Reflections From a Former Nursing Home Staff Member

Patty Austin, RN, CPHQ, Nursing Home Quality Improvement Specialist reflects on her time working in the field as Quality Insights kicks off National Skilled Nursing Care Week.

My name is Patty Austin, and I am a nurse who has worked with Quality Insights on the nursing home projects for just over four years. I have tell you, I love my job! It’s a job that I coveted for years as I worked as a director of nursing in a skilled facility in the Western part of Pennsylvania, and it has lived up to my expectations. But, no one is more surprised than I am at how much I miss the skilled nursing setting, particularly the long term care aspect of it. 

Don’t get me wrong – I don’t pretend for one minute that I long for the days of my phone ringing at 11:02 p.m. to tell me that the night shift supervisor didn’t show up for work. I don’t miss having to figure out how to ask a nursing assistant who has just worked a nine day stretch to please pick up that 10th shift. I am happy to have left behind sleepless nights when my county was under a severe storm warning wondering if we would lose power, and was I sure I had enough fans on hand in the event the air conditioner went out? I can tell you though that four years away makes all of those things seem like such a small part of the job.

What I miss is the gentleman who waited at my office door for me to get to work every morning. Most mornings he had plenty to say – mostly about what he and his wife did last night, although she had been gone for many years. Some mornings, he didn’t say anything but “Good morning,” as he wheeled himself in and would then sit silent as I got ready for my day. I miss the team of managers that came together with me when Nursing Home Compare first arrived on the scene, and we tried to figure out the best way to understand another new thing. I miss the satisfaction of being one of the first facilities to actually write a QAPI plan in our area and the pride of watching the staff become used to using root cause analysis.  

Sometimes I find myself remembering a particular family member and the way we came together to solve a problem or another with whom I shared genuine grief over losing someone we both cared about. I think about the nursing assistants most often. It’s where my career started, and I understand how hard they work and for how little. I hope that each of them feels valued, not by just the residents and families, but by their managers and coworkers. These are our common stories – the things we share as long term care professionals that make us who we are.

In times like these, with COVID 19 ransacking our facilities physically, emotionally and financially, that I am most conflicted. Times when the media is telling only the tales that generate clicks or sell papers and never the countless positive stories that all of us could share. Times when people I know and those that I only know by profession are putting their own lives on hold to make sure other lives continue as safely and as normally as possible.  

Of course I am grateful to have a job I enjoy that allows me to help nursing homes across our state, but I am also plagued with a sense of guilt that I am not out there on the front lines with all of the true combatants in this crazy time. That is what I miss most – a team coming together to find ways to beat what can seem like insurmountable odds to improve the lives of real live people. I am thankful for the time I was given working in the skilled nursing setting, but I am most thankful that there continue to be unsung heroes among us who unflinchingly man the fort. I hope you know, you have my respect, my gratitude and are never far from my thoughts.

(picture features Patty (right) and her mother)

5/11/2020 12:00:00 AM | 5 comments


Beckey Cochran
Great blog Patty. You are such an amazing nurse and I know how much you love the nursing home community and their residents. I know you miss the interaction but hopefully you have the best of both worlds now as you advocate for the staff and residents in our nursing homes.
5/21/2020 5:21:48 PM
Kelly Brooks
Great post. Thanks for sharing. I understand that it is incredibly difficult right now to get nurses to staff LTC facilities because of COVID-19. While I understand the trepidation, it absolutely breaks my heart to know that these individuals, so at-risk and having survived so many things in this life, are not able to receive the quality care they deserve at a time like this. I am reassured that there are still nurses hanging in there for the patients who need them so much.
5/11/2020 3:18:00 PM
Donna Balsley
Thanks for sharing what makes you such a great nurse! We need to hear the good stories about long term care and the staff that work so hard to make life meaningful for residents.
5/11/2020 9:17:56 AM
Cindy Thumser
Great story and very timely, especially as we just celebrated National Nurses' Day on May 6th. Nurses on the front line and those supporting their efforts are truly unsung heroes. Thank you for sharing.
5/11/2020 8:36:28 AM
Misty Kevech
Thanks for sharing Patty! I love when I see one of the few stories about how nursing home staff are being creative to connect families to their loved ones. You are right, we need more of them and nursing homes need more help! Thank you for sharing,
5/11/2020 8:13:46 AM
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Information, insights and actions to improve health and care from Quality Insights, the healthcare improvement experts.

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