New agency nurse .. is 40 patients normal ?

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

I am in Colorado and know that some of the LTC's here staff great = 1 nurse (LPN/RN) and 1 - 2 cna's (don't do med techs here) Others I won't step foot in - had 50 patients, 1 RN and 1 CNA for 8 hours!! Never go back - I feed my children with my license, don't you?

Didn't CO start a med aide program like a year ago? I wonder if facilities are reluctant to utilize them...

Forget the med aides. Hire more nurses.

Lindarn, RN, BSN, CCRN
Spokane, Washington

I just came off an assignment two days ago. I was given 27 patients. Doesn't sound like much but the acuity level was quite high for a nursing home.The entire unit was 54 patients. It was myself an LPN and 4 CNAs. It was one of those days when everything went wrong. I had several intermittent G-tubes. Several insulins. Caths with irrigations and a few very end stage Hospice patients with q 1hr and q2hr Mso4s. At 2 pm on a 7-3 I was still passing meds from the morning med pass.I wasn't able to chart ,do vitals let alone treatments. The shift end was at 2:45 and being Agency I wasn't permitted to stay over. I forgot to mention that there was an RN supervisor at the desk who sat all day and didn't lift a finger to help. I was at the point where I was in the middle of a melt down. I was so out of compliance with the med pass that I felt horribly unsafe and I have never felt that way in my 35 year career.. The sad part of it is that there was nothing I could do about. I got no slack from the RN Sup. just an ass chewing for not haveing all the work completed. Thanks for listening..I needed to get that out with out burdening my family with it. I send love to all my Nursing collegues. Aloha