I understand that there are a lot of good nurses/nursing homes out there (I used to volunteer at a good one back in high school), but where I live right now that's not exactly the case. Two nursing homes have been shut down by DOH in the past 3 years for violations of all sorts of stuff, as well as inappropriate care. Two others are on "probation," and the reason the one at least hasn't been shut down yet is because they had such a hard time finding places for all the patients they had to take out of the most recently closed facility, and all the other nursing homes in the area are still overcrowded. There are also a few more in the area that have been on probabtion from Medicare for violations of their regulations.
I've reported nurses to the administrator (about the LPN to the one of very few RNs actually in the building), and as a result she called our office to complain that the crew was being "disrespectful" in front of the patient, when in fact my partner was taking care of the patient, and when the head nurse showed up to make sure we were treating the right one, I took her out into the hallway to talk to her. I've filed reports at the hospital and by written documentaion about some of the stuff I've seen (ie: dining room of 50 residents with nobody from staff there to watch him, and therefore nobody to tell me how the patient had fallen, when he had fallen, or if he lost conciousness, since I don't speak German and couldn't ask him myself).
As far as educating the nurses go, we've tried to tell the nurses at one nursing home that when a patient falls and is complaining of head/neck/back pain, it's not a good idea to pick them up and move them, but is better to just leave them on the floor to minimize injury. The LPN's response (because nobody could find either of the two RNs that were in the building) was "but the patient isn't comfortable lying on the floor" and to walk off. At one of the nursing homes that every time we go, we have to explain to the same nurse every time that we need the paperwork for the hospital, and each time she's walked off in a huff saying "nobody's ever told me that before." The time we had an arrest there, we told her to just fax the paperwork over, since we weren't going to wait 10 minutes again for her to finish copying it. Our agency has in fact tried to talk to the administrators at some of the area nursing homes about teaching them what they need to do in certain situations (falls, hip fxs, etc) and each time have been turned because "we teach our staff everything they need to know."
So basically, even though I know there are some nursing homes out there, since I have been working in EMS, I have yet to see it.