nursing homes and large patient to nurse ratio

Nurses Safety

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I just started a new job in a nursing home and I am having a hard time. I have about 26 residents to take care of and I basically spend the whole time giving meds. I have no time for treatments or documentation. All my documentation usually gets done after my shift is over. They also expect us to check each medication 3 times before giving it to the patient. How am I supposed to do that? I hardly have time to check it once. They also wonder why so many patients have pressure ulcers. I can tell you why. It's because we have so much to do that there is no time to turn and re-position patients.

Any advice and encouragement is really appreciated.

Specializes in critical care, ER,ICU, CVSURG, CCU.

delegate turn and reposition to CNA, when they do incontinent care, have orders for barrier cream, you will get faster, once you know everyone, med pass will go smoother

Tell the CNA's that on the 2's, 6's and 10's the resident are turned to face the windows, and on the 4's, 8's and 12's they face the door. That way when you walk the halls you know if patients were turned.

Be creative and bold when it comes to organizing all those meds and giving them. Checking your meds three times, eh? Sounds like a business person came up with that. If you don't scan meds into an electronic MAR, yes, a good double check is in order. The point is NOT to literally three times check the med against the order, no matter what the business person has to say about how you do your job. This same business person also determined your staffing levels and expects you to prevent all errors, bedsores and calamities with the grossly limited resources they give you.

I'm not saying don't make every attempt to make no errors or allow bedsores. I'm saying take control of how you do your job, have high personal standards that are yours as a professional, be well versed in facility policy and procedure, and let go of any idealistic nonsense distracting you from just getting your job done.

Make your documentation into a thing of spare beauty :D . Get it so cleaned up and precise you could spit polish it. Over time, the med pass WILL get a lot faster, just due to familiarity. Just be careful then as familiarity can lead to carelessness.

LTC seems to just be like this, the nature of the beast. So you do YOUR professional best, you own your skill set and license. If the expectations of this particular facility far exceed your ability to do your job in the way you do it, then move on. It goes both ways, in other words. It's common to feel victimized and oppressed, but it's more of a choice to feel that way than the reality.

Specializes in NICU, PICU, Transport, L&D, Hospice.

"Make your documentation into a thing of spare beauty".

So say we all...

Is acute care easier since there is less patients

Specializes in LTC Rehab Med/Surg.
Is acute care easier since there is less patients

Nursing isn't an easy job. Each area has its own stress. I'd have to agree that LTC is the worst, with med/surg a close second. I'd bet you'd get a dozen other nurses who post here, arguing that their area is worse.

Nursing isn't an easy job anywhere.

Nursing isn't an easy job. Each area has its own stress. I'd have to agree that LTC is the worst, with med/surg a close second. I'd bet you'd get a dozen other nurses who post here, arguing that their area is worse.

Nursing isn't an easy job anywhere.

Can you explain to me why med/surg is so bad

Ltc is really all I have worked because I can't get a job in acute care. So I really would like to hear your opinion and anybody else's on what the pros and cons of each field is.

Thanks

Boy you and I can hang out!! I am a new grad. My friend (also a new grad) was working in a nursing home and she was responsible for 43 patients in an eight hour shift...needless to say she quit after a few weeks. I don't know if you work 8 or 12 hour shifts. I do know that when I work (both long term and subacute units) I am usually there an extra 1.5 to 2 hours completing paperwork. I don't know if this will help but two things I have tried to do is try and put as many "treatments" in the cart or in my pockets, so when you go into a room you can do meds and foot checks or meds and vitals (esp if you have to take a bp before a med take the vitals) I also do a mini "to do list" so I can keep track. It is almost impossible to keep up with everything....I totally get it. Just take your time, talk to the CNA's about turning your peeps and try not to sign off on forms (for example a skin check) unless you've actually seen the skin!! Good luck!! HUGS!!

Just wanted to say, well said I totally agree and it's unfortunate that LTC seems to be this way everywhere :(

Specializes in Medical Oncology, ER.

CNA's will be your best friend in LTC/SNF's, also its a matter of routine, it's tough in the beginning but once you get to know your patients it'll go much quicker.

Specializes in Med surg/ tele, LDRP.

i love that turning trick someone posted with the times, ill have to try that!!

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