Is this what nursing is? 30:1 patients with quality of care seems to be impossible.

Specialties Geriatric

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I am a new nurse. I was so eager to get out in the field and fine tune my knowledge with hands-on experience. I was hired with absolutely no experience as a charge nurse in a LTC facility. I knew it would be extremely difficult but I was up to the challenge. After 2 days of orientation, where I basically shadowed a nurse that was too busy to even utter more than two sentences to me, and one day were I was able to pass medications to about four residents I was thrown on the floor by myself. The census was at 30 residents on the busiest 7-3 shift! 5 diabetics, 5 g-tubes most everyone needed their hearing aides place in, most everybody needed fentanyl, exelon and nitro patches, handful of patients with infections and antibiotic monitoring. I also started on the weekend where there was only 1 supervisor for 3 floors and an influx of family members demanding that all medications be exactly on time to the second. I was ready to quit! ...just walk away! Is this what nursing is? 30:1 patients with quality of care seems to be impossible. I see a lot of short cuts going on some seeming unsafe. Is this the average first day of nursing? Does it get better? I am more than capable of doing my job and I absolutely love being a nurse but I was wondering if this is the norm?

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I'm sorry to say but, that's fairly typical. I don't think you should've been put on the floor by yourself that soon but, the workload seems normal. When I worked ltc we had between 25-55 patients. 25 for the skilled wing and 55 non skilled. I remember on the non skilled wing one time we had 18 diabetics. The work doesn't get easier per se but, you learn to manage it. You'll eventually be able to do a med pass in your sleep. Use your time wisely. I found it helpful to make myself a schedule of everything I was going to do for the shift and allotted a time for it. If you get behind charting can wait for a bit. As for cutting corners, it happens. For example I was supposed to go my med pass from 6-7a, technically we could start an hour early at 5a but, I usually started at 4-4:30a or else I couldn't finish on time. I never pre pulled up my meds though or really cut any important corners. I had to stay over to chart and finish up paper work many times. Are you going to be working on days or just doing orientation? Maybe try a different shift if you can, I'm not going to say 2nd or 3rd shift is any less busy but, they may be calmer with less family around. Good luck!

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Specializes in Gerontology, Med surg, Home Health.

Two days of orientation for a nurse with no experience is just plain stupid. My new grads get at least a month...more if they need it. 30:1 is a fairly common ratio for long term care. I have one 60 bed unit. Each team nurse has 30 patients during the day but we have a desk nurse and a nurse manager. The other 2 floors have 46 beds....2 team nurses, a desk nurse, and a nurse manager. We share a secretary on the 2 long term floors. The short term floor---about 1/2 short term people and 1/2 long term---has a full time secretary.

It can be done. Lots of the residents need nothing more from you than their meds. You'll get the hang of it, but if I were you, I'd ask for more orientation.

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Specializes in Med-Surg, LTC, Psych, Addictions..

That is typical in most for-profits. Non-for-profits tend to have better ratios and more support staff. Welcome to the real world. It's not what students expect.

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Specializes in Managed Care/Advisory Services/Transition Planning.

That's rough, but a common problem. I'd recommend getting on top of your time management and organizational skills now if you want to survive. The only way I function working the floor is by having a checklist of sorts to remind me what I need to do. Hold on, once you get the hang of it you will feel like super woman! :)

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The ratio is right but the training is very wrong. I have a new grad at my facility and he is getting a full 5 weeks in addition to 3 types of classroom training (IV, assessment and cardiac). I'm a semi new nurse with limited experience and I got 11 full shifts

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Specializes in ICU, CM, Geriatrics, Management.

Kinda ridiculous to place a new nurse in the charge role IMHO.

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