This content originally appeared in the Spring/Summer 2020 issue (PDF) of The Washington Nurse magazine.
Long-term care is a growing field in nursing, and the challenges are growing alongside the demand. Our original goal in this issue of The Washington Nurse Magazine was to examine the challenges facing long-term care, explore a vision for what it can be and celebrate the contributions of the thousands of Washington nurses who are the backbone of the long-term care system.
Since Life Care Center in Kirkland became Ground Zero for coronavirus in the United States, the pandemic has exposed many of the significant, systemic challenges facing this critical system.
According to the New York Times, residents and staff at nursing homes and other long-term care facilities accounted for one-third of all coronavirus deaths in the United States as of May 11, 2020. Across 7,700 facilities, tests have confirmed over 153,000 cases, with many more doubtless unconfirmed. Long-term care facilities are prime vectors for contagious disease, and the elderly and medically fragile patients in these settings are at extremely high risk.
The crisis poses another set of challenges for those providing in-home care and the families who rely on them. Families and nurses alike must balance the risk of infection against the needs of patients in in-home care settings — a choice made all the more difficult by the medically fragile nature of the patients in need and limited personal protective equipment for caregivers.
The pandemic may cast a new light on the issue, but long-term care has been too-often overlooked by policy makers in the United States for years. Like our entire health care system, the demands created by a for-profit system put nurses in an impossible position all too often, and caregivers are consistently stretched thin and under-resourced as they care for those with long-term needs.
Meanwhile, nurses whose work is supported by public funding are often under-compensated, with few or no benefits and little institutional support for their critical work.
When we have contained this pandemic, we must all continue the work to support and advocate for the nurses who work in long-term care to receive the support and resources to care for themselves and the patients they serve.
Pamela Pasquale, MN, RN
Long-term care in Washington #
As of January 2020, the Washington State Department of Social and Health Services’ roster of licensed communities included 209 skilled nursing facilities, 540 assisted living facilities and 3,135 adult family homes. Together, they serve more than 67,000 people. Without skilled, professional nurses, alternative care community options would not be successful. Read more…
Albert Munanga, DrBH, MSN, RN
Busting myths about long-term care nursing #
Long-term care nursing is a specialty within community health nursing and provides health services, preventive care, intervention and health education to communities or specific populations. Duties often include optimizing activities of daily living and the independence of patients with chronic illnesses or disabilities. In this article, we examine the myths and realities of long-term care nursing practice. Read more…
Kristin Knudson, BSN, RN
Profile: Kristin Knudson, private-duty pediatric nurse #
Kristin Knudson, BSN, RN is a private-duty pediatric nurse in Seattle. She is a graduate of the University of Washington Bothell, and a member of Sigma Theta Tau. She has been working one case for more than seven years. There are growing numbers of children with medical complexities, those children with repeated and prolonged hospitalizations along with technology-dependence and multiple organ system involvement. Read more…
Ellen Rabideau, RN
Profile: Ellen Rabideau, assisted living #
Ellen Rabideau is Health Services Director of Prestige Senior Care of East Wenatchee, an assisted living community recently purchased by a company that owns several buildings. In addition to the traditional role of the RN to assess and manage medical issues, the role requires a good amount of social work and case management. Read more…
Robert Butzerin, RN, BSN
Profile: Robert Butzerin, skilled nursing #
Robert Butzerin has a passion for the people he serves. He currently works as a manager in long-term care, supervising two large nursing units with 37 staff members and 42 residents, with one of the lowest staff turnover rates in Providence Home and Community Care. Read more…
Reducing errors through electronic health records #
It is rare for anyone in the health care system not to have their medical information in electronic form. Access to the patient’s electronic health record should be available to those providing health care in appropriate settings. There are examples of such systems in place in other areas of the world. Read more…
Caring for aging patients: Liability risks for nurses working in long-term care settings #
Consider this scenario: A nurse working in a long-term care facility ignored the facility’s policies and procedures on medication administration and gave a methadone injection to the wrong patient, which caused fatal respiratory arrest. This case not only had a devastating outcome for the patient but also resulted in litigation against the nurse. Read more…
