Questions To Ask When Looking For A Long Term Care Facility: Fill & Download for Free

Many years ago, I went for an interview at a geriatric long-term care center (“nursing home”). I was kept waiting for probably half an hour after my scheduled interview time and, sometime during that half hour, I watched a very well-dressed woman come out of an office with tears beginning to form and a flush rising up her neck. When she was almost to the exit, she burst into sobs as she left. A minute later, I was called into that same office to meet the D.O.N. (director of nursing).She glanced up at me from behind her desk and stated “You're Christian Thompson? Have a seat so I can ask you some questions.” No smile, no handshake, and no waiting for my return greeting or reply to her “inquiry” about my identity. She immediately started shuffling an enormous stack of index cards and began reading/asking me clinical questions from them. They ranged from reasonable questions about safe nursing practice, geriatric care, and state regulations, to bizarrely complex questions such as “What labs would you request for a CHF patient on these meds with a history of this secondary diagnosis?” and “How would you identify third spacing after abdominal surgery?” and “What parameters are used to diagnose open-angle versus closed-angle glaucoma and what medical interventions would you expect?”I won't go into a lot of explanation for why these complex questions were bizarre except to say that they weren't reasonable for an LPN applying to long-term care. I gave my best answers to the questions that I had at least an understanding of and replied that I'd seek guidance on issues that were beyond my scope of practice…(for a CHF patient developing symptoms, a nurse is going to do a thorough and focused assessment and notify the doctor. HE/SHE will order whatever labs or treatment they see fit. I'm certainly NOT going to “request” specific lab orders. On the third spacing after abdominal surgery, this is something that occurs within hours of the surgery and the patient wouldn't be in a residential facility like this when it happened! …to this day no nurse I've talked to, either RN or LPN, has been able to describe the distinction between open-angle and closed-angle glaucoma let alone pontificate on their specific diagnoses and specific treatments! There were several more questions like this, and my responses remained focused on prudent actions for an LPN in long-term care.The interviewing D.O.N. interrupted me after several questions to say to me “You need to know this shit if you're going to present yourself as a competent clinician in a job interview! Christ, I'm sick of the dumb-asses they send in here!”I smiled and nodded as I stood up and said, “You may be right. Thank you for your time.”She started backpedaling. “Well…wait and let me look over your resume.”“Nope, we are very done. Have a NICE day.”I walked out, ignoring her babbling protestations.

Q: My boss offered me extra hours, but told me to report my normal hours to HR and record how much I worked extra to use later for time off. Is this legal?The long term care facility I worked at played this game all the time. Nurses were expected to punch out and go back to finish their charting. Social services, dietitians, and other support disciplines were expected to complete their work in the 8 hour day. Staffs were dwindling through attrition, and administration refused to replace the empty positions. At first we’d be told, OK, you don’t need to do this or that - and a few months later there would be a shocked reaction: “What? No! That has to be done!” and we would be questioned about our “time management” if we couldn’t get our job + the other person’s job done.One diligent dietitian worked several hours extra daily, but didn’t punch out until she was done. Because her overtime wasn’t approved, she didn’t get paid for those hours. Then the Labor Board did an audit after an anonymous complaint - and we had to back-date approvals for all her OT, and cut a check for several hundred hours. Administration was furious. So she started punching out and going back to finish her work. As her immediate supervisor, I had told her that, while I appreciated her diligence in getting the work done, it made it look like three people could do the work we really need four to do. Human Resources enforced their policies, and I had to do an oral (i.e. minor) disciplinary action, so there would be a record that she was educated not to do the extra hours.Don’t work extra hours without a paper trail to prove you were approved to do it, and be sure to punch in/out. Big business doesn’t like unpaid time. While I don’t know the laws in your state, an anonymous call to the Labor Board might be appropriate.Keep records, emails, etc. so if you are fired for refusing to do the extra time, you can file a complaint.EDIT: In response to comments, I’m adding this clarification: Yes, it is legal to ask an employee to work for overtime or comp time at 1½ reimbursement rate. What’s not OK is that the OP was asked to report only her regular hours to HR. Why would a manager want her hours off the books unless it was to make productivity look more efficient and keep OT $$ down? Right, you can’t force someone to work extra hours. But the pressure to get 10 hours of work done in 8 hours “off the books” is coercive and unethical. I’ve seen managers (including my own, before I was salaried) go blank when asked if a worker could use their comp time: it wasn’t approved, there is no record, and no, you didn’t work that many hours. Why can’t you get it done – do you have some time management problems? If you decline to work extra hours, guess who’s remembered when it’s time for layoffs? Productivity rates continue to increase in the U.S. – because fewer people are doing more work that should be allocated to more people. So, employees work an extra few hours off the clock. Fair enough for salaried employees, but “on the clock” workers can’t legally be expected to stick around off the clock.EDIT as of Feb. 18, 2021: I’m receiving many comments on my reply. That’s great if you are commenting on my answer. But, I’m receiving many comments that should be their own answer to the question: if you want to answer the original question, go to the original question and offer your answer. Comments on my own reply are welcome, but many of these excellent comments should be their own answer.

My experience has been that it won’t get done. I have heard nurses promise families that they would make certain it was being done, and they never follow through. They might ask an aide if they were doing oral care for that resident, and the aide will say yes, but I can assure it is not being done.I have been around nursing homes all of my life and in many different capacities. In the fanciest to the most basic of long term care facilities, oral care is not a priority.It is just not done.Only If you are able to get to the sink and access your dental supplies without help, will it get done.Dentures can normally be found in the drawer of a bedside stand. Sometimes they may even be in a denture container, but they are rarely seen in the residents mouth.For me, washing my face and brushing my teeth are an important part of waking up. I don't feel awake until I have done those things, along with drinking my coffee.Neither of those basic grooming tasks are provided for residents who are unable to care for themselves.Just notice fingernails, teeth, sleep built up in the corner of eyes, you can tell if they need a warm wash cloth for their face and dental care.Do another little test, look at water carafes in resident rooms. Are they full? Check 8 hours later, and unless the resident can pour their own drink, they will still be full. With warm water.Dehydration is rampant in nursing homes and it can lead to serious and often deadly illnesses.Notice how dry the residents mouths look, chapped lips, and chafed hands.I can go on and on, but I seem to do that too often, this is my niche and Quora is one of my platforms for expressing my concerns.If you want these things done, you could go to the next care plan meeting and demand it, but in all honesty you might as well plan on doing it yourself.You need to be popping in and out of the nursing home at irregular times everyday. As often as possible. If you go on a schedule, the staff will notice and your father may not get the care that he needs when you aren't expected to visit.If the staff thinks that you might pop in at any time, your dad has a better chance of being cared for in a timely manner when the aide has to choose who they help next.Nursing home reform needs to happen now! The future plans of our sitting president will only make care for our eldest family members worse.We really do need to do something, people.