New agency nurse .. is 40 patients normal ?

Specialties Agency

Published

I was a float pool nurse at a hospital right out of school and this is my first week as an agency nurse. My first assignment was at a nursing home and when I got there I was told I had 40 patients on the evening shift.

So I had to do the 5PM and 9PM med pass for 40 patients plus dressing changes , fingersticks and insulin and tube feeds. I ran the whole time without a break ( I am used to this so I didnt complain). Meanwhile the patients have no wristbands so I have to ask the CNA's who is who and the patients were all sitting by the nurses station. I felt very unsafe doing this , the workload was insane , and plus giving meds by just asking the CNA's who the patients were is not something I am comfortable with. I was the only nurse on the floor so I just did what I had to as safe as I could.

So the next day I called my agency and told them I had 40 patients and if that was the norm . They said they would speak to the director and get back to me , meanwhile I had to be back at 3PM and it was around 1PM so I started driving there figuring she would staighten it out.

Once I was about 5 minutes away she said I would have 40 patients again and apoligized and said to just go that one day and see how it went. The staff is amazing and very helpful and said since they like me they would all be willing to help if I decided to come back.

The pay is great. The drive stinks. The place itself is nice. But I am just looking for an outside nurses opinion. Is 40 patients just plain unsafe to do 2 med passes on ? And should I find a new agency or is this just how it is?

I am in NY if that helps.

Thanks

:banghead:

Specializes in Med Surg , ER , Psychiatric : float pool.

Thanks for making me feel like I am not the crazy one !! I did not go back to that nursing home. They kept calling me everyday asking me to go back until I finally stopped dealing with the agency all together. I am now doing homecare which is ok but reallllly boring and getting paid alot less than what I was making in the nursing home since both of my patients are medicaid patients. But my anxiety level is a hundred times lower :up:

I just can't wait until I can get back into a hospital. Thats my true love but where I live now it seems almost impossible to get a LPN job at a hospital. :bluecry1:

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Specializes in LTC.
Thanks for making me feel like I am not the crazy one !! I did not go back to that nursing home. They kept calling me everyday asking me to go back until I finally stopped dealing with the agency all together. I am now doing homecare which is ok but reallllly boring and getting paid alot less than what I was making in the nursing home since both of my patients are medicaid patients. But my anxiety level is a hundred times lower :up:

I just can't wait until I can get back into a hospital. Thats my true love but where I live now it seems almost impossible to get a LPN job at a hospital. :bluecry1:

That's how it is here, too. WTH do they have against us? We're all nurses fer cryin out loud. But, I guess that's the topic for another post...I actually love homecare but am enjoying the money I'm getting from agency too, LOL. The one I work for does not bug me about going to facilities they know I will not return to. I'm sorry yours did that to the point where you stopped working with them. :(

Hey, if you have hospital experience, I wonder if there's an agency that would send you on hospital assignments? Just a thought...

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Specializes in Med Surg , ER , Psychiatric : float pool.

Well when the other agency first called me they said they were gonna put me in the ER. Then they saw I was a LPN , I guess they didnt read my resume in depth and saw I worked in the ER before but once they found out I was a LPN they said you have to be a RN to work in any of the hospitals around here :crying2:

I am starting RN school in January and will hopefully be done soon so I guess I will just stick with homecare til then. :banghead:

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Specializes in LTC.
Well when the other agency first called me they said they were gonna put me in the ER. Then they saw I was a LPN , I guess they didnt read my resume in depth and saw I worked in the ER before but once they found out I was a LPN they said you have to be a RN to work in any of the hospitals around here :crying2:

I am starting RN school in January and will hopefully be done soon so I guess I will just stick with homecare til then. :banghead:

Good for you for starting your RN; I guess that's the only thing to do. I need to do the same before I wind up crippled or dead! LOL

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Specializes in LTC, Hospice, Tele, ICU.

Most of my experience in LTC I had a patient load of atleast 30. Once I went to this facility and had 40. I was the only nurse on the floor and had never been there before so I didn't know ANY of the residents. I too felt unsafe in this situation. I complained to my agency and never went back to that particular facility.

Once you've been agency for a while, and get to see other facilities, it'll get easier to pick out where you wanna schedule yourself and where NOT to unless you are absolutely desperate for a days pay.

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Specializes in Mental Health.

:bugeyes::uhoh3::banghead:Try 60...Yes...I had that many patients as a new nurse while working LTC on 11-7. I shared the responsibility with an RN who would come over at 3 am to assist. It was a terrible job and I would not want to be put in that situation again. I only worked there a total of 6 months. The first 3 months full-time...the last 3 months I worked per diem and they added another nurse it wasn't enough to keep me. I moved on to corrections and only had on most nights between 7 and 10 patients.

Here in Miami it's not shocking to here of an LPN with 40 patients at a LTC facility. In fact, the smallest number I've heard is 15. Working with that many patients can be stressful...just because you never know when something could go wrong.

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I moved to Oregon after working at a hospital for 7.5 mths out of college and could not find a job due to not enough nursing experience past 1 yr and had to revert to agency nursing. I had a few assignments like that at a nursing home but demanded to only take the assignment if I was on the Skilled Hall. There you will have less Pts to manage and there are approximately 10-15 patients but not all high acuity...IV meds and dressing changes. There should be a ring binder with each patient's picture and name in it.:nurse:

Remember, this is your license you are putting into jeopardy. Protect it.

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Hi, I, not a nurse yet (Still have three quarters to go) but I was a med tech at an assisted living and this sounds about normal. Yes, It does feel scary and unafe when they don't have any identification on. They had their pictures in the MAR and I got help with names until I knew everybody. I had about 35 pts and the nurse had 25-30. The 5 pm pass wasn't so bad because they were all in the dining room at the same time but the HS pass took longer because your'e going to all they're rooms. At least then, you have the names on the outside of their rooms or room numbers to correspond with the MAR. It really does get better once you know everybody. Good luck!

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Specializes in LTC.
I moved to Oregon after working at a hospital for 7.5 mths out of college and could not find a job due to not enough nursing experience past 1 yr and had to revert to agency nursing. I had a few assignments like that at a nursing home but demanded to only take the assignment if I was on the Skilled Hall. There you will have less Pts to manage and there are approximately 10-15 patients but not all high acuity...IV meds and dressing changes. There should be a ring binder with each patient's picture and name in it.:nurse:

Remember, this is your license you are putting into jeopardy. Protect it.

I know I am risking opening the endless debate about med aides, but at least here in OR most large NH's have med aides and it takes some of the ouch out of going into an unfamiliar building. Are you in the PDX area? :)

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Specializes in Med/Surg;PACU.

I remember the first time I went to a nursing home while working for an agency. No one had wrist bands on, and only a few residents had their pics in the chart. So, I'd ask the aides where's Mrs. so n so? Answer, oh she's the little old white haired lady, with glasses across the room (dining hall, full of little ol' ladies with white hair and glasses). Now which one would that be? If you are a regular employee you can handle those numbers of pts. because you know them. But, coming in cold, yikes! I have not worked with med techs, and they are becoming more popular here, but I don't think I really like the idea much.

Liz

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My hat is off to anyone who can handle that. I hope that everyone is either OK with it, or moving on quickly. I get a sick feeling in my stomach just considering those ratios. I don't think I could do it.

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