I'm tired of being abused and misused in nursing homes or as they say long term care faucilties.I'm a LPN in Memphis,Tn.  The hospitals in Memphis,Tn. are no longer hiring LPN's.  Many LPNs have to work long term care just to have a job.  Hospital nurses have 6 or 8 patients at the most.  In long term care I have 30 to 35 patients. One faucility ofered me $20.00 an hour for a 11-7 shift prn ICF floor prn with 60 patients.  This is just to unreal to me. How,can  I be responsible for that many people?  Who or where can the problem be addressed ?  At the end of a shift my feet and legs hurt, to mention my back.  I hear other long term caregivers complaining to.  But, nothing is being done about it.

I don't know if you want to move or travel but Alabama hospitals still hire LPNs at least the smaller hospitals do.  I am looking for another job at this time and I have found several that want LPNs.  Working in LTC is hard and the work load or patient load can be to much at times (been there and done that).  Good luck just keep trying.  As for as reporting goes I'm not sure about that.

WELL HELLO TO ALL U NURSES OUT THERE! IM IN MISSOURI AND HERE THE LTC HIRE BOTH LPN AND RN  BUT THE LPN DOES LITERLLY ALL THE SHIFT WORK AND THE RN PRETTY MUCH JUST SUPERVISES. U WANT TO TALK ABOUT MINIMUMS  IM A CNA/MED TECH IM ONE STEP UNDER THE NURSE ON THE FLOOR  WEVE RAN I NURSE I TECH AND I CNA ON A EVE SHIFT BC THE OTHER 2CNAS WENT HOME SICK AMD THAT WAS AT A 110 BEDS! THE CNA AND I BUSTED OUR ASSES FOR 1WEEK WORKING THAT WAY BC NO ONE E LSE WOULD WORK THE FLOOR NOT EVEN OUR DON OR ADON WE WERE TOLD JUST DEAL WITH IT   THAT MEANS I PASSED MEDS THE DID SHOWERS PASSED SERVE FED AT SUPPER MORE MEDS MORE SHOWERS AND WHAT EVER ELSE CAME UP ETC>  USUALLY U HAD 2 TO 3 AID TO 20 RES A NURSE AND TECH PER HALL  THAT WOULD BE ON A HIGH STAFFED DAYOH AND DURING THAT BUSY WEEK THAT WE HAD NO HELP WE HAD A FIRE BREAK OUT(NO ONE HURT AND EVERYONE EVACUATED)JUST W 2 OF US AND A TORNADO CAME THROUGH TOWN ALSO RIGHT AT SUPPER!!

Lack of staffing.  Watching the bottom line.   Staff who will only go so far to help out.  Risking safety for the sake of the greater good.  Lack of skills.  Demands ever increasing.  More aging people than ever before needing help.   Where does it end??????     Health care is a constant in society and will only increase in scope.   It is not a luxury but a necessity.  It has been used and abused. BUT no longer.  Sufficient staffing,  Reduction in profiteering.   Involving families in the care of their loved ones.  All are integral to establishing a system that meets the needs of those who require health care at  a critical time in their lives without compromising the future of those who serve them.   Lip service won't suffice.   Quality standards and practises must be met at ALL TIMES!  

I'm an RN working in an ICU unit.

I to am an LPN, work in a LTC care facility for about 3 years.  We were always short staffed and when they started water down the juice, myself and the nurse on my unit would bring in our own for the patients.  That was the last straw and I left shortly after that.  I got lucky and applied at a hospice and worked in crisis care, where you have one on one with a patient for the full shift.  As it turned out this was not for me, to boring.  The Hopsice I was working for did not use LPN's to do home visits, eventually I applied tp another Hospice where they do utilize LPN's to work in the field, I love it.  I am returning to school at this late time in my life, I want to get the respect and pay I think all LPN's deserve.  I currently am working in the triage office taking calls and trouble shooting, I love it, and the hours are working out well with school.  Good luck to all the LPN's.  I think if able and the time is right go back to school for your RN.

 What that facility is doing to its nurses is morally reprehensible and probably illegal!  Each state's Department of Health has strict guidelines for nurse/patient staffing ratios in both hospitals and LTC facilities...some are worse than others.  I would lodge a complaint with your state's LTC facility certifcation personnel and another one to your Labor Relations Board.  Another idea is to "leak" your story to a local investigative reporter for a newspaper or TV station.  Remember, if an error or patient incident happens, it will be your license on the line.  Don't do this to yourself and your professional reputation.

Good Luck!

S. Lamond, RN-BC, BSN

I work in long term care and routinely have 42 patients on my hall. It is very difficult to give my patients all their meds, treatments and wound care; without taking into consideration all the times I have to take people to the bathroom, talk to family members, answer the phone calls, count in medications, and chart. We have too many patients and we can not do the excellent job we expect out of ourselves with that many patients. Even with "full staff" hours of CNAs (the best ones are worth their weight in GOLD!) the task is extremely difficult. A good night is when no one falls, gets a skin tear, you did not get a break-let alone eat dinner, but you charted, gave all your meds and you only clock out 30 minutes late (that takes care  of the dinner break you get charged for that you didn't get to take).

There are certainly a lot of good and bad holding hands with this subject. I am a Director of Nursing Services in a long term care facility. I understand the necessity of increasing staffing ratios, but my hands are tied when corporate headquarters cuts me back to mnimum State required ratios. If the state doesn't raise the reimbursement rate as well as the ratios we will never get anywhere.

In todays nursing world it is hard enough to cover your tracks. The amount of documentation required in long term care is astronomical. I have argued with my CEO regarding staffing of licensed personnel on the evening shift. Traditionally there are less licensed personnel and a greater nurse to patient ratio. In my state the ratio is 42:1. My argument to the CEO for a trial increase in licensed personnel was the number of falls, resident complaints, visitors, wounds, weight loss and physician rounds , sundowning and decreased non licensed personnel. I requested and was granted an increase in licensed staff personnel to decrease the nurse patient ratio to a load of 21:1 with an increase of 2 non licensed personnel for every licensed nurse for a period of four months. My challenge was to prove that an increase in staff would reduce the overall care costs, complaints, investigations, and legal issues by decreasing falls, wounds, weight loss, behavior outbreaks, increasing attention to individual residents and families, addressing pertinent issues with rounding physicians and decreasing employee stress and potential injury.

That was 2 years ago and my staffing increase is continued per the CEO today. The goal was to decrease costs and we did that significantly. The corporate office gauges everything by the bottom line. It can be done but it takes an open mind and a focused team. 

Ann

"Where is your personal and professional fortitude and courage to stand up for your nurses and yourself! "? What is this? If I went over the owners head  to the state as you suggest, my "vulneralbe patients" are certainly not benefiing. My overworked and underpaid valuable staff are ther taking care of these vulnerable patients because they are dedicated and loving. Most of all if I quit as you suggest then where are they? What have I done to try and alleviate the problem? If I simply complain to the state where does that get me, my staff or my patients? Why not start with what I do have power to change? Why not petition the state certification agency for an increased nurse  to patient ratio regulation? Why not petition the Federal Department of Health and Human Services for a statutory federal regulation increasing the staffing ratio? But give up and quit to find another job???? I think not. I guess I ask a similar question Where is your personal and professional fortitude and courage to stand up for your nurses and patients? If you don't fight for them who will?  I guess I don't consider it  just a position. I have been on the receiving end of a complaint lodged with the State Department of Health, the verdict the State ratios were met! The problem is with the State required ratio ! You can not lodge a complaint with a regulatory agency and expect to get anywhere if the facility is meeting the regulation!

Kittyrn,

I agree. That is precisely what I am talking about. The facility is going to do absolutely no more than is required. I have witnessed many such incidents of disreputable behavior by facility practice such as you mention "I've even seen pt's lose their beds, because their families called state.  They just wait until granny goes into the hospital and suddenly bed gone...we couldn't hold it..sorry." I have witnessed many great nurses lose their jobs for voicing their opinions. I also agree whole heartedly with you that when state is coming some facilities will change their whole routine! My philosophy is do the same as it is supposed to be done all the time and don't worry about who comes in the door.

I do not agree with the regulated ratios. Even if the facitlity meets the requirement they may be unable to provide care to meet the quality of care regulation. However my concern is for the patients too. Who takes care of them if all the nursing staff decide it is endangering their license to care for them? I would certainly not ask any nurse, any where, any time to do anything that would threaten her license. There has to be some solution that is acceptable. In the long run if the facility can not staff then they will close and the patients are the ones that lose their home.

I beleive the turnover rate has a great deal to do with facility functioning and is representative of the facility philosophy and practice. If a facility is not caring for their employees, who are able to leave, then what is happening with their patients who can not necessarily leave.

This is why I will not work long term or skilled care ever again! The senior care in this country is horrific because of the poor staffing ratios mandated by the powers that be.