My AL facility admin have lost their minds.

GSDlvrRN, MSN · Jul 19, 2016

We had a new DON start a few weeks ago. We've already had 2 staff members quit at the end of a shift (which never happens here). She is adding more residents at an alarming rate. Their new goal is 50 residents to 1 nurse. The NOC nurse doesn't even get an aide. It's simply impossible.
The DON is useless. She is salary and maybe puts in 5 hours a day. She then dumps her pending stuff on us to do. I already have 38 residents. I can't do any more! She had to work the floor the other day and admitted it was already impossible. Yet she's adding 2 more residents this weekend. I can't afford to just quit, but you bet I'm looking for a new job. I'm in school so that complicates things with jobs. Ugh. I'm just so livid at this new "goal".

Has this person ever worked the floor?? Does she know what floor nurses deal with?? Has she lost her mind?? Where is all the extra staff she is hiring to help with her new goals??? 50 residents to one nurse? FIFTY residents to one nurse??? And the NOC nurse doesn't get an aide. Looks like it is all about this DON's goals, so kiss Maslow's hierarchy of biological needs goodbye. Basis needs are going to suffer (toileting, feeding, showers) without enough aides, and med passes are going to be unsafe(er). It does not look like this DON has patient safety as a priority either. Find out who you can talk to, and you go on with your bad self with your staff, as a team, and outline exactly what is going on. It is okay to say "I can't do it" and it is okay to say "This is is not safe, this is impossible." You need to have overwhelming support and everyone needs to be on the same page. There is not getting better in time with this time, that risk cannot be taken when, the woman said herself that it is impossible. Is she willing to provide you with the resources and training so that you can met her expectations? Neh.

OrganizedChaos, LVN · Jul 19, 2016

I'm so sorry. *hugs*

walkingon, CNA, LPN · Jul 27, 2016

Sounds like a nightmare! Good luck with your job search!

TEXASWAG, MSN, RN · Jul 27, 2016

Yes, this trend is growing very fast...load up patients and decrease staff. Your DON has no real power with all of the changes. Corporate is making all of the decisions with no regard to patient safety. I give your new DON a year before she quits. You can either suck it up until you finish school, of find something PRN. I feel bad for all staff working in nursing homes, LTACs, etc. It has gotten bad and will continue to get worse.

lmjsierra · Jul 29, 2016

that is horrible!!!!

strawberryluv, BSN, RN · Jul 29, 2016

It's actually pretty normal for 11-7a nurse to work 1:60 patients in LTC facilities in NJ. At my second job that is the ratio for me. I don't do any direct patient care though. I think your DON wanting no aides for such high amount of patients is just wrong and unsafe! Most of patients need incontinent care and or assistance to toilet at night. With no aide, they will work that nurse to death. People are not going to be toile ting in time or not at all! At my job, at night I have at least 3 nurse aides for a floor of 60 patients which is okay. I can't imagine not having an aide at all for my assignment. I would just resign...

NurseQT · Aug 3, 2016

So the noc nurse is on her own? That can't be legal, what about residents who are assist of 2 for transfers and bed mobility?! Care plans have to be followed, a facility can be cited for failure to follow a care plan.

I doubt these changes are coming from corporate, I'm gonna bet it's a combo of the DON and NHA who are responsible for these changes. If I were you I'd address my concerns first with the DON, if she won't listen then go to the NHA, if they won't listen then it's time to go above them. If you have a union bring it to your rep's attention as well.