I have to say no when I know I am going to place where staffing is poor and I cannot give patients a decent once over and feel I can do a safe med pass! DO NOT feel bad! It is our license on the line. The agencies I deal know that I will work hard, but not unsafe and I am sorry but 27 residents on daylight, with 5-7 diabetics is not safe.
I used to have a problem saying with this when I first began Home Care. I often said 'yes' when I wanted to say 'no'. My family suffered as a result. I finally got some backbone and began saying no without giving an excuse. One of the few benefits of Home Care is the flexibility. So for whatever reason you can't/won't work a PRN shift, say no and lose the guilt!