Umm...I will have 47 residence to care for !!!!! - page 4

I am oreintating as a new grad for the 3-11pm shift. I have found out that I will be doing all the meds, charting and treatments for all 47 of them. Is this even legal? The unit manager doesn't help... Read More

  1. by   Marylou1102
    My concern would be only one nurse in the building. What happens if there are 2 emergencies at the same time.
  2. by   PurpleHairUnicorn
    This was sent to me by the Illinois Office of Health Regulation...
    excerpts from the Illinois Skilled and Intermediate Care
    Facilities Regulations to define the different classifications for residents.
    These can be located in section 300.1230 of the Regulations.

    "l) Skilled Nursing Care
    Residents needing skilled nursing care may only be cared
    for in facilities licensed as Skilled Nursing Facilities. Each resident needing
    skilled care shall be provided at least 2.5 hours of nursing-personal care each
    day, of which 20% must be licensed nurse time. (A, B)

    m) Intermediate Nursing Care * General
    Residents needing intermediate care may be cared for in
    facilities licensed as either Skilled Nursing Facility or Intermediate Care
    Facility. Each resident needing intermediate care shall be provided at least
    1.7 hours of nursing/personal care each day, of which at least 20% must be
    licensed nurse time. (A, B)

    n) Intermediate Nursing Care * Light
    A Long-term care resident needing light intermediate
    care is one who needs personal care as defined in Section 1-120 of the Act; is
    mobile; requires some nursing services; needs a program of social services and
    activities directed toward independence in daily living skills; and needs daily
    monitoring. Each resident needing light intermediate care shall be provided
    with at least one hour of nursing/personal care each day, of which at least 20%
    must be licensed nurse time. (A, B) ..."

    Medication passes may start up to one hour before the ordered dose time to no
    more than one hour beyond the ordered dose time.

    We have a regulation that indicates that the facility must have enough staff to
    meet the needs of the residents. Are any of the residents not receiving ordered
    services because you are unable to get them completed? If you are unable to
    complete task/s, how do you chart the inability to provide the service/s?

    The facilities get away with understaffing by not classifying residents apropriately. They also turn in staffing sheets with employees listed who no longer work for the facility (Happened to me 7 nights out of 9 in a 2 week period, leaving me and 2 CNAs to care for 62 residents, most of them confused and fall risks) Until the "State" comes in and catches the facilities with inadequate staffing, and actually verify the resident's true level of care, the nurse on duty will be left holding the bag. It is my understanding that if you clock in and take report,if you leave, you have abandoned your residents and are subject to legal action. (Don't know if this is a fact or not, this is just what the "higher ups" have stated.)If you stay, and something happens, you can be held liable also. Darned if you do, darned if you don't.
  3. by   jonear2
    wow...i had no idea that such demands were made on ltc nurses. i am a new rn grad (nclex march 1) and i am on orientation to a progressive care unit at a teching hospital where 6 patients seem very daunting. it absolutely seems impossible for you to do your jo the right way. beyond the med pass, charting, etc... how about turning the patients??? i understand that there are cnas but protocol is turn q2 hours, even with 2 aides and yourself that is impossible and dangerous. pressure sores will kill just as quick as anything else. run far far away. but please don't forget the patients. dont just go and get another job and put that terrible place behind you. contact your state inspector. something. does jcaho inspect ltcs like they do hospitals??? maybe its time for a visit.
  4. by   dinkymouse
    I am generally charge, 3-11, of 70 residents. We do have 6 aides most of the time and I have at least med tech to pass 1/2 the pills. On a good day I have 2 so I only have to do the tube feedings, insulins, orders, charting, assessments etc. This last weekend staffing was awful, "Superbowl Flu". The on call RN wanted an LPN to be responsible for all 70 patients without a med tech. I told her no and that it wouldn't be safe. She said she thought a lot of facilities had 70 patients and only 1 nurse. I told her that if they asked me to do that Iwould refuse. The LPN did have to be alone for 2 hours.
  5. by   donmomofnine
    Quote from jonear2
    wow...i had no idea that such demands were made on ltc .... does jcaho inspect ltcs like they do hospitals??? maybe its time for a visit.
    we are jcaho accredited for three years now. :hatparty: the accreditation process now involves unannounced visits. it used to be an announced survey, though.
    Last edit by donmomofnine on Feb 19, '06
  6. by   xmaxiex
    This is not safe ! And any facility who would do this to a new grad is not somewhere you should be working . Your licence is too valuable to put it in jepordy .
  7. by   Momto2Boys
    Quote from BigB
    Oh I would be in heaven to have only 22 patients. I just got two more admits so I have 49 patients now!! 4 nurses aids. 5 GT patients. Too many diabetics to count, although I only need to do "finger sticks" on about 11, twice during the shift. I have to answer all the phone calls, pass all the meds, chart on all the daily charting and 3 weekly summaries, do all the treatments (there are about 40 to do ranging from protect barrier cream, to complete hard stage 2 - 3 and 4 decubs. How do the lvn's before me get all this done??? Oh I know.. they dont do it, but chart that they did. I do everything I am suppose to do and have to say at work and extra hour UNPAID!!!!. I have put my two week notice in . The DoN is pissed off cuzz they gave me a 3 week orientation and now I am quiting. Screw this place. I am not losing my license and I am tired of being thier slave.
    GOOD FOR YOU!!!

    KEEP US POSTED!!!
  8. by   yadda_yadda_yadda
    Run for your license!
  9. by   BrendaLeeRN
    I work in a state that requires 3.0 nursing hours per resident. That would be great if we had meters and once we hit 3.0 hours were done with that resident for the day, but real life doesn't work that way. I too am a new nurse (NCLEX Aug 2005). I oriented for about a month on every shift except 11-7, then started working 11-7. I was responsible for 55 residents, some in a subacute condition. Many just off med surge. That was too much, with treatments, medicare charting, early am med pass, trach care, and multiple g-tubes. Never mind all the other paper work they thought I could do while the residents slept (ha! ha!). So, I explained that as a new nurse I was not comfortable, and then floated 7-3 and 3-11. I had responsiblity for half the patients then, and other nurses to ask advice when in doubt. Much better for me, the facility survived, and I'm now on 7-3 only as charge nurse (55 residents, 6-8 aides, and 2 - 3 other nurses also). Much, much better.
  10. by   Twix
    I would like to know what state is this in. I live in N.H. and I have 4 patients, and 3 aides. Make me worried about moving now.God knows what's out there.
  11. by   Nascar nurse
    Quote from Twix
    I would like to know what state is this in. I live in N.H. and I have 4 patients, and 3 aides. Make me worried about moving now.God knows what's out there.
    Are you sure you are working in LTC?
  12. by   Twix
    OOPs, I meant to say 24.. hehehe:chuckle
  13. by   Nascar nurse
    That's still really fantastic staffing. Good for you.

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