I'm exhausted...it's ridiculous (and unsafe)

[jelptex]

Hi !! Just got home after the most ridiculous assignment of my (33 year) career.

As an agency nurse, I accepted an assignment at at local nursing home (night shift).

Bottom line --- 58 patients (that's right 58 !!) on my floor. Only RN in the facility. LVNs worked other floors. No shift supervisor.

Tube feedings, 27 chemsticks, 15 scheduled insulin dosages & (perhaps) 30 scheduled meds.

THANK GOD, no "incidents". All alive and in their beds/wheelchairs by shift's end.

Had benefit of three CNA's, but they are restricted to direct patient care issues. No glucometer, no med techs, NADA.

Perhaps it's time to go back to ICU/ER/PACU (25 years) with my pitiful 1-2 patients and essentially sit on my BUTT !!

I'm BUSHED !! Don't ever talk to me about "difficult workloads". BEEN THERE. Give it a try all of you who feel overworked.

[email protected]

[MassED, BSN, RN]

sounds really crappy. Hope you move on out of that travel assignment soon!

[MassED, BSN, RN]

many areas call it differently - chemstick, glucometer, chemBG, CBG.... oh and glucose check.

[P_RN, ADN, RN]

I used those when I worked for a doctor, it's a stick like a dipstick but only has one pad. You put a drop if blood on it time 6o seconds then wash the blood off with a stream of water from a squeeze bottle. You then compare the stick with the color panels on the side of the bottle. Dextrostix is the brand name. And the last time I saw one used was 1974, Unreliable and dangerous.

[SlightlyMental_RN]

I am thinking it's the old fashioned term, because that's what they used before they had glucometers.

It's like where I work, several of the long time nurses calling a saline lock, a hep lock, from when they used heparin flushes for peripheral IV's.

What she said.

[indigonurse]

Unfortunately what you are describing sounds about right to me. I did that type of nursing for most of my career the only thing you were missing out on was a full code, res. death, a fall, an admission, of course 15 minutes before the next shift comes on which legally makes it your responsibility to carry the entire thing through from start to finish. Gets even better when you are working a 12 hour night shift. I have seen some older nurses BP's go up, have chest pain and had to call 911 to get them help before their shift ended (no joke!).

[GM2RN]

many areas call it differently - chemstick, glucometer, chemBG, CBG.... oh and glucose check.

we also use glubed, for bedside glucose

[kcochrane]

Unfortunately what you are describing sounds about right to me. I did that type of nursing for most of my career the only thing you were missing out on was a full code, res. death, a fall, an admission, of course 15 minutes before the next shift comes on which legally makes it your responsibility to carry the entire thing through from start to finish. Gets even better when you are working a 12 hour night shift. I have seen some older nurses BP's go up, have chest pain and had to call 911 to get them help before their shift ended (no joke!).

Sounds about right to me too. I left that type of scenario when I got my RN. I worked on a LTC respiratory unit. I was lucky in that there was usually 2 LPNs for 36 patients. I say usually since they sometimes pulled one if other floors were short since they only had one LPN OR sometimes my fellow LPN would call in sick too late to get a replacement. It was an experience that left me able to handle more than one thing at once. And they wonder why I don't complain now even when I get 7 patients.

CNAs in this area in LTC can only do vital signs and patient care. That seems to be enough given the level of care needed for these people coming in to nursing homes.

BTW in our hospital, techs can no longer do glucose sticks due to billing issues.

It should get easier as you get to know the patients. Then you get can some sort of routine and know who to see first. :)

[carolmaccas66, BSN, RN]

Yep, been there done that!

Accepted an assignment one afternoon for a LTC place and I had 65 patients to do meds for, BSLs, etc, etc and about 5 PSAs (CNAs) to supervise. I got no handover because the day RN was new and she didn't get a proper handover. The EN (your LPN I think) was sick so I basically barely got through my meds, was late with everything, late giving handover. Lucky the night staff knew the patients.

I promptly rang the next morning to my agency and said don't ever send me back there again.

Talk about a nightmare shift, I thought it would never end.

[CoffeeRTC, BSN, RN]

I'm confused. Have you ever worked LTC before? 58 pts for an 11-7 shift is kinda the norm. At my place we have 50 and do everything. Meds, tx, blood sugar checks etc...it is totally crazy esp in the am getting all the insulins and meds etc.

I've been doing LTC for ever and know my limits. Depending on the acuity the 50-58 is about the norm for an 11-7 shift. Is it easy? Heck NO! is it legal..yeh. That is sick and crazy.

[LesMonsterRN, ADN, RN]

This doesn't have to be the norm, however. One licensed nurse for 58 is dangerous. Sure, someone with a set routine and experience can do it in good time, but that doesn't leave much wiggle room for an event like a code or a fall.