Advice needed! New LTC job...

[StephMSeattle]

So, here's my story...

I just landed my first nursing job...and I really like it there! The problem is this: The facility places the responsibility for everything on the nurses. Noone else seems to have any accountability for anything. It's a LTC & Rehab facility. Here are my tasks for each shift...

17-22 patients. All treatments and meds. Run after the CNA's because they don't do their jobs. Find the CNA's so that I can delegate when I'm trying to do meds...good luck on this one! Answer phones. Fill out med sheets, CNA paperwork that they forgot to fill out, go down to observe patients eating breakfast for 30-45 minutes of my already busy shift, make sure that meal trays are brought back to the kitchen 1 hour after meal (because CNA's forget).

So, today I'm down by the kitchen observing the residents eating breakfast. I can't leave. I discover that my patient's very late breakfast tray is stuck down there with me and I can't go anywhere. I ask the kitchen staff to rush it upstairs...and it's "not his job, call a CNA." Called CNA and they never came.

Is it really the nurses job to keep after everyone else who isn't doing their job?

[Rustyhammer]

I suggest you call a team meeting with your CNA's and talk about working together.

It's the only way you can do the job without going crazy.

They have to be held accountable for their own responsibilities.

You have a lot on your plate and as a newbie to LTC it will take you a bit of time to get organized.

Plan your day as much as you can. Meds, tx's, Dr calls, charting.

I try to have a deadline for all of the above.

If your CNA's won't work with you then you need to transfer them off you floor and get some in there who will work with you.

-R

[canoehead, BSN, RN]

I thought I'd move this to general nursing discussion because in the ER forum you are unlikely to get many replies. Good luck.

[sixes]

You will get organized.

And yes it is your responsibility.

On days Mon-Fri. we have 3 charge nurses on and 3 RPN's

On Sat and Sun we have 1 RN with 3 RPN's

On evenings we have 1 RN and 3 RPN's

On Nights we have ! RN and 1 RPN

for PSW's on Days 14 for the building

Evenings 13 for the building

Nights 5 for the building

As the RN I am responsible to make sure everyone is doing there job which includes the staff in housekeeping, kitchen and general help

We have 157 residents that I am also responsible for

Honest you may feel overwhelmed right know but once you get to know your staff and residents it will come together.

If you find someone is always neglegent in their assignments report them. They might not like you very much but the other staff are probably as frustrated as you with there laziness as they have to compensate

Good luck and hang tight

[CoffeeRTC, BSN, RN]

Yep sound like my job..... Meds, Tx, phone calls, supervision of CNAs and meals. I have 24-26 pts with 3-4 CNAs (3-11 Shift). As far as babysitting the CNAs.... I refuse to and luckly don't have to do very much of that. (you would never have time to get your work done) I would have a meeting with the DON and let her/ him know what is going on (unless they already know) then have a group meeting with your CNA and LPN staff.... let them know that you will not tolerate their lack of respect and professionalism. Let them know your expectations.

I know this is easier said than done, but unless you want to get burned out and be treated like a dormat it needs to be done. When I work now everyone knows me and what I expect.... I hear them talking (we need to get vitals before break, etc) and when the CNAs are training the new ones.... they pass it on...Michelle likes vitals by 5, Wts before dinner...etc.

Ps...the CNAs dont "forget" that often...sounds like an excuse I heard before!