You know what Mega City One is, Dredd? It's a fucking meat grinder. People go in one end, and meat comes out the other. All we do is turn the handle. -Dredd
It's hard to get a perspective of how bad long term and continuing care is back in less remote areas. I mean, anyone who's worked in the setting generally knows it's bad- low pay (I started at 19$/hr) , understaffed, high stress. There's a constant parade of agency nurses - and nothing against them, I've been one - who don't know the residents, often aren't oriented, and have a high rate of medication errors. Why's that? They don't know any of the patients, and the Personal Support Workers (PSWs) either are too busy to help, or just don't care. Even in familiar settings, the stress rate is high. Routinely, a Practical Nurse will manage between thirty and fifty residents- all their meds, their wound care, their behavior, with three to five PSW's tasked with toileting, supervision and mobility. An RN will assist (mostly with high risk behavior/med administration and paperwork) for double to quadruple that many people, as well as filling staffing shortages if need be.
I considered it a good day when I was able to chew my food, to say the least.
As a result, overworked people get sick and injured. That leads to more strain on the team, which is usually a skeleton staff- very few people want to stay in continuing care, and there seems to be an ever-churning line of young nurses who do their year or two in the field before moving on. Staffing levels are low no matter how nice the facility is- I had quite a bit of agency work at one facility which was nearly brand new, with comparatively excellent staffing levels(32 patients, 4 PSWs, one practical nurse per floor, and an RN) simply because they couldn't keep staff. RN's worked 60 hours per week as a matter of course. Psychologically, there's a ton of burnout as well, with work ethic fading in the face of day in, day out overwork. Patients are two to four to a room, sharing toilets.
Honestly, it feels like a meat grinder. Staff are often stretched thin, and care suffers as a result. If I can't stop and talk with my patients, how can I assess their needs? How can I possibly help with emotional issues if I hardly have time to eat, much less talk to residents?
Up here in the North, my facility has ten patients. Ten. I have four PSW's. My patients are toileted and transferred quickly, which means they're comfortable and have less skin breakdown. I'm not moving at a sprint all shift, trying to fit bouts of wound care between marathon medication administration. I watched the woman orienting me sit with a resident for more than a half hour, and help her through an anxiety attack. In the South (as it is referred to up here) that would be absolutely unheard of. Each patient has their own room. No matter how old their are, no matter how severe their condition is, each resident and staff member has exponentially better quality of life than even private long term care facilities in Ottawa or Toronto.
Like I said, sometimes it takes seeing how things should be to realize how bad things are.
It's hard to get a perspective of how bad long term and continuing care is back in less remote areas. I mean, anyone who's worked in the setting generally knows it's bad- low pay (I started at 19$/hr) , understaffed, high stress. There's a constant parade of agency nurses - and nothing against them, I've been one - who don't know the residents, often aren't oriented, and have a high rate of medication errors. Why's that? They don't know any of the patients, and the Personal Support Workers (PSWs) either are too busy to help, or just don't care. Even in familiar settings, the stress rate is high. Routinely, a Practical Nurse will manage between thirty and fifty residents- all their meds, their wound care, their behavior, with three to five PSW's tasked with toileting, supervision and mobility. An RN will assist (mostly with high risk behavior/med administration and paperwork) for double to quadruple that many people, as well as filling staffing shortages if need be.
I considered it a good day when I was able to chew my food, to say the least.
As a result, overworked people get sick and injured. That leads to more strain on the team, which is usually a skeleton staff- very few people want to stay in continuing care, and there seems to be an ever-churning line of young nurses who do their year or two in the field before moving on. Staffing levels are low no matter how nice the facility is- I had quite a bit of agency work at one facility which was nearly brand new, with comparatively excellent staffing levels(32 patients, 4 PSWs, one practical nurse per floor, and an RN) simply because they couldn't keep staff. RN's worked 60 hours per week as a matter of course. Psychologically, there's a ton of burnout as well, with work ethic fading in the face of day in, day out overwork. Patients are two to four to a room, sharing toilets.
Honestly, it feels like a meat grinder. Staff are often stretched thin, and care suffers as a result. If I can't stop and talk with my patients, how can I assess their needs? How can I possibly help with emotional issues if I hardly have time to eat, much less talk to residents?
Up here in the North, my facility has ten patients. Ten. I have four PSW's. My patients are toileted and transferred quickly, which means they're comfortable and have less skin breakdown. I'm not moving at a sprint all shift, trying to fit bouts of wound care between marathon medication administration. I watched the woman orienting me sit with a resident for more than a half hour, and help her through an anxiety attack. In the South (as it is referred to up here) that would be absolutely unheard of. Each patient has their own room. No matter how old their are, no matter how severe their condition is, each resident and staff member has exponentially better quality of life than even private long term care facilities in Ottawa or Toronto.
Like I said, sometimes it takes seeing how things should be to realize how bad things are.
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