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Thursday, January 3, 2013

"Nursing Homes" and the nurses, get a bad rap.

I remember my first day of nursing school clinical like it was yesterday.  We, nervous in our white scrubs with our stethoscopes slung around our necks and our 50 pounds of books pulled behind us in rolling bags, met at "the old folks home", as my grandmother calls it.  We received a tour of where we would be doing clinical and our instructor told us on that first night to observe, get acquainted with things, and help out the Certified Nursing Assistants and Nurses in any we could.  This meant helping to feed, helping to bathe etc.

I hated it.  

No one looked happy, not even merely content, and this was disheartening.  Could I work some place like that?  This is where these people live and will continue to live for the foreseeable future and yet they all seemed like they checked out years ago.  There were no activities, they were not engaged, and many of them were too ill to do anything more than sit...and wait.  The level of care they received was adequate; the staff did the best they could; commenting that they were often short staffed each and every shift.

No, I knew then that I could not work in one of these places because I did not want to live in one of these places.  Every clinical day I dreaded returning to that site.  I had a negative experience, and all nursing homes had a bad rap from that day onward.

Today I work in one of those places.  It is not the place where I did my clinical rotation (I will never work there), but it is a "nursing home".  The correct term for where I work, and the term that I prefer, is Skilled Nursing Facility.  I thought I was crazy to apply there with the memories flashing back in my mind of the dreadful experience I had during nursing school.  Today I am glad I made the decision to work in my facility, which brings me to the point, I originally gave "nursing homes" a bad rap and if I did that as a nursing student what do others think?  Well, I recently discovered just that.

A popular internet forum for Emergency Medical Professionals as well other medical professionals had a meme posted that was supposed to be in good spirits that said "Skilled Nursing Facilities:Heaven's Waiting Room".  Then the pile on began which essentially went the ways of "people go to nursing homes and are dead in no time" and "nursing homes nurses are so stupid/incompetent".

Ah, that bad rap I was talking about.  Let me clear up a few things.

I work in a skilled nursing facility that provides care for a wide range of patients.  Some of them are recovering from open heart surgery, orthopedic surgery, amputation, some are very ill and can not go home, some are on ventilators, some are there for rehabilitation and therapy, and finally, we have a population of the elderly that have made our facility their permanent home and have lived there for a decade or more (you have to love those 90+ year old folks).  I did a Critical Care Rotation in the hospital, yeah we have a wing that looks like that.  I did a rotation in Acute Care in the hospital, yeah we have a wing that looks like that as well.  The fact is I work with some of the most knowledgeable medical professionals that I know that make decision that have and do save lives.  We have a Doctor and/or a Nurse Practitioner in our facility at least 5 days a week.  We have respiratory therapists in the facility around the clock.  We have amazing nurses from varied backgrounds (chemistry, psychology, acute care, critical care, wound care) and certifications,  that work hard to treat and rehabilitate and we have nursing assistants that bust their butt to help keep our residents safe, clean, hydrated,happy and healthy.  We have activities that keep our residents engaged, and most of all we have people that care a whole hell of a lot about the people living in the facility.

You see, our facility is not Heaven's waiting room, our facility heals and rebuilds lives.  Yes, we have some that are dying, and they come to us looking for comfort and care and we provide that for them.  We work hard to make sure they are pain free and comfortable during their last days and I always try to make time to sit with them for a few minutes, hold their hand and speak kind words of comfort, but that is far from our facility being a place where people are waiting to die.

Are there bad skilled nursing facilities in this world?  Yes, as well as bad hospitals, rehabs, clinics, and Emergency Medical Providers.  Are there "stupid" nurses in the world?  I would not call them stupid but yes there are nurses that seem to make inappropriate clinical decisions, just as there are doctors, therapists, and even paramedics and EMT's that have the same problem.  To say that skilled nursing facilities and the nurses in them are dumb that can not provide quality care to your family member is not only a gross misrepresentation of facilities and the profession, but it perpetuates the idea that you go to "the home" because no one else wants you and you are going to die soon; it feeds the bad rap.

It is time we re-consider that image, re-shape that image.  No one wants to send mom or dad to a place where the reputation is that they are just siting around waiting to meet their Maker.  No one wants to think that some day they will be in the same situation.  No, instead we want to know that we will not be shoved into a corner somewhere and left alone but that their are very skilled and very caring men and women that will care for you and continue to ensure that your life is enjoyable.

I would re-do that earlier meme to read "Skilled Nursing Facilities: The Nurse said that Heaven can keep on Waiting".

Anthony


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