Are ALL nursing homes such horrible places to work in?

Many nursing homes are understaffed, which does make it more difficult for those people working there. But it’s not only nursing homes that have such an extensive turnover. Most acute care hospitals do, too. You’re right; it is the elderly who will suffer the most.

having worked in hmo’s and large group practices all my working life, I hate to say it but these positions I think attract personality types like this. I’ve seen it over and over. And not just nursing homes and hospitals, any large practice.

I have had bad experiences with nursing homes, both as an employee (years ago when in college) and as a consumer (my mother has recently been in one for recovery).

In the case of the former, I was a nurses aide, and I saw enough stuff that I went to the state and reported the nursing home. It was many years ago now.

In the case of the latter, I saw neglect, overworked staff, and other bureaucratic foul-ups.

MY 95 year old mother was in a nursing/rehab facility for 6 weeks about 10 months ago. She had fallen and broken her wrist. My sister or I went every day to make sure that she walked around, got decent food and wasn’t left in a chair, strapped in, to rot on the vine.

We put out brush fires, got her more regular therapy and kept an eye on things. The staff was pleasant and willing, but the number of patients with Alzheimer’s and dementia kept nurses and aids rushed off their feet.

The most efficient and best run department was the financial, billing, and collect what-you-owe-us one.

Low wages and bad management discourage competent people from applying for these jobs. Unfortunately, although a home may charge a family or resident a large fee, these workers make minimum wage or less and perform a LOT of physical tasks, on top of having to tend to the psychological and emotional needs of their residents.

Therefore, you have people potentially working really hard with no job security and minimum wage (at least in my state) and no formal training dealing with senior issues and possibly language barrier issues, dealing with overbearing supervisors/managers/owners who just want to get the most out of their workers. And with limited government assistance to these private facilities, homes can only provide what they can afford. Sad situation.

I have been working in the medical field since 1982, starting in nursing homes. Yes, I was one of the rare male nurses’ aides.

Not all are terrible but, from what I have seen, most are. When reading my answer, please bear in mind that I only worked regularly at nursing homes until the mid 1980s, only taking the occasional shift until the early 1990s when my registry, basically, pleaded for me to take a shift that they could not fill. I worked staff at a few then went strictly registry.

The only way I managed to stay sane was the patients. I developed friendships with them and, without that, I would not have lasted a week. Of course there are very unpleasant patients but the good ones are the reason I was able to stay until I could move up. One of the things that I could not handle was the patient abuse. I was idealistic and, at first, thought I could make a difference and stop, or at least slow, the abuse. My bubble was burst very early on that one. Conversely, I was able to actually change hospital policy at a major hospital in the late 80s regarding AIDS patients.

I can tell you that, due to this, I am terrified of every being ill enough to be stuck in one. I would rather die first. There are a number of contributing factors to this mess:

There is the low wage factor. General pay for nursing home CNAs is terrible. This results in disgruntled, angry workers who, literally, have shit jobs. Many have to take more than one job to pay the bills. This results in all of the issues that disgruntled employees face. Manifestation of this included patient abuse, lashing out at other employees, and more.

Most often nurses aides are given very high patient load and are both stressed and unable to provide decent care to all.

Nurses aides are often treated like crap by the RNs and administrators. They are seen as easily replaceable (which is true), unintelligent (which is usually false), not motivated enough or intelligent enough to be “more” than a nurses aide (usually not true… it is not easy to go to school while working).

Often the nursing home itself has an administration that only cares about $$$ and will do dangerous things to cut costs. I did a few shifts at a place, for example, that would only let the aide wear ONE glove when doing patient care, including cleaning incontinent patients. They said that we only “needed” one glove. Any aide who used two gloves per patient or who did not only use gloves if cleaning incontinencies was written up and faced firing. This was when I was working registry and, after a couple of shifts, I told them to NOT send me there no matter how short staffed the place was.

The job of nurses’ aide is an irreplaceable one. It is one of those shit jobs that has to be done. A good nurses’ aide is, really, a treasure. If the on job situation and pay was such that the good ones stayed, rather than getting out of the job as fast as possible, the situation would be much better.

There is the education factor. CNAs are often not expected to have the type of training they really need. (cue me sounding like an old codger) In my day these jobs were plentiful and employees not well screened. You could quit or be fired, walk down the road, pick up another job. Now, I am certain, this is not so due to the unemployment factor.

There are also fantastic RNs who realize that nurses’ aides are neither stupid nor unimportant but they are, sadly, the minority.

Private pay facilities are usually the best. The worst are the medicare facilities. I was sent to a couple of those and asked to never be sent back. The conditions at those places are shocking to say the least.

I was a CNA for a couple years and I really enjoyed it. I worked at two different very good homes. The one had no defiencies from the state for a couple years in a row and when they did get a mark it was usually a medical records issue and not patient care. It is a thankless job in terms of your superiors. The CNA does most of the nasty work. You reap your rewards with the residents. A lot of them really bond with you. It seemed that a lot of the folks said I reminded them of someone- a neiece, a granddaughter etc. I got really attached to some of those people and was heartbroken when they passed. I got out of that type of work when I quit feeling so much when someone died. It was kind of like “oh, Betty died last night? When are they admitting someone new?”

I really think that the quality of the home has a lot to do with the quality of the staff, obviously. Tell your friend to apply at the places that don’t have a lot of turn over or is a really well respected home. I just bet she will have a better experience.

@Arisztid Sorry to hear your experiences weren’t good. For whatever it’s worth, the glove thing would never happen today. It’s a lawsuit waiting to happen.

@Dr_Dredd It was pretty shocking… this was in the early 90s. Another thing that another place did was have the patients slathered with Crisco rather than any accepted form of skin barrier.

@Arisztid OK, now that’s just gross.

@Dr_Dredd No kidding.

My S/O works at a retirement home and has done so for many years. She loves her work and most of the people she works with. This is a type of job where you’re either cut out for it or you’re not. For example, I couldn’t do the job because I’m too empathic and it would likely depress me having to see people I care for and respect become mired the final downward spiral at life’s end. I just couldn’t so it. Many get into the line of work thinking it will be like every other job they’ve had and quickly fond out otherwise. Residents and their families pay dearly for the right to be in these homes and many of the elderly have traded or given up everything they have just to live in this protected and proactive environment. So, if you’re not prepared for life at a retirement home, or if you’re not willing to give it your all or if you think it’s just a job, try another line of work. Everyone will be better off.

@Rufus_T_Firefly I believe my friend has what it takes, but the direct management, the head nurses, etch. all seem to be so second rate. Almost like…they couldn’t find anything else and had to “settle” for a nursing home.

I wanted to say that, while my post highlighted the problems at most nursing homes and why they have come to be, some are not like that… this is sadly the minority.

There are a few nursing homes with staff that has been stable for decades and provide excellent care.

The negative perception of nursing homes is sadly much more common, however, there are some really good ones.

One of my personal big shocks was the first time a patient who I had been friends with died. It was within my first month working and I just was not ready. This was an eye opening experience and, if you cannot handle that, you are not going to make it. Conversely, if you do not come to care for your patients, you are not going to do a good job.

I am able to both care for my patients and handle their deaths. I worked hospice for years.

@Val123 – That is the case in a lot of nursing homes, but if the facilities director is worth a crap at his/her own job, then the lazy, controlling types should get weeded out fairly quickly. However, many managers are guilty of complacency and there will always be those who would take advantage of others rather than carry their own weight.

@Rufus_T_Firefly That’s true in all businesses, but nursing homes seem to be especially bad. And that’s really a shame, because a nursing home is one place where everyone from directors down to CNA’s should be stellar.

I guess we have been incredibly lucky, because my Grandfather actually thrived in the nursing home we found for him, and my Mother-In-Law was well cared for. We did not run into any problems with the staff or management.

I did volunteer work for many years in several nursing homes in California, and as a volunteer, I worked closely with management and never felt that there was any problem.

I think it’s important to remember that most retirement homes do attempt to keep the dark side in check. There have been a few who were cutting corners and/or taking advantage of their patrons and many of those continue to make headlines. As Val123 said, the problem doesn’t belong only to the nursing home industry. So, if you ever notice anything out of the ordinary, you should speak up and speak loudly, because you and your loved ones are paying for it and for every good thing being done, there are probably a couple of bad things the owners and proprietors don’t want you to see.

I do think that most nursing homes are bad to work for. The staffing is low. The work load is to much for the staff to handle. Administation lies and only looks out for themselves.
The worst place to work is Luthercrest Personal care home in Allentow PA