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The LTC industry should be ashamed

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Buffy Howard, MBA, NHA
Buffy Howard, MBA, NHA

I left long-term care in 2016. One day, I sat across a long conference room table and was awestruck by the decimation I observed before me. 

This woman — once a spry, inspired, vibrant young single mom of 4 — had prepared to give all to the nursing profession. Before me was someone whose empty spirit couldn't be camouflaged by the fake passion she tried to muster up.

She was the most brilliant DONs I had met in my 25-year career as a nursing home administrator and regional director of operations. Stunningly smart. Amazingly intuitive. Someone I had relied on, not only for my career, but for the moment-by-moment, exemplary care she had given to each of the patients that we had the opportunity to care for together. 

But, do you know what I saw today as I sat and watched her at a final job interview? I saw a dried-up, beaten-up spirit. I saw a woman who was kicked around by surveyors. She had been vomited on, not by patients, but by the corporation she had worked tirelessly for. She was bruised from the Immediate Jeopardy baseball bat hitting her head. I saw the pain from the punch in the gut when she swore she thought of absolutely everything to avoid a citation. And I saw the lungs deflate as this long-term care system slowly, methodically sucked the joy of life, the joy of giving, and the joy of being a nurse out of her once energetic body. 

She was a shell of a woman. 

You know what else I saw? Desperation. I have seen that look in her eye before. I have felt it in her spirit when we knew above all else we did the right thing. We made the right decisions. We completed every single line on that investigation and yet, it was not good enough. It never seemed to be good enough. 

Not for the state surveyor. And not for the COO. It. Was. Never. Ever. Good. Enough.

The DON wanted out of long-term care. I could feel it palpitating through her veins. She caught a glimpse of escape through me. I had escaped, as if fleeing from an abusive cult. I was the one that got out. She had followed me before. Many times.

But, despite knowing in my soul of souls what this woman is capable of, what determination, grit, tenacity and just damn straight up brilliance resided in her small stature, as I watched her, I knew she was not shining. She was not plump and shiny and vibrant. She was the puppy that was left behind; the runt of the litter. 

This is what long-term care did to this woman, and so many others of us. Over and over, day in and day out, tearing us apart. You left us empty shells. How dare you? 

Long-term care company: How did you not commit to building up your talent? To keeping them plush and pliable so they are bursting with that initial joy and desire to help others. Do you remember how joyful and young and vibrant they looked that day you interviewed prospects? It was obvious they were the pick of the litter. You thought to yourself: “I'm going to get tons of mileage out of this one.” Yeah. You sure as hell did. 

This nurse isn't the only one. There are so many of us leaving long term care. We are LEAVING the industry. 

We are leaving with our experience. We are leaving with the tips and tricks to get YOUR Company out of a lawsuit. We are packing our bags and leaving you with our full understanding of the regulations that you so strongly cling to for your operational success. We are leaving you. 

Companies like this should be ashamed. Ashamed for not taking better care of its leaders. There will be no one left to care for these priceless, precious patients that we still so desperately love. The patients that no family comes to see. We made a difference to these patients, even when you didn't see it or care to acknowledge it. We loved them. 

But no one took care of us.

Many of us who have left long-term care have healed, rebuilt our spirits and are ready to take action. We are coming for this woman. We will rescue her and love her for the leader, the woman, the nurturer, the warrior that she is. It's just a matter of time. 

That's unless the industry changes. It's up to the presidents, CEOs and COOS. I'm talking to you. How are you building up the life of your leaders? How are you supporting them? How are you acknowledging their expertise at keeping your company away from CMP's, IJ's and substandard care? Do you realize how much you rely on their actions? I know you do. 

Treat employees like this woman as if they are priceless gems. Acknowledge them. Educate them. Praise them. Support them when DSHS is unrelenting and impossible. Give them the tools, freedom and ability to make their own decisions. Invest in their future. Invest in their education and training. Good grief, give them some time off! I mean, real time off. Time off with no calls, no texts, no conference calls. When they won't even get called if state walks in. That's how important their recuperation time should be. 

Limit their hours each week. Send them home without a bundle of work to do that night. Care. Care about them and their families. Not just what they can do for you and your bottom line. 

Keep your word. Without these leaders, you have nothing. I implore you to look at your administrators, your directors of nurses, and regional teams. Look at them with a new set of eyes. Look at who is ready to leave. Who is working to the bone for your company. Decide to make a change. 

If you do,  patient care and your company will flourish. Wake up. Open your eyes. Make a difference. Your priceless patients, and your employees, are counting on you.

Buffy Howard, MBA, BA, NHA, was a regional director of operations and a nursing home administrator for 15 years. She works as an operator in the healthcare industry, but left long-term care in 2016.

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