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| Nursing
home care appeals to nurses who like the stability
of a long-term care population coupled with the
variety of issues that arise in elder care. Many
also enjoy working with clients in a more holistic
way. |
Quanadra Denise Hatcher, LPN, works in a nursing home,
caring for the nation's most vulnerable citizens in
an industry dominated by regulations, comparably low
pay and high turnover.
Six days a week, Hatcher tends to as many as 36 patients,
checking in on them and managing their medicine, as
well as writing assignments for nursing assistants and
conferring with doctors at the Beverly Health and Rehabilitation
Center in Columbus, Ohio.
"It's a constant balancing act, and it's hard
when you have so many patients and the patients are
demanding," said Hatcher, who is working toward
her RN license.
Care of the elderly is a sensitive field that is often
the focus of publicity only when heart-wrenching tales
of abuse surface. Now, the federal government has published
online quality measures for homes, distinguishing one
from another with disheartening statistics such as the
number of residents with pressure sores, pain, restraints
and infections, followed by a list of regulation violations.
Without differentiating between levels of acuity, the
Web site compares average nursing hours per patient
to state and country averages.
While many homes welcome the scrutiny-many states already
had more detailed versions of the federal Web site-the
numbers listed do not always fairly represent what goes
on inside the home, said Deborah Cloud, vice president
of public affairs for the American Association of Homes
and Services for the Aging.
"If a nursing home percentage looks out of line
in one of those areas, there may be a valid reason why
that's so," she said.
The information has placed added pressure on directors
of nursing like Nyra England, RN, director of nursing
at Beverly Health and Rehabilitation Center. England
cited the bedsore statistic as an example.
"We have a low rate of people developing [wounds]
here, but we have a high rate of accepting them from
the hospital and healing them," she said. "You
don't see that in the paper and on the Web."
The Centers for Medicare & Medicaid Services, the
division of the Department of Health and Human Services
that reimburses nursing homes for Medicare patients
and publishes the Web site, found that homes should
have a minimum of 4.1 hours of nursing per resident
to avoid jeopardizing patients' health.
Yet many homes say they cannot keep their staffs full
during a nursing shortage when hospitals are able to
pay higher wages and sign-on bonuses, said Cindy Shemansky,
M.Ed., RN, president-elect of the National Gerontological
Nursing Association.
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