New agency nurse .. is 40 patients normal ?

^^ dreadful for you and for the patients.

I understand about the meds. and the problems with getting them out on time.

OK my turn. I just got home from a facility where I've worked a few shifts at their LTC unit. Not my favorite place to go, 2 CNAs for 28 (which is noncompliant for my state), but only 1 trach and a couple tube-feeders. Time-consuming, but I've done enough shifts there that things are starting to go smoothly.

So I get there today and they tell me they need me on another unit. OK, I've walked briefly through the other unit and saw enough to know that it's high census and skilled plus has a few peds, which I have no experience in. So I call my recruiter and tell her the situation, and she is sympathetic and tells me they should not be putting me in any place that is beyond my skill level. She calls the staffing coordinator and the SC tells her that the unit that is new to me is pretty much the same as the one I've been working on. So I say OK.

I go to take report and the nurse there was kind enough to show me around and give me a very thorough orientation, which I thought was awesome. BUT. BUT. BUT. I have a census of 30, 19 of which are tube-feeders and 4 of which are trachs. SO NOT SIMILAR to the other unit. Turns out the reason they put me there is they had another agency nurse who had worked that unit before and would not work it again.

I called my recruiter back and told her that the SC lied to her and I would NEVER go back. She understood and was angry on my behalf.

By the grace of God, I finished my shift on time, and nobody went downhill and I did all my meds and hung all my feedings on time. I am still steaming and am gonna turn the TV on, watch Lifetime, and eat half a pint of Ben and Jerry's.

Thanks for listening!

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...

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

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.

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.

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.

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

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!