Another low staffing - am i being a baby- new nurse post!

Published

I got hired into a rehab skilled unit at a LTC facility. I was told I would have 5 patients and would train for at least 2 weeks and more if I needed it. I trained for a week and a half, and I know that's more than some of you but by training I mean I did the things I already knew how to do like vitals & assessments on my own while the one "training me" took care of the 9 new admits we got. I asked for more training and they said they didn't have anyone to train me.

So I'm on my own, tube feedings, dressing changes, admits, discharges, 3 sets of meds, and everything else with 14 acute care patients with no other nurse anywhere around. I call my supervisor when I need help but come to find out they rarely trained her and she's new too. I ask her what to do in my current situation and she leaves out a ton of things. My 8 hr shift M-F has turned into 12 hour shifts because I can't get everything done in time! I am exhausted. I don't even take a lunch because I'm rushing the whole time so I can actually get sleep before having to get up with the kids. In the morning. I dread going in everyday. The two people who took the job before me quit shortly after training bc of how demanding the job is.

My question is, is this the norm...will I get used to it...or did I make a big mistake and should have held out for a hosital job??

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I got hired into a rehab skilled unit at a LTC facility. I was told I would have 5 patients and would train for at least 2 weeks and more if I needed it.
You were told that you would have only 5 patients at a LTC facility? Never in a million years would management be able to keep this staffing promise. Medicare/Medicaid reimbursement rates have always been way too low to justify 1 nurse for every five patients in a nursing home.

14 patients for the skilled unit sounds about right. If this is not your niche, I suggest that you keep searching for other job openings. Good luck to you!

Up Vote Up Vote ×
You were told that you would have only 5 patients at a LTC facility? Never in a million years would management be able to keep this staffing promise. Medicare/Medicaid reimbursement rates have always been way too low to justify 1 nurse for every five patients in a nursing home.

14 patients for the skilled unit sounds about right. If this is not your niche, I suggest that you keep searching for other job openings. Good luck to you!

They told me 5 because that's how many patients they had at the time of the interview...but they made it sound like that's all I would ever have.

I guess I just hate that I wasn't trained and I asked for more training but they said no. I have no one really to ask for help and I'm on the 2nd floor all by myself so I can't just go down the hall to ask for help kwim? I'm practically running the whole time and am exhausted.

And that the two people they trained before me quit & no one in the facility wanted the job bc of how demanding it is. Its just a lil disheartening.

Up Vote Up Vote ×
Specializes in Psych, Corrections, Med-Surg, Ambulatory.

The fact that no one stays in that job for long should be their clue. But when you finally run away screaming they'll find more fresh meat - er, I mean a new nurse to replace you. I'll bet you're not getting paid for those extra hours you work, so can you even afford to work there?

You sound like a conscientous nurse who wants to provide the kind of care you can be proud of. I doubt anyone can do it there. If you don't want fudging and corner-cutting to be your way of life, start looking for something else.

Good luck!

Up Vote Up Vote ×
Specializes in ER.

My question is, why would you think going to a hospital is easier? LTC is busy, but the pt's are chronic, not acute. Once you've been there for a while, you will find that things are a bit easier because you get to know the patients and routines, ect. Acute care in a hospital changes, new pt's come in. 15 pt.s in a LTC doesn't sound bad at all! Usually you have 30 to 40? Hang in there- being new is always hard.

Up Vote Up Vote ×
Specializes in LTC, Med-Surge, Ortho.
They told me 5 because that's how many patients they had at the time of the interview...but they made it sound like that's all I would ever have.

I guess I just hate that I wasn't trained and I asked for more training but they said no. I have no one really to ask for help and I'm on the 2nd floor all by myself so I can't just go down the hall to ask for help kwim? I'm practically running the whole time and am exhausted.

And that the two people they trained before me quit & no one in the facility wanted the job bc of how demanding it is. Its just a lil disheartening.

Seriously, I would start looking for another job asap!!!!!!. It sounds like you have no support on a very busy unit. Management does not care about staffing issues, they just want a warm body to do just enough to keep the unit going until the next nurse arrive. As for hospitals, it is not easier and as a matter of fact it is very fast paced and the orders can change at anytime based on lab results, pt conditions and etc. I am convinced more than ever that it is not about patient care but it is about documentation and getting ready for state surveyors to recieve a good grade. I feel for the patients. just my:twocents:. Wish you the best

Up Vote Up Vote ×
Specializes in Gerontology, Med surg, Home Health.
My question is, why would you think going to a hospital is easier? LTC is busy, but the pt's are chronic, not acute. Once you've been there for a while, you will find that things are a bit easier because you get to know the patients and routines, ect. Acute care in a hospital changes, new pt's come in. 15 pt.s in a LTC doesn't sound bad at all! Usually you have 30 to 40? Hang in there- being new is always hard.

Not all the patients in an LTC have chronic diseases. Some of them border on acutely I'll. It's not an easy place to work, but you will learn wonderful assessment and time management skills.

Up Vote Up Vote ×

When I was hired I had 16 skilled pts and the regular load of LTC. Totaled about 36 pts! Feeding tubes, IV antibiotics, treatments, caths, meds etc. 1 RN and two aides and 1 float. The other wing with another 30 some patients had 1 LPN and two aides. So if they had atb I had to run to other side. Right before state came they released and did not restock with pts. I figure its time for them to bring them all back in and a few new nurses. Never got the training I was promised but was a trooper and did what they wanted without any breaks or lunches. As long as we put up with it they will keep pulling this on new nurses. The DON and ADON will not support you because they like their money and will not risk losing it by pressing administration for needed changes. No help for them. Good luck and always be looking for a better job!

Up Vote Up Vote ×
Specializes in Gerontology, Med surg, Home Health.

If the DON doesn't support you, you're in the wrong facility. Nurse in the HOSPITAL have 5 patients. What made you think you'd only have 5 in a SNF?

Up Vote Up Vote ×

In CA in a SNF the law of patient/nurse ration is 5:1. I think patient morbidity and mortality would greatly improve if all states adopted this. All I see in SNF today is NEGLECT. Short staffing is dangerous and unfair. It's about the bottom line and we ALL KNOW that these companies could afford safe staffing if they'd stop lining their own pockets.

Up Vote Up Vote ×
Specializes in LTC.

I want 15 skilled....

I have 30....

I have NEVER heard of just 5, are you sure you heard right?

Up Vote Up Vote ×

I suppose I read wrong, but this is a proposed staffing law anyhow. I think 5 patients to one nurse is fair. i think over 12 is too much and unsafe.

http://www.nationalnursesunited.org/issues/entry/ratios

Up Vote Up Vote ×
+ Join the Discussion