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The text that I’m including in this post — blue, italicized text — is compiled from the comments of various nurses who visit this blog. By editing the comments of several nurses together and leaving out names of facilities (and other intimate details) I hope to protect contributors from retaliation by the nursing homes where they are employed. One thing is for certain: telling the truth (as these nurses have done) about problems in nursing homes is a one way ticket to unemployment. So protecting the identity of all nursing home staff who contact me is a high priority for me.

What nurses working in the nursing home industry have shared…

Nursing in a nursing home setting is not  for the light hearted. I recently became a nurse. These days nursing can be a very sad profession to work in. While I frequently think about quitting, what keeps me going is the love I have for my residents. I truly enjoy the little bit of time I get to spend with these precious individuals.

I’m working for one of the all-powerful for-profit nursing home chains. In spite of the current economic hardships they manage to flourish financially. “How?” you may ask? One way is that they bring in headhunters to fire every employee they can — holdovers from previous owners. Then they bring in their own people to take care of the residents. These people are very business minded, but not very caring. They are more concerned about the (financial) bottom line than about providing quality care for their residents.

Meanwhile residents suffer. No friendly faces (with the revolving door employment situation). No one who knows how to make their tea or who has been around long enough to really know their personal preferences or interests. No one to position them just right so their arthritis doesn’t hurt while they are watching TV.

Further, these corporate suits come in and decrease staffing levels that were inadequate to begin with! In my facility they have one person over laundry, housekeeping and maintenance — eliminating two positions. This means that not enough staff are available to keep up the building. Rooms are dirtier when there is only one housekeeper for the whole building. Residents go without clean clothes when they have an accident. The laundry staff is lucky to get all the linens done and delivered for 200 residents with only two laundry aides, let alone doing resident’s laundry in a timely manner.

Nursing home management often insists on changing resident’s doctors, professionals who have been in place for years. These doctors know the residents and their medical history. Nursing homes often hire very young nurses and place them in positions of power.  New doctors and new nurses go along with the big corporation’s rules, placing corporate profits above compassionate care.

Then the nursing staff-to-resident ratio (for both nurses and CAN’s) in our state is a real problem. The nursing staff can’t keep up! Meanwhile this company is making money hand-over-fist, buying the administrative staff “iphones” and redecorating the facility. High tech gadgests and designer décor should never be more important than maintaining appropriate staffing levels! Cutting back the time that the nursing staff can spend with our residents is not good for resident care! Priorities, please!

With such horribly inadequate staffing levels, resident care truly suffers.  Taking care of that many needs of the residents, including knowing their medical diagnoses, allergies, keeping track of doctor appointments, their quirks and mannerisms, and their baseline behavior so I can tell if something is not right – all of these things along with doing the paperwork required by the state and facility – truly make for a heavy workload for the nursing staff.

An answer of “I don’t know, you see I didn’t get to spend much time with our residents because we are so busy due to short staffing” isn’t going to make a good impression in a court of law.

When the “priority” in running a nursing home is anything other than resident care, obviously nursing home residents suffer. The priority of maximizing financial profit is NOT compatible with the priority of providing quality care. Sadly, especially in for-profit facilities these days, the quality of care is bad to downright pathetic! Truly “bean counters”need to be run out of the nursing home industry!

The dedicated nurses, CNA’s and other nusing home staff also suffer when greed trumps care. Understaffing, clearly a problem rooted in corporate greed, adds to stress for those caregivers who want to provide quality care but aren’t given enough time to do their job right.


As always, I’m very moved when I receive a message from individuals who have worked or are currently working within the nursing home industry who basically confirm what I already know about the pathetic problems with nursing home care. Their insights help me to better understand what is going on and their courage to speak out — albeit anonymously through this blog — give me hope that one day (hopefully sooner rather than later) the quality of care will significantly improve!

I received one such message from a former nursing home Administrator within the past few hours. She wrote…

I am a nursing home administrator who has left the field. Let me tell you why. I’ve gone into several buildings as the new administrator and I came in like a lion. The facilities were filthy, the care was substandard — even scary — and the staff was crude and rude.

I made the managers walk the halls and help the overworked nurses pass medications. I made the Certified Nurses Aide’s help activities to get residents to the cafeteria to enjoy the entertainment. I gardened, painted, spent my weekends there, dragged my husband in to mulch and fired a whole kitchen staff who were stealing.

Guess what? The managers made up stories about me to corporate. I wasn’t “liked” I was told. It is important that I be “liked” by the managers ,my corporate boss said. I was told to back “down” and “back off”. I was going too fast. I asked him to interview the residents to ask them if I was going “too fast”.

I changed buildings around and even got high fives from state officials as to improvements — but I got fired for riding managers to do their jobs.

Here are the facts. The good administrators leave, the bad ones stay. What do I mean by “bad”? They never leave their office, they listen with a smile as residents and families complain — then do nothing because they don’t want to make waves with nursing and management. Their job is to simply keep costs down . . . Period. The Director of Nursing really runs the building, which means she supports shortcuts for staff and management. If she didn’t she would be rode out the way a good administrator is.

When I went into the field I wanted to make the world a better place. Boy was I a fool.

In a word: WOW! This former administrator — truly one of the “good ones” — tells it like it is. I’ve known at  least one such “good administrator” (or at least one that went out of her way to improve the quality of her resident’s care). She too was HATED by her staff. How dare a nursing home administrator show up at 5:00 am to personally check out complaints she had received about third shift staff?!?  How dare she take seriously the concerns of family members about their loved one’s care?!?

The former administrator’s words give us true insight into the dysfunctional culture of the nursing home industry, serving as a reminder WHY we nursing home reform activists MUST keep the pressure on our legislators and the nursing industry.If we don’t keep u p the pressure on the corporate goons and politicians NOTHING will change for the better!

Nursing Home News Watch

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