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

Specialties Geriatric

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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??

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.

Ayiyiyi!!!

You didn't MEAN to sound that way did you?

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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

LTC nurses also draw labs, deliver them to the lab, communicate them to the doctor and change care plans and MARS based on those labs. In LTC, we have a few patients per shift that are experiencing acute situations and 20 or 30 more that are chronic. Our orders can also change at any time. We're not morons.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
In CA in a SNF the law of patient/nurse ration is 5:1.

California does not have any legally mandated nurse/patient ratios for SNFs and nursing homes. This is why nurses in SNFs in CA routinely have 30+ residents.

Although I'm aware that some organization has proposed a nurse/patient ratio of 5:1 in SNFs in CA, it will never happen due to horrid Medicare/Medicaid reimbursement rates. No nursing home in existence can justify having 1 nurse for every 5 residents unless it is a completely private-pay facility that does not accept Medicaid or Medicare.

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Specializes in Gerontology, Med surg, Home Health.
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.

You should attend a few budget meetings before you make blanket statements about companies lining their own pockets. Many facilities operate at a loss every year due to low reimbursement rates from Medicare and Medicaid.

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All I know is that in an 8 hour shift, a nurse with 30 patients has 15 minutes (with a hald hour break because where I was at, they took your pay for 1/2 hour whether you took a break or not) per each patient. That's just 15 minutes for charting, labs, making and answering calls, meds, sugars, vitals, handwashing, and all other care.That's simply not enough to be safe. And heaven forbid you have to go spend 5 minutes to pee or get a drink, you get even less than that amount of time. 30 patients is NOT safe. I don't care about the budget. What does it matter if the patients are clearly being neglected?

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They seem to have tons of money for streamers and decorations and crap for every holiday, too. They can afford to hire another nurse so my life isn't HELL and patients are SAFE. If I didn't see the administrators driving lexuses and BMW's I'd be willing to take the "they're not lining their own pockets" with a grain of sand.

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And I'm sorry. 30 patients is physically too much. Even if it is just a med pass. I just quit a position where they stuck me 7p-7a with 33 patients, 2 aides (they don't do sugars or vitals or anything like that) no unit clerk or anyone like that, no LPN, no one. Just me and the aides who change the briefs. It's too much. It's NOT SAFE.

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If I didn't see the administrators driving lexuses and BMW's I'd be willing to take the "they're not lining their own pockets" with a grain of sand.

No one lines this lowly SNF LPN's pockets..and I drive a BMW. ;)

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Just want to add, I'd KILL to have 5 pts on SNF..hell I'd kill to have 15..I have 33. And as CapeCodMermaid said, LTC/SNF is no long the rest home of days gone by. Many of our patients are d/c from the hospital (far quicker than they should be) b/c Medicare/Medicaid or whatever ins the pt has will not pay for a stay longer than a certain amount of days.

What that means is these poor people are shipped out and sent to us, they are still too ill to go home safely but not "ill" enough for the insurance companies to allow more days for a hospital stay. Not all the patients/residents are chronic..many have acute issues going on.

If you've never worked LTC/SNF you don't know, what you don't know :)

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Well the DON at our facility drives a lexus, has all kinds of horses, ATV's, a huge house. She does NO patient care then tells us "you need to take more patients with less hours and less help because census is low and we have to cut back." Well I can't cut back on safety, sorry. I got bills to pay and I don't get paid enough to afford a BMW.

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The 33 patients they gave me needed more than just a pill and the blankets pulled up. They say "ltc" but those patients are needy. I simply don't have the time to be safe and thorough with that many patients.

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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.

Do you not have an aide or med tech?...nobody?

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