to hear it referred to as 'Walking the Green Mile'. The smells from Green are NOTORIOUS. I think its a combo of feet, funk, poo, urine and a side of vomit. GROSS! You've gotta love it!

We got a patient last night from a nursing home. She is 74 years old, a diabetic and recently put in a nursing home. Apparently, she was getting her PO diabetic meds, and all of her insulin WITHOUT having her sugar checked. Hey guess what?? She was found unconscious with a sugar of 29! She was also uncovered and had a temp of 92.0 F. That is criminal!!!The EMS peeps gave D50 and warmed her up. The nursing home didn't even know her last name. When she woke and was more with it she said that "Nobody should treat older folks this way. They all have this coming."

These homes claim to take excellent care of our loved ones. But they are left in urine and feces so long we have trouble cleaning it off. They are allowed to waste away with hardly a look... much less a turn every 2 hours or a bath everyday. These places are EXPENSIVE! The shitholes will cost you an arm and a leg and they are the nice ones! Those poor people deserve so much better.

OK, so to counter my bummed out mood may I present....

THE TOP 10 REASONS I WORK AT (UNIVERSITY MEDICAL CENTER) EMERGENCY DEPARTMENT:

10. The respectful and courteous patients that are always thankful for the high quality of care they received.

9. Teamwork!

8. Betting on ETOH levels.

7. Being able to stroll into the Trauma room and say to the patient "That looks like it hurts."

6. Plenty of state of the art equipment available.

5. Hospital administration views diversion as a sign of weakness.

4. The ICU intern telling the ED attending "I think that patient will do just fine on the floor."

3. Being able to drop the F-Bomb at will.

2. Sexual harassment as a job requirement.

1 The staff is crazier than the patients and almost as dangerous!

By Dr B.


Don't stick stuff in your ear. No pens, pencils, small furry animals, lottery tickets or after dinner snacks. Just don't do it!

20 Comments:

Blogger shayla said...

I can relate to the nursing home problem. More than once i've worked an evening shift where 20 residents were in my care. 20. 1/2 of whom were bed-bound, and needed assistance with meals.

There was also an incident where the charge nurse gave one resident's meds to another resident. Made for a long night for both of us.

Seems that most places have the same problem, just not enough good staff.

shayla

4:44 PM  
Blogger Pat said...

You're right about nursing homes. They are vile. I have a loved one in a nursing home and I have to go in every day and take care of things the nursing home does not do. I hate to say it, but the staff is awful. I don't say anything because that will only cause trouble, but the aides treat the people as if they are annoying children. They are neglectful and don't seem to have any compassion. It's quite shocking. Nearly everyday I visit I see people asking to be changed for well over an hour, the strong smell of BM coming from them, and they are completely ignored. The aides will only change the residents if they agree to go to bed. If a person wants to stay up, they have to sit in your full diaper. Many people there sit in filthy clothes, I've seen aides drop food on people, and they always, without fail, just leave it there. If an aide is out sick, some people end up having to stay in bed for the day. If an aide is out sick on the day a a resident is scheduled for a shower, they don't get a shower that week. Many residents have BM under their fingernails, even at the dinner table. The aides seem to have no compassion or empathy. The residents are not allowed to complain- they get a verbal lashing. It's shocking,and this is Lutheran Church non profit nursing home.

3:33 AM  
Anonymous Anonymous said...

Hell yeah. Nursing homes are a joke. I am at one with 50 pts. on my side and one supervisor and usually 3 stna's. I have anxiety for hours before every shift. I am really thinking about quitting this shit. No glamour here. I am also tired of fat assed women supervisors who treat me like shit b/c I don't flurt with them or show interest. I am a male by the way. Why is it ok for those bitches to screw with me but if I say something back they get all pissy?

4:43 PM  
Anonymous Anonymous said...

I work as an lpn at a nursing home and hate it. I wish i would have gone into auto mechanics. I started late, in my fifties. I work nights to stay away from the suits. I am never on the same hall, do noe half of one hall and one half of another. Always something different and there is no continuity of care. I am sick of other nurses who are rude, dont respect fellow workers, and think they are the Dr. Staff is always short, no one stocks the med cart for the next shift, tx cart is never stocked. I am tired and anxious, waiting for someone to berate me for an honest mistake. I get sick when i have to go to work. This is a small town and not much hiring going on. Geeze, I thought i would be helping people, all i do is rush around all night worrying about getting it all done so dayshift doesnt get mad and the other shifts think we sit and do nothing all night. Changeover is another horrible thing every month. I can relate to all the comments. It is a shame i feel this way.

2:27 AM  
Anonymous Anonymous said...

Oh Gosh I also worked at a nursing home and it was HORRIBLE! The CNAs were extremely rude and took 2 hour breaks. Would get angry when asked to do their work. I had 33 patients and was floated to different units within the nursing home. There is no way I can possibly get to know 90+ patients in total. Half of them were Medicare residents so they had to be charted on so there is absolutely zero time to spend with any of them except to change their dressings and give them their insulins. To make things worse, about half of them did not know who they were and they wear no arm band so you could make a med error and the training I got was 3 days! There was no way you could go to the restroom for a minute, much less go on lunch break yet the ADONs would write you up for not clocking out 30 minutes. BS. Nursing is stupid. When I went in I thought I'd be so happy helping people who can't help themselves but now I regret it and wish I had known people who already were nurses and had told me how horrible it really is. I wish I had gone to school for something else. Now I have kids and no money and no time so going back to school is not an option. How sad!

5:40 PM  
Anonymous Anonymous said...

I am a nursing student. We have to obtain our CNA to earn a "point". So I did my first clinical at a nursing home yesterday. I wanted to vomit all day long. I felt so anxious all day about everything that I thought I would break down at any moment. I am an MA and have 5 years experience in Dr. offices. I don't think this is what nursing care is supposed to be like. I absolutely abhorred it and have to go back for the next 8 weekends. Residents had poo under their nails at the dinner table, one aide was yelling at a lady for having her light on. Aides were sitting in dark corners texting, and everybody was put to bed right after lunch. What kind of a life is that? I am dreading going back. I swear, if I didn't have to have this point, I would never ever return to a nursing home.

10:06 AM  
Anonymous Anonymous said...

Ok, so yesterday was day 2 in clinicals. I spent one WHOLE hour digging poop out from under a lady's too long fingernails. Followed up with a trim and a coat of polish. I felt so bad for her as she had just eaten lunch with this crap under her nails. It was so hard to get out, it was obvious it had been there for a long time. She said they don't do that for her. Mind you I'm a student. I'm doing clinicals. And of course, the CNAs hide when they should be doing their work. I wish to God I didn't need this stupid point to get into the RN core. What BS. RN's don't do this, so why should I have to do it?? Ugh. 7 more Sundays and I'm SO outta there!

12:16 AM  
Anonymous Anonymous said...

For the most part all nursing homes are terrible places. The problem is on the care giving level. Cna's should be paid more, trained more, and watched and disciplined more. And, every dime patients have to pay for staying in these places should be spent on their care. How can our country allow someone with alz. that doesn't even remember their own name and doesn't have any family be care for by a business that is run for profit? Sadly, I am in this business and I don't see any end to the evil in sight. The so called state inspections are a joke. The communites (strangely) all these nursing homes are in have no supervisor authority I know of whatsoever. Never if you can help it let a loved one be addmitted to one of these places.

1:11 PM  
Anonymous Anonymous said...

I'm proud to say I work I'm a good nursing home in one of the states with the strictest state surveys. My question to the nurses who are currently working in bad ones is what are you doing to make it better are you disciplining the cna's who are doing wrong? If not you are as much of the problem as they are, and to the family have you contacted adult protective services about the care this facility is providing. Honestly hospitals aren't always that great, I have a hard time believing that cnas in hospitals are repositioning every 2hrs when I have admitted people with black heels.and stage 4 pressure ulcers from hospitals. Hell I've seen a stage 3 to a persons nose from a bipap that wasn't removed or repositioned. To the one nurse to sat and cleaned under the nails of the woman trimmed and painted them bravo to people like you are what we need. Medscape has released a study in which it takes the best of the best if nurses to work in a nursing home. Oh and for bad care we recently discharged a resident to the hospital who left with a dressing on his arm which had been placed on fresh that day and returned a week later with same dressing. Sorry for typos doing this on my cellphone.

9:29 PM  
Anonymous april said...

sLegainLet me start off by saying that Im now a registered nurse working on a medsurg unit but when i first started nusing as an LPN i worked at a nursing home. The problem was we had 22 pts to 1 nurse during the day and 44 residents to one nurse on night shift. It is IMPOSSIBLE to given excellent care to the pts when you have that many and they are ALL pretty much total care pts. The state regulation says that this number of pts is appropriate so that is all the staffing the nursing homes will hire. I am now on the receiving end of the pts as i work at a busy hospital and i admit that i dont like getting NH pts. I know there are people working in the medical field that dont need to be there and could care less about pts, but there are some that try there hardest and still are unable to do EVERYTHING that has to be done. I can say with NH experience that its not that i didnt want to give excellent care to 22 pts, it was just that it was an impossible demand. Also you may have 1 tech to 8-10 pts that all need to be turned, fed,bathed, etc. Then you as a nurse are trying to give everyone medications, treatments, charting, and any other surprises, admissions, sendouts etc. Its a very stressful job.

11:35 AM  
Anonymous Anonymous said...

Hi, I have to agree! I am only nursing student, fresh LPN, but I have eyes and brain. I knew nurse who as a fresh graduate had to take care of 50 patients. Average nurse has 28 pts. Where it leads? To errors. I caught several med errors in medication at nursing home. Nurses fault? Oh no! How can she possibly check meds as law require (check MAR, vitals...) for 28 patients within 1 hour. If the CNA did not do it, because they are taking vitals at 10 a.m. While morning meds has to be passed at 8??? So I could because me as a student I had one patient only.... It is impossible to do all what nurse have to do in one shift for all patients... in order to "prioritize" and have done the most urgent things... the nurse has to neglect the less important. Someone was funny when hired 1 nurse for so many pt, alzeimers, bed bounds, long list of meds...! It is the smart team of owners and management educated administrative persons who have no idea what the job is about, how the elderly have to live there and well - if the law allows it - who cares right? Money are more important... and if patient dies because of neglect - well - now this is not a joke, the facility gets around twenty to thirty thousand fine only. Stop complain about nurses or Cna not doing enough. Use your common sense... stop requiring impossible! It is like wanting to have a palace built over night and employ only two masons! You see the nonsence? Why no one see that in medical care for years??? So what have to be done? START LOBBYING FOR LAW CHANGE!!! Make a law demanding a 1 nurse for 15 pt., CNA for 10... then you can complain if the job is not done. Force the greedy nursing homes owners to employ adequate staff. It is the only thing which can change this horrific situation in nursing homes.

6:29 PM  
Anonymous Anonymous said...

And mandatory training... 3 days - I know NH do it, but it is another non sense! Learn patients, computer program, place... the way they chart, their policy, who does what, and who to call if this happens... take care of dementia patient... SURE.. NO PROBLEM :)) I wish to see the greedy smartie pants able to handle it in 3 days :))) That should be mandatory too... Mandatory training for new hire four weeks minimum.

6:34 PM  
Anonymous Anonymous said...

This is horrible. Every comment on here has nothing but negative to say. I will say I have not worked in Nursing Homes, and I refuse to. Reasons include:
1. Staff are horrible. RNs have virtually no quality assessment skills. If they have a problem, they call 911! One "Nurse" joked, "I don't use any of my nursing skills" Very funny, until a patient dies.
2. Understaffing
3. They are in it purely for profit. That being said, they do not honestly report issues, such as HAIs, Falls, etc.
4. Overall, hygiene 101 is so lacking, it's a disgrace. I observed Doctors and nurses not washing their hands before examining patients.
5. Most of the staff have become so complacent, that they just don't give a shit.
Overall, nursing home staff are some of the worst around; they complain, berate patients, and ignore dignity. I have friends claim they are nurses, but work in nursing homes-- I call them glorified babysitters. Actually, I would be wrong-- Babysitters actually change diapers.

12:40 PM  
Anonymous Anonymous said...

People fail to see that the nursing homes that are horrible is because of the staff. There are places out there making only $2000 a month profit, less than what a nurse makes, and cannot afford more staffing. The government keeps elevating the paperwork and decreasing the profit. Where do you think this leads?

But keep complaining that YOU don't respect the workers or wanna work hard, that will solve it for sure.

11:41 PM  
Anonymous Anonymous said...

I work at a nursing home and will tell you it is the corporate office that refuses us to work with bare minimum staff in every dept. I am a Director of my dept. but that means nothing. I have talked, encouraged the Administrator, etc. to do something about and told it will not happen. I will leave after finding new job, probably after the first part of Jan 2014. Cannot take it anymore!

11:32 PM  
Anonymous Anonymous said...

Hey now,
I'm a LPN at a nursing home and the job sucks the life out of me. Not the the patients, because it isn't their fault that they have to be there. I'm talking about working back to back doubles, and then receiving a barrage of phone calls and texts from administration asking you to come in and work another double. I am responsible for the medication and treatment administration of almost 30 residents, and I have 2 aides on my hall, which means I am toileting, transferring, and putting residents to bed before they try to get up and do it themselves. If someone falls, I'm doing neuros every 15 minutes for 2 hours. I became a nurse to care for people, and I have so little time to do that it makes me sick. Don't label nursing home staff (nurses and aides) as glorified baby sitters, because I guarantee my 8 hours is far more stressful, emotionally draining, and backbreaking than you can imagine.

11:58 PM  
Anonymous Anonymous said...

Hello everyone. I have been working in nursing homes for the past 8 years as an activities director and can say that they are all the same in terms of being rotten. Understaffed..underpaid...you name it they have it. Nursing homes are no place for good clinical staff to make careers at. I have a degree in recreation and decided to make my exit by going back to grad school and majoring in healthcare administration. I have no intentions of ever applying back to any nursing home jobs. The lack of care from administration, the lack of team work, the lack of supplies, high turn over rates.. Ive seen it all.

2:35 AM  
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8:54 AM  
Blogger RN21 said...

I have been an RN for 21 years and 12 of those years have been in long term care. I love it! My residents do not lie in urine and feces for hours, they are turned changed and re positioned at least every 2 hours. What I can say to you all if you hate then you need to leave or you need to make a difference, not just complain about it but do something. Work with the CNA's, set a good example, others will follow your lead. Don't be part of the problem be the solution

6:46 AM  
Anonymous Anonymous said...

I have to say as a CNA in a long term care facility that all homes are not created equal nor the quality of the cna doing the care. Often the CNA's are stretched so thin that its all they can do to get the work done due to high job over turn, lack of staffing and money to staff, state regulations allow more patients per cna than is actually possible to do depending on the type of care. SO be careful when you lump all people together, that's like saying all doctors are good, all cna's are bad, all cops are pigs, just not true. Be glad there are people out there willing to do this job at very little pay and poor working conditions. Most health care workers have back issues that they pay for, for the rest of their lives not to mention stress and other health issues directly associated with the work. I am a proud professional CNA and have been for over 9 years. I give it all I got not my fault everyone else doesn't.

9:00 PM  

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