New grad with 1 other nurse and 79 patients

  1. Tomorrow will be the day from .......!!!! I've been training/working at this LTC facilty for appx. 3 weeks prn and tomorrow I found out I have to work with only one other LPN. There is 79 patients, some are tube feeders, alot of brittle diabetics, 2 colostomy's, and residents that fall left and right. I'm still uncertain about how everything runs and I'm slower than molasses when passing meds. How in the heck will I pass meds to 40 residents, chart, do dressing changes, etc. all in 8 to 10 hours? I consider myself a fast worker but not when it comes to giving meds, because if I mess up someone gets hurt. I wish I could find something that stated patient/nurse ratio. I live in Illinois if anyone finds out something. I've already told the DON that I didn't think I was cut out for the LTC environment. I told her she would never have one resident complain about my care or empathy I provide, but the facility will eventually get mad because I am slow with the med pass, not only because its to large, but because if I go into a residents room and their messy and the CNA's are busy, I don't just walk out, I clean them up. Now I'm behind, and then the next resident is messy, so I repeat the cleaning and now I'm further behind. Yes, we work our CNA's short too. They usually have 12 residents a piece on days and 20 on PM's. I see a lot of good quality care, NOT!!!. The CNA's that work with me do a very good job, but they to are only one person taking care of to many residents. It seems like this scenerio is something I've read way to many times. Why as nurses can't we just do what we went into nursing to do. Take care of patients, help heel through touch and hollistic nursing, not just pop pills into someone's mouth and walk away. It's a viscous cycle.
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  2. 16 Comments

  3. by   NicoleRN07
    Sounds like to me it could put your hard earned nursing license in jeopardy! Your DON and any other nurse managers should be working as well on days such as that. If not, do not take your assignment. You have to protect yourself, and your patients, and 2 nurses to 79 patients is DANGEROUS!!
  4. by   Simplepleasures
    Quote from kstec
    Tomorrow will be the day from .......!!!! I've been training/working at this LTC facilty for appx. 3 weeks prn and tomorrow I found out I have to work with only one other LPN. There is 79 patients, some are tube feeders, alot of brittle diabetics, 2 colostomy's, and residents that fall left and right. I'm still uncertain about how everything runs and I'm slower than molasses when passing meds. How in the heck will I pass meds to 40 residents, chart, do dressing changes, etc. all in 8 to 10 hours? I consider myself a fast worker but not when it comes to giving meds, because if I mess up someone gets hurt. I wish I could find something that stated patient/nurse ratio. I live in Illinois if anyone finds out something. I've already told the DON that I didn't think I was cut out for the LTC environment. I told her she would never have one resident complain about my care or empathy I provide, but the facility will eventually get mad because I am slow with the med pass, not only because its to large, but because if I go into a residents room and their messy and the CNA's are busy, I don't just walk out, I clean them up. Now I'm behind, and then the next resident is messy, so I repeat the cleaning and now I'm further behind. Yes, we work our CNA's short too. They usually have 12 residents a piece on days and 20 on PM's. I see a lot of good quality care, NOT!!!. The CNA's that work with me do a very good job, but they to are only one person taking care of to many residents. It seems like this scenerio is something I've read way to many times. Why as nurses can't we just do what we went into nursing to do. Take care of patients, help heel through touch and hollistic nursing, not just pop pills into someone's mouth and walk away. It's a viscous cycle.
    The reason why we as nurses cant do our jobs properly is because of corporate greed and consistently bad working conditions, LTC is critically short staffed. Nothing but state or federally mandated nurse/patient ratios will help this disgusting situation.I personally believe a strong union, with political clout, like the CNA can help change the future in the healthcare profession.
    Last edit by Simplepleasures on Jan 28, '07
  5. by   CaLLaCoDe
    Kstec quote: Why as nurses can't we just do what we went into nursing to do. Take care of patients, help heel through touch and hollistic nursing, not just pop pills into someone's mouth and walk away. It's a viscous cycle.
    I totally agree with you, sista/bro! This is not a hospitable environment for anyone wishing to fulfill the reason we got into nursing in the first place, patient care!
  6. by   morte
    where is the RN? or in your state are you not required to have one in the house? 40 to one is not that unusual.....but 20:1 on the cna, i think is....because YOU can not stop your med pass to clean up patients....you just cant......that further endangers your other patients by them not havng their meds on time....
  7. by   CapeCodMermaid
    Quote from morte
    where is the RN? or in your state are you not required to have one in the house? 40 to one is not that unusual.....but 20:1 on the cna, i think is....because YOU can not stop your med pass to clean up patients....you just cant......that further endangers your other patients by them not havng their meds on time....
    Have to disagree....99.9% of long term care residents take far too many meds....I would hazard a guess that NONE of them would be 'endangered' by getting their meds late...come on...once a day is once a day. If they get their digoxin at 8 one day and 9:45 the next, it is NOT going to endanger them. We're not working in a telemetry unit............
  8. by   kstec
    That's funny that one of you mentioned having a RN. In Illinois I guess there only has to be in a 24 hour period. We usually have one on night shift. Well since I was the original thread writer I'll tell you how my day went. I managed to get all my meds passes by 9:30 am. I actually did pretty good, and still managed to do a quick and I mean quick assessment on my Medicare patients. I did have a patient fall towards the end of the day and you know how much paperwork that is. But that's not the interesting highlight of the day. The other LPN who worked the other half of the facility had to stay over because the nurse that was supposed to show up was going to get fired if she came in, so she did a no call no show. They tried to talk me into staying, but after 8 hours, I'm burnt out and have nothing else left to give. The other nurse is staying until approximately 5:00pm. We called the ADON to come in and cover, but she said she was at a shower and couldn't get there until then. But this was only after she didn't answer her phone all day. She's on call to cover if someone calls in. Go figure!! Are all nursing homes this way? Do people just not take the LTC facilities serious because they know if they quit or get fired, another nursing home will hire you the next day? Nursing is a whole new world for me and I'm not sure that I like it. I figure I'll keep on trying to like it and all its politics, because I figure the patients are better off with me being there than they would be if I quit. I feel terrible for them and I hope what goes around comes around and when I'm old someone like me will take care of me.
  9. by   tkhayman
    These are exact same reasons i quit LTC after 2 weeks. i was thinking it would be a relatively easy per diem job. I had to take care 40 pt;s not LVN, doing everything, no secretary. Never left on time either. I quit and the DON yelled at me, but i have no desire to go back to it. Too bad the elderly deserve better.
  10. by   kstec
    Unfortunately around here LTC is about the only job option for LPN's. I've tried homecare, but I wanted to jump off a bridge from the bordem. It was a peds case and he was very stable, but need a nurse due to his mickey button and colostomy. Then there's LTC where you run your butt off and don't know whether your coming or going. At present though I do not want to get my RN due to the fact I'm having a hard time handling an LPN's responsibility much less an RN's. Oh well I guess I'll hang in there until I either accidently hurt someone due to short staffing or get into trouble for not doing everything I'm supposed to be doing. Then the state of Illinois will be hearing from me loud and clear. Not that anything will change, but I won't go down without a fight. I guess that's kind of what it comes down to with most nurses. Do your best and bless the rest and hope noone gets hurt and that you don't get into trouble. And to think all I wanted to do was take care of people. What was I thinking?
  11. by   4everlearning
    I feel your pain and frustration! Currently in a rather dangerous situation myself. I can tell you from experience it is not going to get better until legislation steps in and mandates stricter guidelines... and I don't see that happening. Wishing you the best of luck.
  12. by   Gennaver
    Oh my,

    See if your nursing home is on this watchlist?

    http://www.memberofthefamily.net/usmap.htm

    Here are some other quickie google links:

    http://www.hhs.gov/asl/testify/t991103a.html

    http://www.nursinghomeabuseresourcecenter.com/

    http://www.osha.gov/SLTC/nursinghome/index.html

    Good luck, be safe, be good to yourself too,
    Gen
  13. by   st4wb3rr33sh0rtc4k3
    Quote from Gennaver
    Oh my,

    See if your nursing home is on this watchlist?

    http://www.memberofthefamily.net/usmap.htm

    Gen
    Oh my! The nursing home I work at is on this list!
  14. by   linzz
    I agree with the other poster Ingelein (sp), corporate greed is the problem as we all know. Today I was reading the newspaper and there was an article about a LTC facility in Canada where the residents were not being treated well and all the article talked about was how bad the staff was, it was not mentioned anywhere about the fact that it was critically understaffed. Just bugs me to see the nursing staff hung out to dry. I no longer wonder why there is a nursing shortage.

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