Most of the messages sent to me by readers of this blog express appreciation for it’s content. But every few months I usually receive feedback that is a little (or a LOT) less than “appreciative” (understatement) of the informaiton and opinions posted on Nursing Home Reality.

As a general rule, most critics of my blog self-identify as employees of nursing homes. They are quick to point out that they feel “attacked” by what I’ve posted. Yet if one were to really understand what is posted here I would hope that 1) I do not paint all nursing home staff as bad or incompetent individuals and 2) I have much respect for the hard work done by nurses and nurses aides who work in long-term care facilities.

My most recent “love letter” comes from a woman who identified herself as a nurses aide who has worked in the long-term care industry on and off for nearly 40 years.  Her comments and my response follow…

READER:
„«  You have so many rules for people who are
„«  willing and able to do a job that you have no
„«  intentions of ever doing, nor are you capable.

BLOG OWNER:
I’ve done my best to take care of my mother.  At the same time, due to my physical limitations and her need for around-the-clock care, I allowed her admission to a nursing home with the hope that she would receive a far higher level of care than I could possibly provide for her. This is NOT because I didn’t care. This IS because I wanted her to receive an appropriate level of care.

Then again, what are you complaining about?  If you work in a nursing home, people like my mother are helping to pay your salary.

READER:
„«  People who work in nursing homes, work
„«  very, very hard throughout their shift!

BLOG OWNER:
Yes, many do.  But from my personal observation, many don’t.  Many (especially those who work nights and weekends, when management is not around) appear to give the LEAST amount of care that they can get by with.

I don’t know the percentages of “good” caregivers vs. “mediocre” ones vs. “awful” ones, but I do know that my mother has often had to wait 30 or more minutes to be taken to the rest room.  On at least a dozen occasions during the 4 1/2 years that my mother lived in and out of nursing homes, I personally witnessed her have to wait OVER ONE HOUR (and a few times OVER TWO HOURS) to be taken to the restroom from the time her call light was activated.  Oh and did I mention the one nursing home that allowed my mother to go 10 to 14 days without having a bowel movement?  That isn’t just “neglect”, that is downright CRIMINAL.

READER:
„«  They max out their bodies lifting, pulling, and pushing.

BLOG OWNER:
Isn’t that part of the job description (e.g., transferring non-ambulatory residents)?  There are Hoyer lifts and other devices to assist the transferring of residents from one piece of furniture to another, thus miniming the wear and tear on the caregiver.  If the facility is too cheap to provide these devices for the staff, that is NOT the fault of the resident.

READER:
„«  They clean up more bowel movement and
„«  other bodily fluids than you have most likely
„«  seen in two years time, many times with the
„«  resident cussing at them and even trying to
„«  hit or spit at them.

BLOG OWNER:
Again, isn’t this part of the job description?  If you don’t like doing the job, please (for the sake and safety of your residents) find ANOTHER line of work!

As to the residents cussing and trying to “hit or spit” at their caregivers, why does this happen?  Could it possibly have something to do with the APPROACH of the caregiver?  My mother didn’t
scream or act out against most of her caregivers.  She usually only
screamed when they raised their voices at her or IGNORED her right to refuse treatment (which she had the LEGAL right to refuse).

READER:
„«  They rush to get 35 or more people up and
„«  cleaned up, changed and dressed, while the
„«  other residents are laying on their call lights.
„«  Many time these are the residents that have
„«  already been cared during another shift that
„«  feel they have not received enough of our
„«  time and attention. It gets very hectic to put
„«  it mildly!

BLOG OWNER:
Thank you for supporting my viewpoint: Most nursing homes are NOT adequately staffed!  Then again, why would you think that it would OK to IGNORE the needs of a resident just because they were given care on a previous shift?  If you are speaking of an 8 hour shift or 12 hour shift, it is NOT too much to expect nursing home residents NEED assistance on EVERY shift, especially if they are not ambulatory or have dementia.  Again, this is part of the job description (e.g., to provide care to every resident assigned to them on every shift, as needed).

READER:
„«  Nurses aides get little respect and
„«  credit from the nurses, who are
„«  often abusive and snippy toward them
„«  (some exceptions though) and also
„«  little respect from resident’s families or
„«  the residents themselves. Low pay, risk to
„«  their health, poop-stainned uniforms and
„«  shoes that they can rarely afford to replace
„«  often enough.

BLOG OWNER:
Again, I TOTALLY AGREE with you.  From what I’ve seen at most of the nursing homes where my mother lived, aides were treated as
second-class (or worse) employees by nurses, nursing supervisors and administrators.  This isn’t the fault of the resident or the family
members.  For the record, I’ve been on the receiving end of verbal
abuse by nurses aides and nurses.  On two occasions during the past
year, after visiting my mother I returned to my vehicle to find that
someone (a caregiver?) had let the air out of one of my tires!  I’ve
also heard from at least one nurse that they have had their automobile vandalized by a CNA that they had written up for bad job performance. I also know of at least one aide that was found to have stolen the property of some of her co-workers.  And I can’t tell you of the number of times I’ve heard stories about nurses and nurses aides who have stolen money, jewelry and other belongings from their residents.

READER:
„«  There are several residents that
„«  don’t belong in a nursing home but
„«  rather in a mental ward, and I am
„«   not referring to Alzheimer’s Disease/
„«  Dementia patients either.  They have
„«  mental issues.

BLOG OWNER:
When were you trained to diagnose mental disorders?  I don’t doubt that some nursing home residents have mental problems other than Alzheimer’s or other types of dementia.  But it is NOT the fault of the resident that they aren’t in a different type of facility.  There are very few facilities that offer long-term care of mentally ill individuals and most insurance will only pay for hospitalization to “stabilize” the mental health problems.  So nursing homes becomes a catch-all facility for persons with both physical and mental disorders.  But that is NO excuse for abuse or neglect of persons who have emotional problems beyond their control.

READER:
„«  If the worst thing a nurses aide does
„«  is to smoke outside on one of
„«  their few breaks, you should
„«  congratulate her!

BLOG OWNER:
For the record, I don’t care if a CNA or nurse smoke on their break –
what they do while on their break is none of my business.  However, as a family member, it becomes my business if the nursing staff are taking an EXCESSIVE amount of time on their breaks, since doing so risks the safety of my loved one.  You are NOT paid to smoke.  You are NOT paid to talk on your cell phone.  You ARE paid to care for your residents.

Again, to clarify, I’ve never claimed that “all” nursing home caregivers are bad or incompetent individuals. I have great respect for the very hard work that many of them do day in and day out.  To be sure, I believe that most nurse’s aides are underpaid given the amount of hard physical work they are expected to do. And I’m totally on the side of  both nurses and nurse’s aides who share my concern about the gross understaffing of most nursing homes. Indeed I hope more caregivers will joing family members like myself to pressure the owners and administrators of long-term care facilities to provide adequate staffing. And, in those states who lack minimum staffing requirements, I hope that caregivers will join me in pressuring legislators to pass legislation that will mandate appropriate staffing levels in long-term care facilities.

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