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So a well-recommended, 5 star LTC facility opened up and we were able to get mom in. I'm utilizing this time more almost so I can wrap my mind around some things and still explore the possibility of hiring private caregivers to supplement PACE. She has to be out of her independent living facility, so the timing was good.


The staff was so warm and welcoming. Mom is a bit confused but overall seems well.


HERE is my issue,


I happened to look up one of the NPs that is part of my mom's care team on facebook. Her profile isn't private so I just scrolled down a bit and just in August she posted what I feel was a very disrespectful post about nursing home patients. It went like this:


"Dr., what happens after we die?


"We clean the bed and admit a new patient"


Her own comment at the top was "This is so wrong, but when you work in a nursing home"


I know her personal life is personal. I won't send this on to anyone...


But I am SICK. I need to get mom home sooner than later and this is probably a sign.


But why would an NP who is supposed to care for this population post such a thing?


Would this bother anyone else?


Thank you forum friends for letting me vent

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She did say "this is wrong".

There is gallows humor that gets those of us in helping professions through the day; as someone in one of those professions, we were ALWAYS told to either stay off social media, keep our profiles private or use assumed names.

I would not make an assumption that she is uncaring.
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Many of these places are run as a business. I've heard that some bring in "sales" trainers for the staff to figure out how to increase profits. Turnover of residents is one possible avenue.

I was amazed one time a few years back when I had an impromptu meeting with a doctor in a small employee lounge at a hospital. On the white board were graphics and stats about patient reviews, patient stay duration and re-hospitalization, some revenue type figures including insurance and medicare charges. It looked more like a scene from a Monday morning motivational sales meeting at your local Edward Jones office.

The management at these places likely get bonuses based on things you couldn't imagine. Even not-for-profit places have to make money. Look at it this way, as dark as it may seem.
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I may be misreading, but from what I have read she says it is wrong that this is what happens, but unfortunately this is a fact of life in nursing homes. Why does that make you upset?

I do wonder why you felt a need to go looking for the staffs' personal social media pages. That to me is creepy and unsettling.
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I won't make that assumption and you are correct she did say that "this is wrong". Which is why I won't escalate. Just makes me sad. I'm a newly certified NP myself. And I follow lots of "funny" RN social medias. They shock me sometimes as well, but they are private/invite venting pages. Maybe this NP just didn't know she wasn't private.
But I will say as an RN/NP, I would NEVER post something like that. Ever. And sometimes I think "us" healthcare professionals need to get over ourselves with our sarcasm and "hero" status and remember we do have a calling to treat people/patients with dignity and respect.
Just another lesson in the dangers of social media I guess.
I'm still sick about it. I guess someone would say back to me, well you shouldn't have put your mom in a nursing home.
And trust me ....the guilt is real.
Maybe I really need to do more on my end to just get her back here with family. I can't expect strangers to care for her like family would.
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I should clarify...
She said this is wrong with multiple repeating laughing faces emojis and a shrugging shoulder emoji. Like ha ha , it is what it is. Not at ALL like oh dear heavens this is so wrong. She was laughing and so were others that commented on the post.
Oh also, FB is a bit of a marketplace of jobs, ads, professional connections, etc., so to look up an NP on facebook is not exactly creepy.
Just wanted to see who was on her care team, especially since COVID I left her and won't see her until our state allows visitors again.
I may also add when she called me yesterday, our conversation started out very odd as she said pretty much, "So, what do you need?". I had no idea I was getting a call. She didn't really say much to preface it was kind of cold.

Which is more unsettling I guess is the question, me looking up someone on FB who has a public profile or an NP posting a laughing post about nursing home resident turnover due to death?
Again, I guess I'm getting what I deserve for putting my mom in the facility.
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I don't think your looking folks up is creepy.

She sounds perhaps young and not very professional. I think I would mention to her that you saw this, that her page isn't private and that some folks might find her brand of gallows humor disturbing.

If your mom is eligible medically for NH care, that's what she needs. Not one exhausted daughter trying to do the work of three shifts of CNAs, a DON, a SW and an NP. Please give yourself a break, friend!
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You....made me cry in a good way. Thank you friend.
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Sometime ago someone posted that a medical employee, I believe at one of the care facilities, was discussing a particular patient on FB.   There may also have been photos taken.   If I recall correctly, she was either reprimanded or fired.

The problem I think goes beyond respect for patients. It addresses a psychological need or some kind of need, to be far too open about an individual's thoughts, feelings, interactions, family, friends, and just life.   

Social media has been like a tsunami tearing down walls of privacy and self respect.    The comments and photos posted on social media reveal such a decrease in societal norms that it's frightening.

Younger people seem more vulnerable to sharing everything that older people protect as personal.  None of my personal or working friends would consider any kind of involvement with social media.  We all have contempt and disgust for it.  

But others treat it like a (public) confidant.    I doubt this will change, at least not until enough people realize that they and their data are being exploited by the social media moguls, although I doubt that many of them care.
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And actually everyone here, you all have said things to make me feel better. I am raw from a recent decision having mom go to this place and I am a hot holy mess. So, the comments saying this is how things are and it doesn't mean she's uncaring, all that...
And I sounded a bit self-righteous myself I can see. Ugh. I'm no Mother Teresa/Angel.
You are all right, and as usual have talked me down a bit.
I don't think she's uncaring (the NP).
I'm just one guilty feeling daughter who needs to calm down a bit.
Aging care has always been a great source of comfort for me so thank you all.
Thanks again!
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Wow. Good description. Social media IS a tsunami. My husband who is an older soul hasn't touched it with a 10 foot pole in any capacity. He keeps saying we have no idea the far reaching ramifications this social media will have.
And I agree...I think some people truly feel like it is a place of having public and private confidants.
Weird times indeed.
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Rereading your initial post repeatedly, I wonder if this NP is writing this from a sense of severe frustration.    The NP education curriculum is challenging, and I can't imagine anyone going through that and developing a kind of frivolous, or sarcastic philosophy.    I think her comment is more of a criticism of the profession, as well as perhaps some disillusionment.
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Ebmick, your husband is soooooo right and so insightful.    Once comments are "out there", they're "out there" forever.    And that can backfire.  Think of how many people have tweeted something stupid, or taken inappropriate photos and sent them to someone.    Then sometimes they go viral.

I just don't understand this obsessive need for attention.  Privacy is becoming a lost commodity.
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As someone who has worked in healthcare - I can see it as a statement of frustration coming from the NP. It may have been a sarcastic way to express her burnout and disenchantment with her profession. She may have been looking for some shared sympathy and a pat on the back from her friends and family. Caregiver burnout is common among providers and it must be horrible right now during Covid. Sometimes humor and showing up the next day is the only way to deal with it. So I hope this is the case. And I hope she learns that she shouldn’t post this kind of statement on her Facebook.
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Dear "ebmick1973,"

I know how upset and unsettled you feel especially having it recommended to you and it being a 5 star LTCF. It would bother me too. But, if there is anything I have learned above anything else since placing my mom in a facility for the first time back in 2015 is - it is ALWAYS a business first and foremost. The aging population has exploded and therefore the competition to get seniors to move in is fierce. It took me a long time to accept that fact - it was a very hard pill to swallow. Now, my mom is in her second facility. It is like what you described. My mom is getting very good care but, it will never be perfect care because imperfect people (which is every single one of us) will always be working there.

Maybe another way to look at it is this - what if there were no social media to make such posts/comments? Guess what, this person would still think the same thing and you'd never know it. There is no one in this world who could ever truly know someone else's thoughts or feelings in any given situation or at any given time. Just like we don't know what any of these people do in their own personal lives when they are off duty. Also, I hope you can realize that there will be many other employees who work there who are kind, caring and helpful to your mom.

Please try to give the facility a chance as a whole going forward. All you can really do is "keep an eye out" for mom and if issues arise, bring them to the Administrator/Director's attention.

Like others have said, she sounds young and at least unprofessional in that arena with her social media posts and our world is a very different place nowadays.

I wish you peace and hope you're angst will subside in time!
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No. It wouldn't bother me. I don't fully understand the first sentence. It was not the NP, but someone else saying that this is what happens when someone dies? And then the NP said "This is wrong, but when you work in a Nursing Home......."??
I think what you are objecting to is someone's stark honesty. People who are not in nursing cannot know what sort of awful humor develops, a sad shoulder- shrugging sorrow toward the grim reaper who attempts to steal human dignity by the bucketful before he walks away with someone you are caring for.
She was very very foolish to post such a thing, but that is about the worst I can say of her. Because when you work in a hospital and you lose your patient, that is the sad truth. You are told you are next up for a new admission. Told that while you are wrapping what is an entire human life, and entire lifetime of living, and sending a body to the morgue.
You are not afforded the grieving the family feels. You were there to care for and help, and when that patient is gone ripped from you, and you won't have time for lunch before you are to do the same for the next patient.
This is tough to say, but life and death is what the First Responders and Health Care personnel deal with every single day. Loss is a constant. Can you even imagine triage? Because we were TRAINED in it. One would crumble under it if there were not a reality that sits in. If you cannot create some sort of protective wall you literally cannot function.
As a nurse there were times we did take a gut punch that had us leaning against the walls weeping. I always said that if we did not have these wakeup calls that this is an ENTIRE HUMAN LIFE, then we weren't worth the powder to blow us to Hades as a nurse. But if you lived there daily you could not function at all. For a nurse it is life and death in front of you every single day.
My bro spent the last year plus of his life in an Assisted Living Facility and we would sit outside mostly, in the Gazebo, looking at the beautiful grounds, and there would be ambulances and hearses coming and going as we sat, and you would be surprised at the "gallows humor" of the RESIDENTS. Not EVEN the caregivers.
If the caregiver knew this was seen she would be heartbroken, and embarrassed. And you know what, for her OWN GOOD, I would go to her and say "You know, hon, we all do Social Media these days. Trust me, you don't want anyone to see this, because they would judge a whole human being by this one sentence." And then hand her the copy of what you saw.
I will be honest. If this is all she said, I understand. If she added something other, such as "you have to have no heart to do this" or anything else heartless, I would have a hard time coping with what was said. But this? No. I don't find it shocking. And I am a loving human, was a good nurse, and a loving nurse. You cannot do this work, or fireman, or ambulance, or a million other jobs, even cop, with your dripping heart bleeding out through your uniform. You have to survive. Now, especially in these time, people are doing it every day. Lovingly. And their gallows humor would undoubtedly stun you with hurt. I don't say it is good. I just say that it is.
Let her know you saw it. It is a good lesson. Do it with kindness. I would be she is kind and loving to her people daily.
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Very well said "GardenArtist.," my husband and I have never been on social media and we're glad. If I want to share anything with anyone, I pick up the phone, send an email or write a note. It's much more personal as I may talk about something to one person but, not necessarily share that same thing with someone else.
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"Squatch33," - So very true. A harsh reality we who have to use facilities to leave our loved ones in have to accept!
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I find it hard to believe that someone who not only studied to become a nurse but also went back to school to study for 2+ more years to become an NP does not care about her nursing home patients.

NPs often give better care than MDs. And that's what the joke was about - the stereotypical inability of doctors to be empathetic towards patients.

Death jokes abound. Seinfeld made an episode called The Apartment about getting a coveted apartment after the death of its elderly tenant.
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Again, thank you all for talking me off the ledge. I think I'm just taking every teeny tiny thing as a "sign" that I've done the wrong thing and I need to bring her back immediately. (Not to say we may not have to change and I'll constantly be aware of quality of care), but I needed some perspective.
Thank you all
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Ebmick, you asked in an answer below if your looking this up is wrong. No, of course it isn't. I look up what people have to say on social media all the time. An open page without privacy settings is an open page.
If there were the laughing emojis as you said below, then I would sit this person down, present a copy, and just ask gently "Can you explain this to me?" If she didn't answer I would ask if it reflects her feelings or if she was trying to be "cute". I would tell her that this is a very dangerous practice, and that it could come to her loss of a job at the least.
You are not the only one trolling around Social Media.............Human Resources folks do it BIG TIME.
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It’s an ice cold comment that shows she doesn’t want to get emotionally close to any one patient. I’d ask for someone else to care for your loved one! Or else I’d be worrying & constantly going over there to make sure everything is ok...& I wouldn’t be able to do any of the work I have to do .. hugs 🤗
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My mother lives in a Memory Care ALF where residents pass away all the time. She constantly complains that the staff 'cleans out their apartments immediately' after they die. I wonder what they're SUPPOSED to do? Is there a period of time a for-profit business should wait before they clean out a deceased resident's apartment and allow someone else on the waiting list to move in? This isn't family we're talking about, mind you.........it's a business.

The NP who posted that comment also expressed how she felt it was ' so wrong', yet what are the alternatives? She works in a business where dying is the norm and opens up the opportunity for someone living to move into their place.

It is what it is. I doubt the woman is without compassion or empathy b/c she posted that comment. Some people are more interested in getting 'likes' and emojis on social media than they are in with the content of what they post. Besides, a person in her position has to take a stoic approach to death, or she'd be a basket case each time one of her residents passes away.

I wouldn't give it much thought from here on out if it were me. As long as your mom is getting a good level of care, that should be your prime concern. Don't expect perfection and you'll be good to go!
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I've been reading lots of posts here recently about hospice, NH not being "respectful" of the recently deceased.

I want to own to the fact that my dear mom died on a Friday afternoon at about 2 PM. My daughter and her family were scheduled to fly on a vacation to Ireland that evening and I kept telling her to "go!". She cancelled the trip to help me with the funeral and shiva.

Mom passed at about 3 PM. My brother, SIL and I all loved my mom dearly but we had no interest in paying the NH for another day or of driving back to get her stuff organized. We ruthlessly sorted, kept, bagged and donated all of her wordly goods while my mom's body was still in the bed. The DON came in and asked us to leave for few minutes so the funeral home people could do their job.

My mom was no longer there.

We went to dinner. As I am Jewish and the rest of my family is Catholic, I said to my brother, at about 5 pm, "you do realize that if mom were Jewish, she'd be buried by now?". He got that.

Different traditions have different imperatives.
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As a healthcare member, out hospital has given us all "front cards" that go over our "full name and credential" cards,, these just have our first name and profession, or Dr so and so, and their profession ( no first name for them) exactly because many of us were being stalked on FB, etc by pts or family members,,, often in a nonprofessional way ( like hey your pretty, are you married?, Or I hate you and I am coming after your family). we are also told to "watch what we post",, so if we post at all it is vry vague.. like "what a terrible day, thank you all my co workers"
Barb and others are correct,, we do use gallows humor a lot,, it helps to keep you sane when you are dealing with things like families who are keeping their 95 yo mom who is rotting in the bed alive for the SS check, or the family who is keeping that gunshot family member alive even though they are dripping brain matter on the floor and have coded 3x.
So while I know this is not your moms case, I would guess the constant death and problems the NP faces are wearing on her,, but not affecting her care. I know I care for those elderly PTs and gunshot youths just as carefully and tenderly as the people who I know are going to recover.. And maybe remember she may be able to see you are watching her on social media.. and she may be concerned about you too! You say her care is good.. let this go..
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I have to agree with Tothill. I guess its because my daughter has worked rehabs/NHs for 20 years so that sentence doesn't bother me.

LTC, Skilled Nursing, NHs whatever u want to call them are businesses. As such an empty bed is money. I was up for a job in a NH where my job would have been getting the beds full. That meant that I was to call around to all the Hospitals and tell them that there was an empty bed in my facility.

That conversation was a little blunt. It may not be "that" fast but that is what happens. The Funeral director comes and gets the person. Then housekeeping comes and strips the bed and cleans everything. Remakes the bed and another patient/resident comes in. The bed might be filled that day or it may take longer. So sorry this upset you.

Please understand that Drs, Nurses, CNAs see a lot you will never see in ur lifetime. They need some humor to continue working in these places. I really don't know how my daughter did it and kept a smile on her face. She loved her patients but after 20 yrs it was time for a change. She now manages a Wound care center.
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My mother died at 3am at her NH. The funeral director came at 5:30am. I cleaned out her room while still with her. We didn’t take much with us. I left her clothes thus took only her personal trinkets (a few pics, her eyeglasses). I didn’t want the other items.

My brother and I dropped off donuts as a thank you a few hours later and my mother’s room was cleaned and ready for a new resident. It is what it is. We were done, my mother was gone & I was relieved but sad it was all over.
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My experience was somewhat like Shane's, except my mom's NH had a "serenity room" where they moved those like her who were living in a shared space. It took mom a few days to pass after we made the decision to not seek treatment for her pneumonia so my sister and I were able to bag up and remove most of mom's stuff while her room mates were absent, we came back for the bigger items the day she died. I was impressed by the tender care that was given to her in the days she lay dying and couldn't help but notice the tears in the nurse's eyes (not one of my favourites) as she checked mom's vitals to certify that she was gone. IMO these ladies have to keep a professional detachment or they would never be able to remain on the job, there is precious little opportunity for joy in those jobs because the reality is that everyone there is declining and will ultimately die. It is what it is.
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Im not sure what it is she said that bothers you?
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I agree with the gallows humor for those who work in dangerous jobs--either dangerous physically or emotionally/mentally--have to have an out to remain sane. Actually, what that caregiver posted is mild.

Here's a shift to a totally different perspective: Think of the distressed people on this very forum who are in desperate to place their loved one in a facility but their loved one is on a waiting list. These distressed people are barely holding on. How gratifying it must feel to receive a call that this person's loved one can move in.
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Great answer, BarbBrooklyn.
I work in a forensic setting and can say that our work humor is something that others would not get.
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