Long Term Care

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This topic contains 7 replies, has 8 voices, and was last updated by  TravelingWiscoRN 4 days, 7 hours ago.

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  • #6077


    It’s the weirdest thing out there. So rewarding. So messed up. To fill beds and make more $$ we now have a mix of just about everything. LTC residents, variety of rehab, hospice, respite. Fortunately I am not in one of those “those” facilities that has one nurse to 30 or 40 beds. 20 per nurse but only a charge on day shift if they are lucky with no HOC on any shift. Admissions are done by us floor nurses most days. Management thinks we are way more awesome than we are and can handle anything.

    The 80’s yo who decides they are now full code after a stop in med/surg and who refused intervention for troponin of 1.4 in the ED. PRN’s. Sudden changes in condition for the “stable” patient. Hospice. Increasing paperwork.

    I know what doesn’t kill me make me stronger, but holy crap. It’s just getting crazier.

  • #6099


    I’m only about five years in, I work LTC but am a physical therapist. I’ve noticed this trend in the patients I am asked to treat being sicker and sicker and much more medically complex. And also much much larger 🙂

    • #6228


      Nope. ICU nurse here. Same for us. Sicker, heavier, but ratios remain the same and no extra help. My boss actually said in a staff meeting once, “It’s not gonna get any easier, folks!”

  • #6163


    This ain’t limited to LTC!

  • #6195


    CNA here… I work as a private caregiver. I am hired on by families to provide 1 on 1 care for residents of long term care facilities because of staffing shortages. My patients are lucky enough to A) have family who care enough to make sure they get the extra care and B) have the money to pay for the extra help. I see the facility CNAs and nurses as partners in the care of my patients and work to develop a good rapport and communication with them. I die a little inside each time I start seeing kind, compassionate caregivers burning out due to staffing shortages and BS from administrators.

    I have also seen family members harass, belittle and berate caregivers. If your parent is in a memory care unit and tells you that they haven’t had a shower in weeks, you can’t take that at face value! They will also swear you haven’t been to see them in a month five minutes after you leave!

    It is a crime that there are few (and woefully inadequate) rules for staffing ratios at long term care facilities – when you think about the fact that these are human beings and they are paying a SHIT LOAD of money for services that they often don’t receive (because of short staffing). The CEOs of these places should be brought up on fraud charges.

    Stepping down from the soap box. ⚡

  • #6376


    Totally agree the staffing in long term care should be considered criminal. Great 3 part investigative article on the nursing home industry in Louisiana last year: the nursing home lobby is very well funded and very powerful. They make sure they are getting those Medicaid dollars. Our waiver program for home based services is very underfunded as a result.

  • #6403

    AZCase Manager

    There are so many levels to long term care. There are Adult Care Homes, Assisted Living, and Skilled Nursing Facilities. Adult Care Homes probably have the best ratios due to their size. But in these and Assisted Living, you are going to get a non clinical person giving meds to your loved one. Skilled Nursing Facilities are working to change a lot of things. Especially their ratios. This will take a long time, because it takes a lot of money. Which most places don’t have, or don’t want to turn loose of. It is so hard to see families who are struggling with the care of their loved ones. Not many people have the extra money to pay for private care givers. If you pay for 24/7 care, it is about $4000. per month!! On top of their Assisted Living which can run anywhere from $2500-$5000 per month! It is not that most people don’t love or care about their loved one, they may not have the means to pay for the care. Assisted Living is designed as just that assisted. Due to the cost of private long term in a Nursing Home many stay at the wrong level of care far too long.

  • #6439


    I did long term care for 5 years including supervising. I left because it got to the point where I was buried in paperwork and burned out on the expectations. I feel your pain!

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