Because of the length of my commentary I will be dividing it into three parts. I hope you find it informative and useful.
My writing this piece is a purging for years of frustration. I am an RN, and I have been for over thirty-one years. I grew up in
Long Term Care (LTC) and my children were raised in the environment also.
My family built and ran LTC facilities. I have worked at every job in a facility from laundry to cook, NA, CNA, and Director of Nurses. Later in my career I was also a LTC surveyor in two different states. So you can see this particular topic is near, and dear to me.
My LTC background started at a time when you had individual run homes. You did not have the large corporations coming in and buying several in a state or across the country. You still had good homes and bad ones. Trying to make the all mighty dollar would drive a lot of issues.
The LTC facility I was first involved with was Regency House Nursing Center. It was owned by my uncle and my mother was the administrator. As I grew up, as I mentioned before, I did every job in the facility at one time or another. I knew how things were suppose to be done. Over time I became the Director of Nurses. It should go without saying the administration and myself had a very direct line of communication.
The first rule in that home was, you had to give good care. All of the patients were like family members. Even the poor souls who no longer were themselves. You had all the personalities from the very aggressive to the very meek. It was a family, and I lived with that family for ten years. I watched people I cared about leave this world and new ones would come in to take their place. It was a cycle of life.
We had annual state surveys, that nursing always did well at. They might find a medication not being initialed, but the patient care was excellent. The building always received the same deficiency every year, but there was a waiver to cover that particular issue. Everything ran smoothly, and the patients were happy.
The food was good and fresh for three meals a day. The menu was catered to the farming community the patients came from. Diet guide lines were followed for the most part, but the bottom line was the patients were happy with the food. You also must know, there is always someone who doesn’t like something. The fact that the food can’t be seasoned properly with salt caused a lot of unhappiness to be voiced.
Then of course you always have the hard to please family members. You know the one’s that every member of the staff cringed when they came through the door. Absolutely, nothing you did, or tried to do made them happy. It didn’t matter if you had
seventy other people who required care. If Mom or dad wanted something right now, then right now they should have it. Life in a facility did not and does not work that way. Luckily those family members were few and far between.
Since that time, let’s say from the mid 1980’s, multiple cooperation’s have bought up the LTC facilities and have also built many
more. I feel the majority of Administrative staff in today’s homes want good quality care. The problem as I see it, is the cooperation’s bottom line has to be money. So everything is maintained at the bare bones level and if you talk to them about
staffing the words will come out such as “we have more staff for the amount of patients we have, than what is mandated.”
Staffing a facility is a constant changing nightmare, for a number of reasons. Once again you are dealing with all different types of people and their personalities. I believe the majority of the personnel in any facility want what is best for the patients they care for. This goes from the maintenance person, to the nurses and CNA’s that are working directly with the patient.