[BearyPrivate]

I am an LPN and have worked at my current position for 3 yrs now.
I am the only nurse on Noc Shift with 79 Residents. I will break this down. We have 15 Alzheimer Res. 12 Medicare Residents and 52 skilled / non-skilled residents on 2 other wings. The Alzheimer Unit is a closed locked Unit. The Medicare is on one wing opposite the unit. Now, my gripe is that they only schedule 4 CNA's ( some noc's it's 1 cna and 3 na's I might add),and me, the one nurse. Our fire code is 20 to 1 ratio at noc. This is what all facilities go by, the bare minimum for fire code. It does not take into consideration that there are 4 G-tube pt that need flushed, 3 of which gets bolus feedings q morning, 2 IV's in the building, 3 trach's that need suctioned numerous times during the noc, treatments that need done, one of which is a horrendous decub the hospital caused by not turning our incontinent pt, the decub is so bad we are in the process of dakins wet to dry and the skin is literally falling off. Oh, and I get to pass my own meds. What do they think we are super nurses. It is getting ridiculous. Every time I talk with the DON about more help ( another nurse to be exact) she gives me the same BS there aren't enough PPD's. When I talk with the Administrator he assures me we can have a Med Tech but I ask him where are they I don't see one. He actually told me if I could find one who was wanting to work noc shift let them know and he would hire them. Excuse me, I thought that was the DON's department. Thanks for letting me vent. My hope and prayer is to get another nurse for one side of that building cause I can not leave this position for reasons I do not wish to share here.

[semiller36545]

Clearly , something needs to be done. I have a lot of LTC experience and that is just unsafe and WAY inappropriate.

[racing-mom4]

I can not even get my mind on the logistics of this scenerio. If the ahlz unit is locked, who is in there with them? One of the CNA's? Do you carry a pager/beeper? How is a CNA to get ahold of you if someone needs a nurse if your in another wing/hall?

This just seems so unsafe to me I have no advice for you, if the DON wont come in and work with you at night and they wont hire from an agency I dont know what to tell you, except stop doing anything that is non-critical.

If you cant get done your assessments because you were passing meds or your CNAs cant do the pts baths or pass their ice water/linens because the they were helping you with the dressing changes or something along those lines. Point being if 1st shift has to start picking up some of your work because you simply did not have the time to complete it, maybe they will listen to them complain along with you and you will get some help.

I wish you the best of luck and pray there is not a fire, cause you couldnt get everyone out safely....

[KarynicaRN]

wow. just wow. You have to be majorly stressed. I can't imagine working in such an environment. That is clearly too much for one nurse to handle. The DON needs to do his/her job and get you some help, even if it's through a staffing agency. I feel for you.

[nightmare]

Have moved this to LTC for more informed input.

I work one nurse to 30 and I think that is just do-able depending on the number of carers working.

[nursejaybird]

I hear you on the poor LTC staffing. I am an LVN and have worked only LTC since getting my license in 1996 and what you are describing is exactly what I have encountered-especially on noc shift! Some nights there was just me and one cna for 80 patients and the DON just said "what do you want me to do about it?" My advice for now is become aware of your state's LPN practice act (here in Calif if we are short staffed, the nurse in charge can decide what "non-essential" duties can be omitted and then notify your on-call supervisor and the next shift) Also, think about going for your RN-that's what I'm working on and believe me, it is a whole new, better world for jobs out there and in the mean time I support every safe staffing initiative that I hear about!

[BearyPrivate]

Thank you all for responding. No, it's not changed, We now have 80 Residents and one that was admitted is a J-tube pt to boot. I have called the cooperate representative. No luck there, he spews the same BS the Administration does about PPD's whatever. I am calling state dept tomorrow. Wish me luck.
PS; I love ICONS!!!!!!!!!!

[NRSKarenRN]

Call your state patient ombudsman too...
Expect to be out of job if you go through with this as "ppd doesn't support the staffing".