Nursing Home Nightmare - page 3

new LPN started first nursing home job. I have only recieved 8 days of training and was left in 40 bed facility for whole shift with 1 TMA myself and 3 aides is this normal. oh my god should I get... Read More

  1. by   banditrn
    Cerebrum - that was an awesome link - thank you!!

    I have a question about it, tho. I compared my LTCF to the Ia. state average of 2hr, 6 min. of CNA hours. Ours is 1 hr. 41 min. - this means we have less than the average # of Cna's, right?
  2. by   carolbear
    Oh my gawd. You need to move to the Northwest! At least we make 20.00 - 22.00/hr depending upon experience and only have 25 residents at the most. I would not survive in your facility and I have many years experience! Why don't you talk to your Union and tell them what dangerous conditions you work in?

    Good Luck
  3. by   nursekris
    Sounds okay to me. When I was an LPN, we worked 50-55 bed units with 2 or 3 CNAs on the 3-11 shift. It also depends on the acuity or dependency needed. For instance, we usually only have 2 or 3 PEGs and do not admit trachs. There should be state staffing info. Check with your local state agencies Re: the safety of the situation. Most staff nurses feel overwhelmed with the numbers when they are new.
  4. by   hbiawos
    I work on the dementia unit of an LTC 3-11, and the staffing is as follows: 41 patients, 1 charge nurse (me) i.e. the ONLY nurse (lol) and 4 CNAs. That's it. No LPNS, no one to help with meds and treatments. I have two meds passes, gtubes, diabetics, decubiti from hell, etc., etc. The doors are locked because it is after all a dementia unit, so in addition to everything else it's hot as hell, and I arrive just in time for sundowning. Yes, it's a lunatic asylum and I'm probably the biggest lunatic there, but I have to tell you I love it. We have some of the most adorable, lovable people on the planet on that unit, and their only sin is that they have a habit of wandering. We also have screamers, hitters, and chair throwers, but after working 6 years in adolescent psych, this sort of behavior is deja vu all over again. What does make me angry is that on the day shift they have three nurses and 6 CNAs. :angryfire
    What I'm trying to say is that yours is not an unusual situation, and I truly believe that you either have the temperament for this sort of environment or you don't. When I first started I wanted to quit too. Give it a little time and you'll know whether this is right for you or not.
  5. by   nursekris
    Yes, most facilities have very high patient loads per nurse. Like I said before, it does depend on the acuity. New nurses frequently feel overwhelmed, but it does get better. I was a staff nurse for 8 years (LPN) before earning my BSN and becoming MDS Coordinator and now ADON. I have been there. Please also remmber that hospital nursing is totally different. The nurse to patient ratio is much different, but there are totally diff. things going on. The hosp. pt. is usually acutely ill and has IVs, etc. Even after 10 years of nursing, I would want several weeks of orientation for hospital nursing. In the LTC setting, the most important skills are assessment and comminication.
  6. by   micco
    i started out as a new LPN with 35 patients. I thought things might be greener and went to a differnt facility. What a nightmare. I had 3 months of experience. I worked graveyards and had 58 patients with 2 CNAs. Of the 58, 18 were diabetics and there were 6 patients who required tube feedings or flushes twice during the shift. I was required to pass alot of a.m. meds. After 2 days, i expressed my concern and was told "according to corporate, this hall was adequately staffed." Needless to say, i started looking for another job.
  7. by   st4wb3rr33sh0rtc4k3
    Currently, I have up to 30 patients on the Alzheimer's Unit. Not many treatments or assessments going on there. :spin:

    But, on the Sub-Acute Unit at 11pm to 7am you have up to 50 patients. The other person on is the Nurse Supervisor, who will help you or might not. It all depends on who.

    Don't know how you do it.

    Definately, need some tips. Because soon I will be the one of the Sub-Acute Unit staff. Extra hours are a must and my good ol' Alzheimer's Unit has new nurses that were hired for that unit.

    What a bummer I must add. I was getting used to it. :trout:
  8. by   chadash
    Ah! These three little words should forever be linked in our anesthetized little brains:
    Nursing Home Nightmare
  9. by   Drysolong
    Quote from micco
    i started out as a new LPN with 35 patients. I thought things might be greener and went to a differnt facility. What a nightmare. I had 3 months of experience. I worked graveyards and had 58 patients with 2 CNAs. Of the 58, 18 were diabetics and there were 6 patients who required tube feedings or flushes twice during the shift. I was required to pass alot of a.m. meds. After 2 days, i expressed my concern and was told "according to corporate, this hall was adequately staffed." Needless to say, i started looking for another job.
    Your second job sounds almost identical to my second and current job!!
  10. by   sunfire1725
    This sounds normal to me. We have 104 residents right now where I work. If we are lucky we have one nurse and 2 aids to every 26 residents. Most of the time we work with less because we have alot of call offs. I am the supervisor on my shift, have my med pass, and treatment to do, call the Doctor, look up labs and phone them in, handle call offs, and numerous other things that come up during my shift. It's crazy!! Just this last week, I had 2 nurses call off for my shift, and we could not get any one to come in so that left only 2 nurses working. I have 3 residents with tube feedings, numerous on IV's and too many to count that are diabetic. I had my first real anxiety attack. Is it hard to keep nurses and cna's in LTC facitllities? We seem to be in a constant shortage of staff.
    Last edit by sunfire1725 on Aug 26, '06
  11. by   Natkat
    Quote from aerinlpn
    thank you but won't that look horrible to the next job interview I have. To say I only last a week?
    So don't bring it up on your next interview. I would keep going on interviews as if I don't have a job yet.
  12. by   kwagner_51
    My advise is :

    GET OUT NOW!! RUN do NOT walk!!!

    I passed boards in Oct. 2005 I have worked in 2 nursing homes. The 1st one had 52 res. On 7pm-7am I had 28 pts. and a cna.

    In the entire building, there were 3 CNA's and 2 nurses one RN [me] and 1 LPN.

    I would start med pass at 7pm and wouldn't finish until 11PM!!

    I preset for the 6 AM med pass and still didn't get done on time.

    I lasted 18 days.

    Got hired into a bigger nursing home in March. 5 units, North 1 has all private rooms [16 res] North 2 has 28 res 5 gtubes, several decubes, and a trach most of the sickest pts are on this unit.
    South 1 has 25 pts South 2 has 28 pts 2 gtubes and LOTS of 9 pm meds [It takes me four hrs to do the evening pass.]

    Rehab currently has 7 pts.

    On North 1 there is 1 nurse or QMA at night no CNA and 6 are total care and must be up with a lift. 1 has a gtube. 6 are accu cks but all in all a quiet unit.

    North 2 has 1 nurse either RN or LPN 1 CNA who also works North one. The nurse must give the insulin to the res on North 1 when a QMA works.

    South 1 has either a QMA or a nurse. South 2 has 1 CNA and a nurse or QMA The nurse or QMA must help do bedchecks for both South 1 & 2. I have 28 pts and this is the hardest unit in the building. There are 10 + accu checks Q AM gtube feeding round the clock because they are bolus. Dressing changes, treatments. and these people are SPOILED ROTTEN!! They all gather around my cart and get upset if I don't get their meds first!! I had one woman cuss me out because I didn't get her fast enough!!

    Rehab is my favorite. Right now there are 7 pt. Alot of them get to go home. We had one die Wednesday. He was in a coma from bilat subdural hematomas fron an MVA. Very sad because he was normal before the accident very active. Actually went home from the hospital but died about 2 weeks later.


    On nights there are 3 nurses, 2 QMA's and 3 CNA's for 136 pts. it doesn't sound like much and and it isn't, but it's alot more that you have!!

    I have worked when I was the most senior nurse in the building!! That just ticks me off!! I got my RN in Oct. Another got her's in Dec. and the other one got his in March.

    I said [typed] all of this to show you that it is NOT normal to have Just 1 LPN in the ENIRE building. As far as only having worked 8 days goes, so what? Most LTC's don't look down on you for quitting under those conditions. The DON is a jerk and is only looking at his bottom line. He doesn't give a rip about you!!

    Nuses need to remember that we are the patient's ADVOCATE and we can't do that if we don't know who they are.

    PLEASE get out of there. It is NOT safe and if [when] you make a mistake they will fry you!!

    This is the bottom line: Can you and your CNA's get ALL of the res. out of the building in the event of a fire? Of course you can't because you are not superwoman.

    Just something to think about!!

    One other thing, I started out at $17.50 hr. I got a pay raise in July and am now making $18.35.


    ________________________________

    In His Grace,

    Karen

    Failure is NOT an option!!
    Last edit by kwagner_51 on Aug 26, '06

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