Nursing home nurses can make you scared to live in there

Nursing home nurses can be Scary People Sometimes


There are some nurses working nursing homes who are caring and compassionate people, unfortunately they are usually few and far between. For the most part, many of them say and do things that are what I could only describe as ‘scary.’ For example; the DON of the nursing home decided a woman with dementia was a ‘disruption’ and needed to go out for a psychological evaluation because she kept removing her shirt in the hallway. This concept of going out for psych evaluations always made me cringe because if people have dementia, going out for a psychological evaluation usually meant the facility wanted them drugged. Why anyone with dementia would need a psych evaluation is beyond me. I had to make arrangements for this because the Administrator and DON were adamant about ‘sending her out.’ When the resident returned to us, the hospital where she had been sent for a psych evaluation called from their Social Services department and said this lady would remove her clothes when she perceived she needed to use the bathroom. Again, this observation may have been noticed if there were permanent assignments given to staff. When I relayed this observation to the Director of Nursing (DON) her comment was; “Why would she take off her shirt to go to the bathroom?” People with dementia, as mentioned previously, remember bits and pieces of how tasks they used to perform are carried out. A person with dementia will ‘remember’ something has to be removed to use the bathroom but cannot always recall what article of clothing is removed. Since the shirt was the only clothing she had easy access to, she probably felt, in her own mind that the shirt needed to come off. She was not able to verbalize any longer what she wanted or needed. The fact the DON made such a remark made me think she expected dementia residents to ‘understand and think normally’ in every situation. Extra staff for dementia residents works much better and is healthier for the resident than psychotropic medications.


sometimes

This was a scary concept to me because each and every staff person has training in understanding dementia and nurses should have extra training in it simply by virtue of their nursing license. This is the sort of example that tells me many nurses do not take time to get to know residents either. These are not the kind of people whom I want to care for me when I am old and are probably only nurses for the paycheck alone, nothing more. Many nursing homes rely too heavily on mind altering drugs to control people’s behavior, especially dementia when it has been proven these drugs do nothing for dementia. All the drugs do is control a person for convenience of staff. Those drugs do nothing to improve a good quality of life for the resident using them. Whenever residents were ordered the powerful psychotropic drugs it was usually because a resident had dementia and was combative. Residents with dementia sometimes become combative and cannot help it when they strike out, usually due to confusion or being afraid of not knowing what is happening to them.

good observations go a long way

A couple of other incidents in the nursing home concerned me as well. One of them involved an elderly woman and her husband who, at the time had been residing in the facility for 10 years. At one of their care plan meetings the husband mentioned that every night after dinner, his wife had chest pains when she tried to lay down for bed. The nurse attending the meeting said she would request an order from the doctor for medicine for indigestion. A few nights later the woman was rushed to the ER and she died of a massive heart attack. From most of the literature about women and heart attacks, the symptoms can masquerade as heart burn. The second incident also involved an elderly woman who was overweight and sedentary. I came to work one morning to find out she had gone to the ER and subsequently died from complications of diabetes. This woman was not on insulin and nurses said they had no clue she was even a diabetic. These two incidents scared me because I began to wonder how these medical conditions could just slip past nurses and doctors. Is it because they were elderly and the medical doctors see no need for tests because of their ages, or is it due to nurses not spotting signs and symptoms. Both of these incidents might have been avoided if staff were given more permanent assignments. Perhaps staff, with a more permanent assignment, might have picked up on subtle changes in those women’s conditions, I do not know for sure, but both incidents are scary to say the least. Those incidents did little to exude confidence in a traditionally run nursing home. If families think their loved ones need another opinion and do not like answers given at care plan meetings, they need to inquire further and maybe even obtain another medical opinion. I do not care how old anyone is, everything possible should be done to ensure a person’s health is taken care of. The first woman should have been given an EKG to rule out heart disease and the second one should have been given a diabetes test due to the fact of being overweight and sedentary in her lifestyle. As mentioned before, most often the LPN’s and the RN’s hired in nursing homes are often sub-standard compared to those hired by hospitals.

the bottom line syndrome in nursing homes

This is usually due to nursing homes wanting to preserve their bottom lines. Private owners have less cash flow to work with, and corporations have to show a profit for stock holders. In either case, saving money and making a profit can translate to short changing the residents of the facility in many ways. If wages were increased, nursing homes would be able to attract a higher quality of worker which would translate into higher quality of care for those living there. Better care would also result in less abuse and less cutting of corners concerning goods and services. The really good nurses in nursing homes are few, they exist and when they are found they generally the ones who are expected to do a good share of the work, making them exhausted. Whenever a person from my department would answer a call light and a resident needed something, usually the nurse at the station would tell us it would get done as soon as an aid was available. This is ridiculous, at best. Nurses are trained to do the same tasks nursing assistants can do, and then some. This is a sign of lazy nursing when they think they are there to do mostly paperwork and nothing else, except dispense some medications once in a while. The facility where I worked had probably three really good nurses and the director of nursing was not one of them. This particular facility was only concerned about the bottom line and so was the administrator. This was a place where the term ‘team player’ only meant you were in the pocket of the administrator, I saw many good people who had been there for years, go out the door like smoke. The administrator never got it, the owner never got it, and probably still do not get it to this day. It is a sad thing when people are a commodity and the bottom line is valued way above customer service in nursing homes.
Sometimes I envied the nursing department as theirs was a cut and dried and black and white world, pretty much. Medical training does not have as many shades of gray as Social Work tends to have. If a resident did not fall blindly into place in attitudes and behaviors, once entering the nursing home, then it was a problem for Social Services. Nurses were best dealing with that ache Susan has, or the loose bowels Marvin is dealing with. Sometimes I envied their neat, tidy and medically ordered little world of mostly black and white problems. Problems that seemed to be easily solved with this pill or that shot, into the correct area of the body. It is a bit harder to heal a person’s mind and soul when this new, strange place does not resemble home or even look anything like a home should be.

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Comments 17 comments

Jackie Lynnley profile image

Jackie Lynnley 4 years ago from The Beautiful South

You said a lot and I know it all. I went through years of this with my mother and all they do is dope them and pack them in a bed or corner in a chair with feet dangling half the time, losing circulation and causing them even more distress. I hate nursing homes with a passion and sometimes as I have personally witnessed in one city two considered outstanding hospitals have the same resentful type caregivers for Dementia and Alzheimer's patients. Something needs done quickly, this is so wrong, although it is too late for my mother.


FloraBreenRobison profile image

FloraBreenRobison 4 years ago

The nursing home with Grandma is a nightmare. It is indeed scary. Mom and I are both under a lot of stress over this. I wish I could take all the stress away from Mom and take it on myself, but that is not the way it works. Mom and Grandma have both gone through so much garbage in their lives that I would love to solve everything for both of them.

like Jackie's mother, the situation is too late for Grandma, but I wish that these people could be punished.


BobbiRant profile image

BobbiRant 4 years ago from New York Author

Jackie Lynnley: Yes, nursing homes, traditional ones anyway, can be scary places. Generally nursing homes do Not get the cream of the crop in nurses. I'm sorry to hear you had a bad experience with one. Thanks so much for commenting.


BobbiRant profile image

BobbiRant 4 years ago from New York Author

FloraBreenRobison: I hear ya! But there are Culture Change nursing homes, the only ones worth the money, in my book too. But things can be improved in traditional nursing homes with enough pressure from resident's families. Thanks so much for commenting.


lmmartin profile image

lmmartin 4 years ago from Alberta and Florida

I've seen the inside of a number of "assisted living" facilities here in this area due to my work with the elderly. Some are wonderful, set up like hotels with lovely dining rooms, waiters in uniforms looking after the residents, great nursing staff, cozy and comfortable rooms, cheerful and solicitous care -- for those that can afford all this, and others that would make a public school look luxurious, for those on Medicare/Medicaid. It is in the second I see most of the abuse: residents drugged out till all they can do is slump in their wheelchairs all day, left sitting in soiled clothes for hours, complaints left unattended, overworked and grumpy aides who toss the old bodies around like slabs of meat... And there are many other facilities that fall in between these two extremes, in all ways.

Thanks for this insider's look. Lynda


Liz Walmoth 4 years ago

I have sadly found the same incidents have occurred in my own work in nursing homes. Nursing is a very task-oriented profession, very black and white as you put it. I obtained my nursing license but did not go into the profession because of what I saw and I am still trying to help those most vulnerable. Nice hub and well explained.


BobbiRant profile image

BobbiRant 4 years ago from New York Author

Liz Walmoth: Hello and welcome to my hub. Yes, for the most part, society ignores the elderly. We have become a society that seems to be oblivious to social issues. I agree, when seeing what goes on in nursing homes, we see all those government 'regulations' are a big joke. Thanks so much for commenting.


d.william profile image

d.william 4 years ago from Somewhere in the south

As a retired RN, reading this has brought back some vividly nasty memories of my years of dealing with the ineptness of the nursing home environment. Some of those D.O.N.s are not even nurses, they are just given that title. The majority of nurses working in these places could never make it in a hospital or acute setting, or anywhere else that requires common sense.

I fought for years to get better staff/patient ratios, for obvious reasons. I found many nurses who passed their state exams should never be in this profession - mainly because for some people passing tests is easy, but using common sense, and logic, will never be one of their strong points.

Your comments about maintaining staff stability for continuity of care was also one of my greatest gripes in this profession. The people in charge have only one thing in mind: a nurse is a nurse, is a nurse, etc..; and thinking this way causes more patient problems than you can ever imagine. Putting "float" staff in any environment for one shift or so, is one of the major causes of nurse errors being made. Especially when those in charge are unqualified and inept in management skills to oversee them properly; (the dumber they are, the faster they advance, the longer they remain in those positions, the greater amount of money is saved by management because dumbness requires less pay).

I could write volumes, but what's the use? Until nursing/medical professions are treated as professionals, and as long as the administrators see only the profit margins instead of the people they are caring for, noting will ever change.

Greed runs America, and anyone who gets stomped on in the process of greater profits are only considered collateral damages to those "extra special wealthy elite" who run it all. Hoorah for capitalism!!


BobbiRant profile image

BobbiRant 4 years ago from New York Author

d.william : Hi! Yes, I agree that money is the object not the quality of care. Those nurses though who were very good, I just adored their integrity. Great comment. Thanks so much for sharing this.


DREAM ON profile image

DREAM ON 2 years ago

The families who have a loved one in the nursing facilities and spend more time seeing them keeps the staff and the nurses on their toes. Many times they have no family and have nothing left because whatever money they worked their whole life for is now property of the Nursing home. I have great respect for those who work in the nursing homes they deal with sick and miserable people many times. They also have to treat their patients properly. You wrote a terrific hub. This could lead to many future hubs.


BobbiRant profile image

BobbiRant 2 years ago from New York Author

DREAM ON: Thank you for stopping in and reading my hub. I've literally written the book on this subject as it is near and dear to my heart. I'm pleased to meet you and I appreciate the comment.


Bonnie Foster 18 months ago

I am a Long Term Care Consultant...Do you have any idea that we are the most regulated industry in the country? Do you have any idea that we are going through a tremendous change with Culture Change and Resident Centered Care? I would like you to spend one day with me and see what it is really like - How dare you write a book based on your experience without a knowledge base.


d.william profile image

d.william 18 months ago from Somewhere in the south

Bonnie:

Granted that there might be some facilities that do provide 'adequate' care for the elderly, but the majority falls within the perimeters described in this article. As with most every other institution in this country those with money to pay for the best care actual get the care they need.

Nothing has changed over the past 40+ years for those without the financial means to get what they can pay for. There is still inadequate staffing ratios and untrained personnel caring for the elderly in the majority of long term elderly care facilities.

Even the new physicians have limited training in the subtle differences between treating the elderly versus the "average" person.

And yes, it still rings true that those who minister health care in nursing homes in general are substandard in their respective professions, whether one wants to say it out loud or not. As with anything else in life: denying that a problem exists does not make it disappear.


BobbiRant profile image

BobbiRant 18 months ago from New York Author

Bonnie Foster: Yes, having worked nursing homes for more than 25 years, I am quite familiar with the regulations. Nursing homes are second in regulation, Only to Nuclear Power plants. But stupid regulations and throwing money at a problem does Not solve the problem. Why? It is Still the Medical Model when it should cater to those paying $1500 and up, per week, Not cater to the convenience of staff only. Culture change facilities DO fly in the face of stupid regulations and DO care about the people who butter their bread. Did You know a survey indicates 98% of elderly people would rather be dead than live in a traditional nursing home?


BobbiRant profile image

BobbiRant 18 months ago from New York Author

d.william You are correct. Some people think elderly problems are solved from text books. LOL I do not fit into a textbook. My knowledge base is from observing for many years and working nursing homes. Adequate care is not enough when asking people to pay huge amounts. Do not kid yourself, anyone, nursing homes ARE a Billion dollar industry. Corporations, doctors and even lawyers would NOT own so many if it were not a big profit. Thanks for your great comment.


Fed up nurse 16 months ago

Until you've walked in my shoes! I know many nurses who've left the hospitals to go to nursing homes to be in a more family like work environment verses the cold, sterile hospital. Nurses go to nursing home for better schedules. They go for more money. I personally left the ER, ICU (hospital) for many reasons, including the ones above. Not to say there are not any "bad" nurses, just like any other profession there are "bad" dentists, doctors, lawyers, police, teachers, etc. To say nursing home nurses are substandard is ludacrist. The first thing a nurse learns in school, is delegation. Of course she can do the jobs of the aides, but if she is doing their jobs, who's doing hers? As a hospital nurse I had 1-3 patients. As a nursing home nurse I have 30. Substandard? I think not! Maybe you should walk in nurses shoes before you criticize . Those who can't nurse - write ;). PS: A nurse can suggest labs, tests be done on their patients, but ultimately that is determined by the doctor and insurance company. Nurses take the blame for our own shortcomings and those of most of the other staff as well.


BobbiRant profile image

BobbiRant 16 months ago from New York Author

Fed up nurse: I did not say All nurses in traditional nursing homes are awful, but some can be. Funny, but Many nurses certainly thought They were Social Workers....well...nurses do Not have the exact same training as Social Workers so I could say the same. Thank you for your comment.

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