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

Specialties Geriatric

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??

Specializes in ER.
Ayiyiyi!!!

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

Mean to sound what way? 30 residents seems to be the norm here in NY- I did it for years as a second job. 5:1 staffing in LTC? Heck, we don't even get that on a med/surg tele floor that does drips, ect. I usually have more than 5 in the ED. Great staffing wise? Not so much, but it is the way of the world.

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Specializes in Gerontology, Med surg, Home Health.

When I was a floor nurse, I had 30 patients on a sub acute floor. Meds, treatments, IVs, trachs, TPN, Gtubes...I got it all done and still had time to talk with the residents. You learn how to do an assessment while the person is taking their meds. I didn't stroll around, I walked fast. Were any of my patients neglected? No.

I'm the DON now and I don't drive a Lexus. I am well paid because I am responsible for the lives and well being of 181 residents and 200+ staff members. My current staffing is 1 CNA to every 5 or 6 residents on days and evenings. Sub acute floor...each nurse has 13 residents...all 3 shifts. Really if you can't manage 13 residents.....the long term floors have 19 residents on days and evenings..again...not difficult if you can manage your time. My residents get EXCELLENT care. If there are extra admissions or lots of transfers to the ER, I am on the floor helping the staff, not sitting in my office...and they still complain they are too busy. Being busy as a nurse no matter where we practice is a fact of life.

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I would love some tips for time management...our facility has 14 sub-acute pts per nurse with four aides on a 42 pt floor. They expect all work to be complete in 8 hours minus a 1/2 break that is mandatory. this includes documentation all still be hand, tx, skin checks, meds (and many of these pt have 8 or more to pour at a time, assessments, dc, admissions, family meetings, being available for family or pt questions, and to answer any call light and assist pt regardless if you are trying to complete a med pass. I had more respect as an EMT than I do now as a nurse and there is no support from the front office what so ever. I am very conscientious about my job and unfortunately I can say that i have observed many "holes" in MARS and TARS due to lack of time and the pressure of leaving on time!

It is a sad state of affairs in healthcare today as a whole and I wonder just how much worse it will become before if ever it will change. I got into nursing for patient care, not to increase the profits of corporations at the cost of quality of care. Many of my patients are alert and oriented and have often commented that care is not was it once was a few years ago. So where do I go from here? Believe me, it appears to be the same most every place, so please, any advice to provide quality, expedient care that leave me feeling I have done a good job at he end of the day without having a nervous breakdown or harassed to hurry up and punch out, after all I worked very hard for my license and would love to keep it. Thanks in advance!

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I am wondering, are you a new grad? I was and had less than 2weeks training in a LTC also. I was then put in an alzhemiers unit that was being treated for scabies. I was expected to pass meds on 35 patients who were constantly wandering around the unit. I made a med error my second week there. I quit the next week without giving notice. I felt that I was "set up" to fail and they deserved it. DON's need to train their nurses better or expect to have lousy nurses working for them. Before something happens make a compliant to your DON.:mad:

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Specializes in LTC, Med-Surge, Ortho.
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.

We certainly are not morons!!!!. Most of my experience is in LTC and I have had my share of dealing with emergency and acute situations. What I meant was labs are drawn more frequently in the hospital compared to LTC because the majority of ltc patients have chronic diseases compared to the hospital that handles more acute cases and different ages of patients.:nurse:

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Specializes in 6 Years Hematology and Oncology.

Honestly, I'm sad. I hate leaving at the end of my shift knowing that all I am is a pill pusher and not feeling like I did any nursing for the residents. I dont know what the residents I have are in for because I don't have time to pull all 31 charts and find out. At what point does patient care take precident over the money? If we as nurses are expected to make sacrifices (no breaks, can't pee, dont dare get a drink of water) why cant CORP also sacrifice. Quality care, give us more help. Not because we are not qualified to handle such a load, but because it's inhumane and neglectful. I want to be a great nurse for these people. Help me help you. :bluecry1:

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Specializes in 6 Years Hematology and Oncology.

Oh, and don't get me wrong, I don't mind busting my hump every day, work does not scare me. What I dont like is feeling used like a door mat and being made to feel ungrateful or or unappreciative because they were so "kind enough" to give me a job. I might be another warm body but this job is just another job. I know very well I can leave and plan to as soon as I can. I just don't see how things will ever get better in these institutions if we dont expect better quality care and raise the bar. Just my :twocents:

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