I recently started a new job at the hospital. I love skilled nursing, and I still think that geriatrics will always be my first love, but the truth is, I burn out too fast. Every facility I worked at, the workload would be manageable, until short staffing or increased workload would burn me out. In the past 3 ½ years I’ve lived here, I’ve worked 4 different skilled nursing jobs. That’s an incredible amount to me, mostly because almost every single one, I start out thinking that it’s a great fit. I’m excited to start, and I like the new way of doing things.
It’s an unfortunate truth of skilled nursing, that there’s just not enough staff. Part of it is the stigma of working long term. Very few nurses want to work in geriatrics. In my graduating class of almost 300 nurses, there were only five or six of us who wanted to work geriatrics. It’s not exciting or glamorous.
Add to that, it’s getting increasingly difficult to earn money through skilled nursing. Patients can’t afford it, and families hate the idea of putting their parents in a ‘home.’ There’s more options now, like home health, which is more affordable, and more Assisted Livings are expanding, so that they can take patients that they may not have been able to several years ago. They might have an oversight nurse, or their own home health to take patients who have insulin or wounds.
Skilled nursing has really been struggling. At least from my vantage point. State’s regulations are pretty clear about staffing ratios. Unfortunately, those ratios don’t benefit the facility, the staff, or the patients. Most nurses and CNAs feel understaffed when in reality, they’re staffed as adequately as state allows. And when money needs to be cut, it comes from the support, whether in charge nurses, management nurses, or even the hours of Medical Records. I’ve seen all of that happen, and unfortunately, the extra load always falls on the floor nurses.
So for now, I’m taking a step back and trying something different. It’s difficult, adjusting my mindset from long term to acute nursing, but I think it’s the right step for now.
I hope that someday, I can return to geriatrics, because it will always be my first love.