Tuesday, August 08, 2006

lets try again

My last post sounded so angry and derisive toward other groups of nurses...and I in no way meant it. I've read on and looked some more and still have found no other LTC nurses...oh and I'm not just talking here...other blog sites as well...so maybe for many folks out there nurses and non-nurses alike an introduction is in order.

First of all about me. I'm 31 years old. I recieved my BSN almost 10 years ago and have been practicing nursing since passing my boards a couple of months later. I have worked agency nursing, PRN school nursing, hospice, private duty, med-surg, ortho, and LTC. I'm the mother of two wonderful daughters and an amazing step son (who has survived his mother for the last 8 years which is a freaking miracle). I'll probably post about them, because they and the rest of my family are a huge part of who I am...and who I am is a huge part of what kind of nurse I am.

My mother died almost 6 years ago of brain cancer. She was also a nurse. She started off as an LPN and went back to school and got her ADN when I was a teenager. She was profoundly mentally ill...and a psych nurse by choice.

I work a weekend program so i can be home with my kids during the week.

okay so you will learn more about me as I rant on.

Now let me introduce you to LTC or long term care nursing. LTC nursing is what used to be nursing home care. But no longer. Very frequently besides grandma with her walker and its obligatory basket or grandpa scooting through in his wheelchair, many facilities have added rehab to our list. And we do "skilled nursing" now.

Don't get me wrong. LTC, by any name anyone has ever used, required certain skills, but now we have duties that once upon a time were called "acute care." But any of you who know nursing and medicine, know that patients are being pushed out the hospital door faster and faster...and to us they are sent.

Now the facility I work in doesn't do IVs even for hydration. That is a huge change for me...they also don't accept trachs or vents...I mean WOW!!!

LTC specific regulations vary from state to state, but most of the time there is only required to be one RN in the building...and that RN gets the title of supervisor slapped on to her and may be responsible for 15-60 of her own residents, 150+ residents in the facility, however many LPNs and CNAs are currently working...that RN is usually responsible for scheduling adjustments and covering call outs...which is complicated by a unique calculation called a PPD...which is a subject of a blog all its own.



allright I have typed and wandered through the internet long enough... I slept about 4 hours and then was up...I'm hoping for a little more sleep before my kids get up in the morning...looks like I'm back on the insomnia kick again...so feeling drowsy and am going to take advantage of it...

Monday, August 07, 2006

well what do you think?

Well i'm looking through all these nursing blogs...and i can't find a single one about LTC...those of you who know it, are it, why aren't you talking? Are you afraid? Has this area of our profession been so degraded by doctors, the public and other nurses that we are afraid to speak out? Well we do a D#### hard job.

There are so many nurses who come to LTC to "retire" or for less stress than acute care...or new grads who want something "easy" to start out. Who the heck do they think they are? We loose more of them than we ever get to know...Many of us have become gun shy of investing ourselves in these "new LTC nurses" ...heck work in LTC long enough and you will know everyone in your local area who is a LTC nurse...we just move from place to place...very rarely is there a "new face" that makes it in our little subculture.

ICU nurse comes in...WHERE IS MY CRASH CART and MONITORS?
ER nurse comes in ...WHERE ARE MY SUPPLIES?
Rehab nurse comes in ...WHERE ARE MY THERAPISTS EVERY DAY OF THE WEEK?
ANY ACUTE CARE NURSE comes in ...where is my 24 hour a day lab? WHAT DO YOU MEAN 2 HOURS IS A STAT MED DELIVERY?

We work without bells and whistles...we carry patient loads of 15-60 patients depending on shift...we see decubs, MRSA, VRE, peg tubes, trach, piccs, CVC, grieving families, angry patients, we are cursed at, we are spit on, we are bitten, we are hit...and its allowed because it is there home...and btw...they are "residents" not patients

But we get hugs, and thank you...we know people and they bless our lives...people don't become their illnesses...and most of the time it is a privilage to work with the elderly, demented, mentally ill, and disabled.