As someone who used to work at a nursing home, I'm getting really tired of nursing staff turning to each other and going, "if I ever end up like THAT, just fucking kill me" like motherfucker the quality of life of these residents is your SOLE responsibility and if they're not living their best lives that is YOUR FAULT.

These residents are here because this is their best option. They're here because if they weren't, their quality of life would be worse.

These residents make friends with their roommates, the people they eat with, and the people who go to activities with them.

A disabled elder's quality of life is not measured by their ability to walk.

A disabled elder's quality of life is not measured by their ability to breathe without oxygen.

A disabled elder's quality of life is not measured by whether or not they're on a feeding tube.

A disabled elder's quality of life is not measured by level of continence.

A disabled elder's quality of life is not measured by whether or not they can chew their food.

A disabled elder's quality of life is entirely measured on whether or not their needs are met.

If their quality of life is worse at a nursing home than it would be if they had just stayed home, then their needs are not being met. If you are not meeting their needs, that is YOUR FAULT and you have FAILED your residents as a medical professional.

Not my usual content but I’m taking classes right now and going to be taking the STNA test in the spring and I need tips for it/generalized study tips 🥲

sapolos have got to be the dumbest fucks on this earth. like even more so than golos and that's saying something. remember when they posted dream's dox on twitter? ya boy lives there too

YA BOY LIVES THERE TOO ICB 😭😭😭

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Big day for jodie-whitaker-loving lesbians obsessed with david tennant

Omg a story that’s so cool but if I had a say definitely eve for sure girl 👌🏼

THATS 2 FOR EVEEEE man yall really want me to be online lol im an eveP ofc i would.

lissa thinks royal extravagance is so dumb. while she’s cognizant of the history and can have respect for some of the traditions and their meanings, she’s so refreshingly.. normal contemporary young person how she approaches all of it and it makes my heart so warm. the adaption grasps this aspect of her character so well and it’s so enjoyable to watch. 

lissa standing in this dim ass library expected to read this old ass text going “might help if we had an actual light on right? lol” looking around like for fuck’s sake???? why are moroi so stupid???? it’s fucking dark in here i can’t SEE and sonya’s like We Have To Preserve The Text and she’s like............sure.........ok (contemplating whipping out her phone flashlight like this is some bullshit) 

her and rose laughing about her crown pulling out her hair. her face at the heavy glass masquerade masks they have to wear for the death watch like... are you serious??? i wear this... on my face???? all of her comments in the books about the uncomfortable frankly ridiculous clothing she’s expected to wear as a princess. that entire scene with the moroi store owner in last sacrifice when she’s buying clothes for tatiana’s funeral and they’re like VASILISA YOU COULDN’T WEAR SHORT SLEEVES YOU COULDN’T POSSIBLY IT WOULD BE SO SCANDALOUS HERE HERE TAKE THIS VELVET LONG SLEEVE ANKLE LENGTH GOWN THAT PROPERLY DISPLAYS YOUR GRIEF and lissa’s like ma’am it’s 110 degrees outside??? the fuck????? and goes you know what if you guys wanna suffer like that you go for it but it’s not gonna be me!

how you know when she’s queen one of the first things she does is express outrage out of how much paper is just WASTED for LITERALLY NO REASON like FOR WHAT!!!! FOR WHAT!!!!!!!! she likes paper books she likes the feel of paper but THIS IS RIDICULOUS!!!!!!!! this is the DIGITAL AGE!!! if there’s a more energy efficient superior way of doing things we’re damn sure gonna explore it we aren’t gonna just do things the same way we’ve always done them because ~~~~trAdiTION~~~ that’s DUMB!!!!!!!!! 

heroic, quite frankly

So, in PA there is a bill in the senate called the Patient Safety Act that mandates nurse:patient ratios. Obviously, I am a big fan of this bill as it would ease pressure on nurses and improve patient safety outcomes. It is also very bipartisan, with both republicans and democrats being for and against it in similar ratios. The big criticism of the act as it stands is that there are little to no considerations for small, rural hospitals who would find it difficult to meet those ratios without going under (don't have enough nurses, will have to close beds/hospitals). I thought the solution to this was to obviously increase protections for rural hospitals (like making the ratios for them say 1:6 instead of 1:5 for example.) But this has the unintended consequence of making it more difficult for rural hospitals to entice nurses to work for them (who wants to work in a rural hospital with worse ratios when you can make more money with better conditions somewhere else?) It's already difficult for rural hospitals to find staff. Do you have any ideas on solutions to the problem? I was surprised to find out how nuanced this situation really is, and how it isn't just "put in ratios plz" and everything would be fixed.

You're right in that this situation is extremely nuanced, especially when it comes to the fact that we are (as usual*) in a nursing shortage nation wide.

Staffing ratios only work when there are enough nurses to meet demand. A lot of times the goal of staffing ratios is to incentivize hospitals to hire more nurses, but if there are no nurses to hire that doesn't work. So you have to then consider alternatives, like you mentioned- either closing hospitals, or closing beds.

Consider, though, that if hospitals go the route of closing beds to maintain ratios, the acuity (care difficulty/complexity) of those patients the nurses are caring for goes up because lower acuity patients get triaged out.

The "sweet spot" of acuity to number of patients then relies on the number of nurses available to serve a population. That means that populations with a smaller number of nurses have either a higher number of patients per nurse, or a higher acuity patient load than a population with a relatively large number of nurses.

And pretty much everywhere right now, rural areas specifically, there are just too few nurses to make staffing ratios possible at scale.

So. How do you go about providing a high standard of care for patients when there are fundamentally too many patients and too few nurses? The system needs to change. I present a few possibilities below:

Bring LPNs back to the bedside in hospitals: While I don't mind Magnet as an entity and think they do some good things, IMO they royally screwed the pooch by mandating RNs (particularly BSN prepared RNs) only on hospital floors. You can make LPNs a lot faster and cheaper (10-18months, $20,000) than you can make RNs (3 years, $40,000), or BSN-RNs (4-5 years, $80,000). And while you still need an RN license to do things like push IV meds and interpret assessment findings, just about everything else can be done by an LPN. So we need to be using that resource to make more nurses fast.

Institute Team Nursing: You know how you use LPNs efficiently? It's not by giving them a group of patients and having them run around to find an RN every time they need to push an IV med. It's either by having them as a dedicated tasker (doing the time-consuming skilled tasks like wound care, catheter placement, IV placement, etc... for many RNs) or incorporating them into a team. With team nursing, you have an RN, an LPN, and an STNA/Tech all caring for 12-15 patients instead of an RN and an LPN caring for 5 each with a tech helping. The RN does the tasks only an RN can do (assessments, IV meds, plans of care) and communicates with the doctors, the LPN does most of the med pass and skilled tasks, and the STNA does the basic patient care. Since there's 3 people working together instead of separately, it's easier to find someone to help with 2-person tasks like boosting a patient in bed. You would not believe how much time this saves and how much more patient care can actually get done.

Institute Advance Practice Providers (or at least universal contact methods): I'm not saying we have a ton of these either, but you only need about one per floor. See, I can't tell you how much time I used to spend just trying to figure out who to contact about a problem, and how they wanted to be contacted. Because God forbid you text Doctor A instead of paging or page Doctor C instead of calling. Now I work on a floor with an APP and you can just go straight to them and they can either write the order you need themselves or contact the doc who can. Probably a good 15% of my time is back and I'm not even exaggerating.

Change culture around nursing duties: this is a controversial one, but as nurses are spread more thinly than ever and medical acuity has gotten so much higher, the basic care is genuinely getting worse. I have seen this happen over the last 8 years I've been in my job. So. Re-teach families how to care for loved ones in the hospital. Make it culture that if you have a family member in the hospital someone is with them. And when I say with them, I don't mean just visiting. I mean actively caring for the family member. Helping them to the bathroom, helping them dress and eat and clean themselves. Helping them do basics. Entertaining them, distracting them, comforting them. Things we used to be able to do when our patients weren't actively trying to die at all times.

*technically, we have been in a nursing shortage since WWII. But a lot of factors, COVID-19 specifically and a shortage of student slots in RN-level nursing schools, have made things particularly bad in recent years.

I'm not really going to miss nursing itself. The job was really starting to get under my skin, and it was never the residents that did it. It was always my coworkers. It was always management. I'm sorry to all my grandmas and grandpas I left behind. I loved all of my residents, and I'm sad that I got chased out of a job that I'm good at. But the fact of the matter is that I'm burnt out. I lasted five years in nothing but nursing homes, and my time is done.

I'm going to miss the lady who patted my cheek and called me her sweet boy when I brought her a blanket.

I'm going to miss the guy who called me his Special Nyx when I brought him Pepsi.

I'm going to miss the people I connected with. Nothings going to change that.

I was unrightfully fired, and I'm not allowed to go back to visit with them.

NONONONONONOONOooooo!!!oOO1o1!!!!! I SWAR IM NOT NOT JOKER STNA!!!!! IT IS 3 OR PERHAPS 4 AM JOKER IS THE JJOEKR I DO NOT LIKE HIM!!! IA M YHEJOKER!!! NOT JOKER STan!!!

hey man stay calm

🤣 relevant af

The things that come outta my mouth be making me sound like a damn sociopath.

STNA instructor asked my class why we all wanted to me nurses when I did that years ago and since "I felt disengaged socially with my warehouse job and utterly despondent at the uselessness of my work in a jewelry store warehouse alternatively sorting jewelry in tedious, boring work or sorting boxes of office supplies in even more boring work for low pay in social situations I did not understand, so I decided to find an in-demand job that would rely on my skills more than my non-existent networking and offer me higher pay and social recognition" was too long I just said something along the lines of "i found out nursing was in demand so now im here."

Bonus: other former coworker -to-be at my current site in another job mentioned also previously being a nurse aide. So instead of saying "I experienced burnout and moral injury working in a nursing home witnessing abuse and neglect and realized nursing was less analytical skill and more like retail with more body fluids, and especially realized that becoming a full on nurse would not solve any of the problems I had with my life as it was and left for my own sanity" I implied I wanted to fight some of the residents and nothing else. Thanks brain.

finally doing my stna clinical on the 30th!