registered nurse

nursing assistant

licensed practical nurse

physical therapist

nursing supervisor

ProMedica

A Typical Day
A typical day would be to get authorization to continue services for 3 different facilities.  In order to meet this goal I would need to have in hand the notes from two important departments to complete my review.  Many of the notes needed were often difficult to locate or  not recorded.  There are few facilities within the company using an electronic records keep system so patient care notes could be hand written or electronic.  There was never a sense of urgency regarding when the notes were completed; even-though the facilities knew that the patient's continued admission hinged on having the notes for review in order to continue care. Often I would request their notes 24 hours before having to call the insurance company for review, and still not have them until 5 pm  in most cases the insurance companies had stopped  accepting reviews between 4 and 4:30 pm. This was a common practice which had been going on for years, and even-though it was common knowledge, I would then get a call from my supervisor asking why I had not given a review, when she already knew the answer.  Moreover, I was often told to stop what I was doing to assist another case manager with her duties, even when the end result would be in my being unable to complete my  own assignments.

What I Learned
I did not learn much from my experience there.  I was able to learn how to provide a detailed patient assessment review with success, obtaining a 85-95% continued stay rate. But the experience was overshadowed by the amount of stress I felt to perform daily.  I would say that the best thing I learned was this:  When you encounter a situation  which seems impossible and unlikely to change, the best thing you can do for yourself would be to leave.

My Co-workers
My trainer/co-worker was amazing.  She gave me the skills to navigate within the system and insight in how to survive a visit from our supervisor.  She was patient and supportive, direct yet not condescending.  I learned how to do my job working with her and she was the reason that I was ranked 8th in the 1st quarter despite working under such pressure.

Hardest Part of my Job
The hardest part of my job was my was trying to work,  my supervisor who would insert herself in all levels of interactions between myself , the insurance companies, our vendors, and ever the director of nursing in the facility in which  I was based  She would come to my office and stay all day; and would interrupt  my conversations and insert herself in situations when her assistance was neither asked for or warranted.  Her constant involvement made it impossible to work there.

The Most Enjoyable Thing
The most enjoyable part of my job was getting the care and treatment the patients needed, and not being there.

I was harrassed by a fellow employee. DON tried to do something the day before to make the person stop. The next day that same employee did it again, and put a nurse to tears because she harrassed her. I had to do the work of the harrasser for the 2nd day in a row as they catered to her work load. The day it happened I told the administrator. I told him he had 20 minutes to stop it all, and explained what she has been doing and the DON handled it the day before. The Admin, DON, HR, and other staff had a meeting the beginning of the shift because the harrasser was out of control from the start of the shift. It was insane watching a nurse break down, and the harrasser cussing me out. While recruiting another CNA to cover back end to her behavior. Admin did nothing I had no choice but to walk out. Before I did I good bye to the administrator and residents. Told him I was leaving because I said he needed to stop the harassment. I didn't care if we were short staffed or not. HR threatened my certification 2 hours later if I didn't come back. I threatened them legally back. Then the administrator and HR called me to fire me, but I was willing to talk about it all! I called your cares hotline. Global HR got involved and then said I should of stayed. They twisted the whole situation god only knows why they don't protect there good employees period. The harrasser continued her tirade after I was gone to other nurses for weeks. Till she was eventually fired. It took me to sacrifice my job, and look bad before anyone did anything. I would of not been gone in the first place if they documented her behavior like they should of wait they did! The harrasser did no call no shows all the time. It was well documented trust me every nurse wanted her gone. It was probably because she was a black woman, and they were afraid of being called racist. Not to mention residents feared her and said that they were mentally abused on a daily basis from her. Now I'm gone it's been two years and guess who calls me...the state unit for fraud on medicare, and looking into the deaths of some people, and abuse. I was grilled for 2 hours and really ticked me off. I wanted to forget about this place and its maltreatment to employees. I would so love my job back, clear my name, because global HR and the Cares line failed me in a huge way. I did what I had to do to protect me, because the company wasn't. I want others to be aware that cares hotline is nothing, but a door to figure out how to twist the story to make sure you get fired and ruin your good name. They are not there to help you. If they read this I'm still willing to talk, but not with the same people.

My caseload was typically 9 - 11 patients at this skilled nursing rehabilitation facility.  That may sound like a lot and good time-management skills are critical, but one learns to fall into the rhythm of the job quickly and the workday does not feel as busy as 9 - 11 patients may sound.  The most common diagnoses I would encounter were orthopedic (hip and knee replacements, fractured femurs, compression fractures), but there was a good smattering of patients with COPD, CHF, skin disorders, and generalized weakness.  

There are 2 gyms with assorted equipment for strengthening, cardiovascular exercise, and balance training.  In terms of physical strength, I found that most patients did not need traditional strength training, so much as they needed better endurance, better balance, and better safety awareness.  I would spend a fair amount of my workday focusing on patients' balance, analyzing their ability to perform their basic ADLs, and teaching them methods to simplify and improve their ADL performance.  The most enjoyable part of the job is that I had the opportunity to work closely with patients to really learn what motivates them and how to use those motivations to enhance their health and wellness.  Every now and then I would shop in the community and former patients would approach me and express so much gratitude for how I helped them regain the independence to manage their lives at home and be able to go back out into the community.  This last point was one of my biggest eye-opening experiences.  It's so easy to take those things we do every day for granted, but when activities like going out to lunch with one's friends is suddenly stripped away, you really begin to appreciate how important such activities are for a person's physical and mental well-being.

The most difficult part of the job is working with the occasional patient who has little to no motivation for therapy.  Some clients feel that they were forced to go to a rehabilitation center.  Some have advanced dementia and their motivations may be quite different from most clients.  A few sessions may be needed to draw out the patients' inner motivations.  However, the situation may be that the patient never shows motivation for therapy or being more independent.  The therapist has to learn to accept the patient for what s/he is and wants and work with his/her team to determine the most appropriate living situation and resources for that patient to be safe in his/her home.

I worked at HCR ManorCare for 5 years. There were some things that really bothered me. There seem to be a lack of transparency with the leaders of the company...also seem very distant too. Employees seem to be in the dark on issues with the company. The messages that were given were very vague and general (too many examples to put..but trust me). Also, with HCR being a very conservative company, I think they were too conservative and sometimes really cheap. Salaries were not competitive across the board often below the market value when i look online. There were a few wage freezes over the past few years due to the economy, medicare, etc... While, i am sure the big managers, directors, vp's , etc...still got their bonuses(because it was never said that they wouldnt, so draw your own conclusions). However, when we would get a raise, it was VERY minimal like 2 or 3% and you would have to walk on water to get that.

When we as internal employees apply for a position, they would not even tell us the job grade or salary. So, I felt in the dark as to whether a position was a promotion, lateral move, or what..which made it difficult for me to make an "informed" decision. I worked there 5 yrs and my salary increased by only $2000.00..That is a shame!!! What really vexed me was their Audacity to continually stick their hand out asking us to contribute to various programs like the Hug Fund, United way, etc..which are all great charities. Just kept nickle and diming the employees and not giving them annual increase, not even a cost of living increase...I had stop giving because I just couldnt afford it...Cost of Living is up!

I understand that you shouldnt take a job just for the money but let's be honest, no matter how much you like your job, you still want to be adequately compensated right?? I know, I should be thankful to have a job but I am just saying...

With all this said..I still think HCR ManorCare is a good company (not a great company) good because of the Long Term Care service they offered and of course the dedicated employees, that often got overlooked, undercompensated, and under appreciated. I met some extroardinary people there as well. They have the potential to be a great company if they would get off that cheap overly conservative role and start valuing their employees a little more, and becoming more transparent with employees too. That probably would help reduce turnover too.

I was hired as a Per Diem Hospice Visit Nurse with the expectation that I worked two 8-hour shifts a month, and no holidays.  I was promised that my visits would be in my local county, closer to home.  However, after I accepted the position and was trained in (if you call that training), the expectations suddenly changed and I was expected to work a minimum of four 12-hours shifts and two holidays a year.  Plus, when I do visits I am driving over 60 minutes to many of my visits (and over 60 minutes back home at the end of the day).  Triage nurses that work on weekends are not local (they live outside of the state) and do not know the local cities so they send you and other nurses all over our region.  Triage nurses don't attempt to help patients over the phone, only send out nurses to "deal with" the patients.  Triage nurses are not wiling to go out of their way for anyone including fellow staff.  Training is absolutely the worst - it is a "figure it out yourself" environment.  Supervisors don't call you back, and you are oftentimes left alone with no support in patient's homes in situations that you REALLY need direction/help.  They hire just about anyone who applies, and it shows.  They accept just about any patient that wants hospice, regardless of their skilled nursing needs (we call ourselves "ICU Hospice" nurses because of the HIGH acuity level of many of the patients).  Communication between office and field staff is awful, communication between field staff is bad too (at least with RNCM to the Visit Nurses). Office staff and supervisors are often times found in the office talking, sharing recipes, eating the appetizers they bring in only for each other to share, and they are laughing while the field staff is busting their butts trying to get all the patient visits completed.  The administrator there does not have a hospice background, and it shows.  The Director of Professional Services (Clinical Manager) is so sweet and kind, but overworked and not available for her field staff. The Medical Director is amazing, always available for the hospice nurses and for all of his hospice patients, he's easy to talk to/get orders from.  The Sales Team will over promise things to patients and families, and then the patients and families get very upset when field staff can not deliver the unrealistic promises.  Very disappointing, since I left a good job to come here (Pay is VERY good but wondering if it is really worth it).

I have worked for manor care for 3 and a half years.  I have worked days, nights and evening shifts. There are many skills you will learn working at my facility: IVs, TPN, Peg Tubes, NG Tubes, manual and cycler dialysis, wound care, diabetes management, LVAD, Cardiac patient care, post surgical care, wound vacs, trachs, BiPap / CPAP, end of life care, admissions, discharges...the list goes on. 

Workplace culture fosters teamwork, some are better than others in this regard. Long orientation (IMO) and they try to work with people who have special needs to get them proficient. However, nurses get a little burnt out orienting. Many new nurses find they cannot deal with the pace, stress and hours. 

I typically love my job, but recently we have had a shortage of staff to fill our needs. Patient acuity has increased, patient load has not  been reduced and it makes what should be an 8 hour shift become a 10-12 hour shift. This is causing a lot of burn-out . This coupled with recent supply issues has caused nursing staff to have to leave their unit to check other units in search of supplies they need for providing care,  which causes even more stress. lack of adequate management  leads to things falling through the cracks and delays. 

In the last 6 months, my unit alone has lost 3 unit managers, 6 orienting nurses and 4  experienced nurses. Many others have expressed desire to or are currently looking for another job.

Management needs to re-evaluate the nurse/ patient ratio on the unit - base it on acuity rather than just numbers. A  full care bariatric patient who is incontinent, has a wound vac, IV and is a diabetic requires more care than a "simple"  BKA patient.  They also need to hold people accountable when they do not show up to work or show up late. The ignoring of the obvious infractions by staff is causing other staff to not care so much about doing their jobs right because no one  is going to hold them accountable apparently. 

On my unit, the work is hard, we rarely get a break and we typically stay on average 3 hours after the end of the shift to document on every patient, finish admission documentation, complete wound care and treatments. If someone falls, add another hour or two of documentation, at least.  I am not sure if this is typical of all manor care facilities.

This was an Alzheimer assisted living facility. I did activities for this community. It was like going into world that just they understood. It takes allot of compassion to reach them, the people here have become very disoriented with life.

They feel very cut off from there loved ones. Your heart goes out to them when you realize that without you coming to visit them everyday; how lonely thier world would be. I breaks your heart when you see how much pain they are in when the family leaves again. You realize how vital what you do really is to everyone there. 

The nursing staff was good but there was a very high turn over with the nurses aides. I saw new ones all the time, however the place was family friendy. I brought my children to work with me many times. They were my assistants and were always a big hit. They loved my children.

I was beloved there and the residents would collect outside the activities door every day waiting for me to come. We went outside on the padio and listened to music and have morning snacks outside on nice days. I tried creating new memories that were simular to the ones they experienced when they were younger, so they felt life still had meaning. 

We had craft time, games, reading current events, the news paper, read poetry, and we talked about what was going on in the world outside. We had birtday parties, holiday celebrations with their family, and lots of music.

Having my children there was the most enjoyable part for me. They were a huge help and loved it when I made my famous cookies and the director came from her office to get cookies; when my children were not there to deliver them. My children went to every room so eveyone got a cookie, if they wanted one.

I went to see one of my residents in the hospital before she died. We had a beautiful time, and she and I spoke of how much she was loved by her family, and how much we all loved her. She was blessed as much as I was by the visit.

The nurse from the hospital saw the sweet tender loving moments and the words we has spoken to each other. It ended up being right before she passed away. The nurse told my employer what a treasure they had in me. I was very close to my grandmother and her influence on my life was apparent when everyone came to visit.

My time with this company and building was short-lived. 
I was constantly trying to battle my time between performing nutritional assessments on my patients (which was VERY high acuity), and running the kitchen. The foodservice director quit soon after I started and had to orientate to my new role, as well as be thrown into managing a kitchen. Did not receive a pay increase, and administration would hound us on overtime. It was set up to be a failure, in my opinion. I usually consider myself a tough person, but I let this experience effect my entire life. There was no real leadership or someone to take charge and fix the things that were broken. Corporate management was not helpful. I barely saw them, and I doubt they cared to learn my name. They would receive complaints often and no action was taken. I truly got the feeling they do not care. The one time someone would bring up feedback in meetings, it was taken in an incorrect manor. 

I had excellent dietary cooks and aides that were basically working with no real manager for months. The hiring process took forever, and I'm sure it was due to saving them money while they overworked me. I reached a breaking point. The reputation of the building is not positive and I feel it makes it difficult to get quality staff. 

I also did not have a pleasant experience with receiving my benefits. My address was put wrong into the system, which later on found out about. I was first told that I would have to wait a year before I could apply again (even though it was their mistake). I spent weeks trying to appeal the process and after around 5 people in corporate would receive the help I needed. By the time I got my benefits, I was already giving my notice. 

Be prepared to have chaotic days here. The system has been broken for years with the high turnover rate in management. We lost around 10 people in management while I was there for 5 months. It will take a very strong and diligent team to get this place back to where it is supposed to be, and even then I question the success.

My typical day at work was pretty easy, I worked night shift and I would come in and get report from the previous CNA abouit new patients or changes in condition. Then I would go down my hall and check all my patients and set myself up for my first check to change the patients diaper or take them to the bathroom. Finally after all my bed checks I would chart, take out all the trashes, and get ready for my  replacment to come in.
   In all I learned to take care of people and learn to love what I do because, a young girl taking careof them is embarrassing but at the same time they are very thankful for the help as I am they help me live as I help them live. I love it! I learned how to handle problems, major problems with this job. Wehter it was with managment, a patient, or a family member.
   Managment changed alot in this job, but the last one before I left was amazing. If I had a problem that a nurse couldnt help me with she would leave her desk put on some gloves and was willing to jump out there and help anyone. She had a wonderful heart and is actually still there.
   The co-workers I worked with were pretty cool and laid back. I had one CNA that was actually my best friend and we helped each other every step of the way and of course anyone else that needed help. The managment stated all the time that me and this co worker/best friend were the best two CNA's in the whole facility. So that made every work harder.
   I can honestly say that the hardest part of this job would be two things. The lifting heavy patients, because it physically hurts you and them to. Its a really rough job when you dont have help or a lift and they weigh two times what you weigh. Finally the hardest part about this job for me was death, because my patients were like my family and I treated them as if they were my own. I get too close to my patients and when they die it made my job alot harder.
   The most enjoyable part about my job was taking care of my patients in a way not even the closest person to them could fulfill. I got to take care of them at their worst and gradually grow with them. It was amazing!

What is the best part of working at the company?
Nothing at all. Management sucks more than it ever did before. They don't care about the staff they have or do anything to try and keep the staff. There are multiple times a week where there is just one aide for almost 60 residents. The office people don't stay and help when there are nights like this. I have never seen a more unorganized work facility. I don't recommend anyone working here unless you like this type of work environment. I work as a CNA, I was full time for 8 years and then went PRN after I had my child. It was going down hill then, The DON at the time would not accept my doctors note for light duty considering I was high risk. There is nothing good about working here. Everyone that tells me they are going to apply to this place I tell them they don't want to and to look for somewhere else. This company really ruined my passion for working in the medical field. 

What is the most stressful part about working at the company?
Most stressful part about working for this company is everything about it. Extremely short staffed. Management doesn't care about the staff or the residents that live there. The place is disgusting. Nothing gets fixed or its not fixed right. I don't like anything about this company. 

What is the work environment and culture like at the company?
Work environment is extremely stressful and the culture isn't good either. I have never worked somewhere where i dreaded walking in the door to clock into my shift. Thinking about working alone for 60 plus residents for an 8 hour shift is not something that anyone should do and it is a constant thing with this company. No matter who they hire they end up leaving within a week because of how bad the work environment and culture of this company is. 

What is a typical day like for you at the company?
A day there as a CNA is more than we can handle. You are always alone, the office people don't help, the nurses won't answer bells or help the person that they know is alone trying to take care of all the residents. You are expected to do more than what one person can handle alone.

Top Job Titles	Average Salary
Registered nurse 16 salaries reported	$38.03 per hour
Nursing assistant 18 salaries reported	$18.75 per hour
Licensed practical nurse 9 salaries reported	$28.36 per hour
Physical therapist 55 salaries reported	$37.57 per hour
Nursing supervisor 1 salary reported	$38.75 per hour

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