Umm...I will have 47 residence to care for !!!!!

  1. 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 with anything on this unit, and the last two people hired on the station both quit after 2 weeks!!! How in the world can a new grad ( me) that doesn't know any of these patients, or have any prior LTC experience get all this done? Meds I could do. But add treatments, charting, and doing the new admits..NO way! I am starting to think I went into something that I won't be at very long.

    After a couple days of orientation I am learning a little about the paperwork but it seems like such an uphill battle. Any advice from TLC works?
    •  
  2. 85 Comments

  3. by   BowlerRN
    Hi, I work in 44 bed LTC facility, I work 2p-10p I am the only nurse in the building with 2 aids and an extra aid from 4-7 just to watch the alzheimers patients. I do all the meds/tx's/charting/medicare assessments/etc. It helps alot that I have worked there as an aid and an Lpn so i know the res. and the routine. I don't usually have a problem with getting all this done, unless there is extra dressing changes or treatments than usual. But if I get a little bit off track from my routine it can be a very hectic night.
    Good luck!
  4. by   RNin2007
    Quote from BigB
    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 with anything on this unit, and the last two people hired on the station both quit after 2 weeks!!! How in the world can a new grad ( me) that doesn't know any of these patients, or have any prior LTC experience get all this done? Meds I could do. But add treatments, charting, and doing the new admits..NO way! I am starting to think I went into something that I won't be at very long.

    After a couple days of orientation I am learning a little about the paperwork but it seems like such an uphill battle. Any advice from TLC works?
    ....wow. I was so shocked reading this, and then reading the poster after you. I had no idea one nurse could be in charge of so many patients....

    ~J
  5. by   suzanne4
    How long is your orientation for? If you do not feel that it is a safe place for you, then do not stay. Remember that it is your license that you will have to worry about it. And as a new grad, with that many patients, it just isn't worth it.
  6. by   TexasPediRN
    I agree with Suzanne completely.

    As a new grad, its not worth it. I think even with a longer orientation, you are still a new grad and thats way to much. 47 patients is crazy.

    Many people (in previous posts and in this one) have mentioned that they are the only RN in the building at that time. As a new grad (grad in May 2005) I would not feel comfortable with this. I rely on my coworkers a lot for help.

    However- if this is what you want to do, I wish you the best of luck. There are some people cut out for this, and others are not.
  7. by   AtlantaRN
    wouldn't do it, worked too hard to risk your license

    linda
  8. by   Blackcat99
    LTC is a no-win situation especially when you have 47 patients!!!! Run for your life while you still have your license!!!!
  9. by   Jerico
    Since you have a license you are responsible for saying "no" to a situation that will compromise your practice.

    I'd say having responsibility for 47 patients is "compromising" to say it nicely.

    :uhoh21:

    As a registered nurse I'd also feel obligated as a registered nurse to REPORT this situation to some organization such as the Area Agency on Aging OR Nursing Home regulatory commission in your area.

    Have another job lined up ASAP.
    Last edit by Jerico on Jan 8, '06
  10. by   rjbaileyrn
    Hi BigB,
    After reading your post, I would have to agree with the others that you are getting in over your head. I have been a Paramedic for 17 years and an RN for 11 years. My first job as an RN was at a nursing home, and it was a nice one, brand new and all. They made me 3-11P Charge Nurse!! I had been an RN for less than 24 hours, and I had zero practical experience at charting, med administration, long term pt care, and Alzheimers. It was an overwhelming task that I managed to do for a month before I bailed out. I had 33 residents and quite a few with Alzheimers, one aide and that was it. I wouldn't wish that scenario on anyone.
    Now don't get me wrong. While I do think the system in Long Term Care is broken, I have ABSOLUTE admiration for those who pursue that line of work and who do it responsibly. My mother died last April in a Nursing Home in Woodstock, IL. She was 91 years old, total dimensia, didn't know me, couldn't feed or care for herself. Couldn't even swallow anymore without aspirating. She was losing weight, had pneumonia, had ZERO quality of life and it killed me to see her like that. The doctor wanted to put her in the hospital, put in a PEG tube, etc. My brothers and I were in complete agreement that a PEG was not the answer to her problems. We chose to provide comfort measures, sit with her every day in the nursing home, talk with her about her life and ours, and wait. In about two weeks she died. The entire time, the nursing home staff went above and beyond what anyone could have been expected of them. They were extraordinary in their care and compassion.
    My point is that the career you are considering can be tremendously trying as well as rewarding. If you have the skills to work in that environment, you are quite a person and nurse. Seek out a workplace that will ease you into the routine, allowing you time to learn so that you won't get disappointed and overwhelmed and quit. We need you in that job. Good luck.
    Sincerely,
    RJ Bailey RN CEN EMT-P
    Lehigh Acres, FL
  11. by   LPN1974
    47 patients is way over the line, IMHO.

    Half that amount would be more appropriate, but I wish you good luck in getting the administration to understand and agree to it.

    Just pile it on. The nurse can do it all.


    And another thought of mine.........
    If 47 patients to them, is an average assignment, they won't have any trouble assigning you another and another and another....
    Where do you think new admits will go.....right there on top of the assignment you already have.


    I work in a setting that is similar to LTC, in developmental disabilites, and my work load is an average of 55 people if we have 2 nurses, some days we have 3 nurses, and our census is 110, so it's better when we have 3 nurses. Our requirements for charting is different than in a NH so I don't have the weeklys and the medicares to chart on like in a NH.
    We chart on them when they are ill.
    I've worked in a NH before and I know that the level of difficulty of NH patients is more critical that the people I take care of now.

    Personally.....I would not do it. It's too much on one nurse.
    Last edit by LPN1974 on Jan 8, '06
  12. by   christvs
    Wow, 47 patients!!! And to think I was complaining the other night because me (I'm an RN ) and an LPN were taking care of 11 patients together and that to me was too many complex patients for us to handle (we're on a med/surg/tele unit). My friend used to work in a nursing home & I don't know how she handled doing so many tx, meds, etc on so many patients! But I agree with the others here: that does not sound very safe to me & I would be afraid that not only would I lose my mind that I'd be making errors left and right. Hope you find a more reasonable workload.
    -Christine
  13. by   BigB
    Quote from suzanne4
    How long is your orientation for? If you do not feel that it is a safe place for you, then do not stay. Remember that it is your license that you will have to worry about it. And as a new grad, with that many patients, it just isn't worth it.
    They want to put me on the floor after 3 days. I said no way..and requested 3 weeks as I am a new grad, and haven't been on the floor for 6 months (in school clinicals).
  14. by   Judee Smudee
    Your manager is a disgrace. After two nurses have quit you would think she would get her butt out there, help you out and make sure you are happy.

close