Hi all! I'm very confused right now, and could really use some input from you wonderful gals and guys! I currently work on a Med-surg unit that specializes in Oncology, I started working there this past summer, I love most of the people I work with and my manager is amazing. The downside? Staffing is horribly inadequate, nights when we're lucky we have 6-7 patients a piece, no secretary, and one CNA. However it's not uncommon for us to work with 6-7 patients with no secretary and no CNA. The acuity of our patients seems to be rising every day partly because we don't have enough beds on PCU so, often times we get admissions that aren't really appropriate for our unit, (GI bleeds, pulmonary edema, acute respiratory failure some of the more popular admitting diagnosises we're seeing) On top of that our oncology patients who are recieving chemo, numerous blood transfusions, IGG, etc and it makes for an overwhelming night. And, the overwhelming nights are becoming more and more frequent. I stay stressed from the moment I hit the floor until I get home and even afterwards I have trouble sleeping because I know we're shortstaffed for the next night I work, I can't seem no matter how hard I try to let my stress go when I leave the building.
Normally I might would be able to cope with this, but with 13 credits on my plate this semester I have a lot going on, I have learned that high stress at work and high stress at school is too much for me. I work PRN on the cardiosvascular stepdown unit at my hospital as well, and love it (I've always been cardiac nut) the staffing is appropriate but currently there are no full time positions. I am considering changing my full time job to one in the LTC setting, don't get me wrong LTC is stressful but it's a different kind of stress than what I'm dealing with now, I've worked LTC before as a CNA and generally things are routine, unless someone falls, needs to be sent out etc. Not to mention pay is incredibly better in LTC some places having starting pay that is almost double of what I'm making now. I have applied to several facilities in my area for baylor positions (work 2 16's get paid for 40 hrs) which would be a wonderful schedule while I'm in school, not to mention the extra pay would make it easier as I am paying for each semester out of pocket.
Please don't think I'm green, LTC is no cakewalk, LTC is chronically short staffed and underappreciated it's a specialty that never gets the respect it deserves, but in a way I feel it may be better for my sanity to try to decrease or change the type of stress I have so I can ultimately achieve my goal of becoming an RN. But I'm torn, simply because I do love the people I work with and I don't want to jump out of the pan and into the fire. If I leave I know I would stay PRN, but still the thought of leaving somewhere that is pure hell some nights to somewhere that is hell every night is very scary for me. Ultimately, I want to do what will be most conducive to attaining my goals. I keep going back and forth on what I should do, I hope any of you who have any thoughts or feedback will please post, I would greatly appreciate it! :wink2:
Where do I begin....first go check out the thread that I started in How to get out of LTC need insight Please. I am a RN and have been in geriatrics for about 4 plus years. I hate all of it. I am frustrated by the lack of time I have to spend with my residents, I am pulled here and there all the time, how no administration wants to hear the truth or even understand that we have licenses to preserve. On a med cart you could have up to 60 residents. On one of our floors, we get all kinds of short term stay residents like hip replacements, knees, all fresh with IV's and antibiotics and drawing vanco levels.
I worked in a variety of settings in the hospital and I have to say that my worst time there doesn't even come close to an ordinary day in the LTC. It isn't nursing.....its not even close. Try keeping track of just 10 kids, and get an idea. Then do all the meds, treatments, calling all labs into doc who won't call back, doing your own pt/inrs, reordering meds, following up on every consult, ect.....it is too much.
Now I have been assertively trying to get out and so far no hospital seems to think I have worked. Go figure..
i'm a weekend supervisor too. i cant help but keep thinking about the 6-8 pts i had when i worked that short time in the hospital. cuz now my nurses have those same type patients only they have 25 of them! its ridiculous and in my little world up in my head i keep hoping one day staffing numbers will change.
this past weekend, for 2 days straight, as the only rn in the building i ran my everwidening butt off going from picc line to cvl, iv infusion to iv infusion. i went thru so much ns and heplock the pharmacy called me and asked me if i was drinking it. (i keed! i keed! but they did laff at me when i ordered "a truckload"). i changed more dang sterile dressings on cvls, flushed the ones that werent getting an infusion.
this past weekend was a typical weekend for me, and it was dang exhausting and sometimes i think i have lost my mind for staying! 4 pts passed away but before they did i was constantly calling my oncall doc for more morphine/dilaudid/ativan (and the patients needed stuff too!). the donor service asked me if i was trying to get rid of them all. i told her "dont give me any ideas!" lol
had 2 patients crash, both ended up in the unit..one on the vent, the other died there.
tried to keep a woman alive until her son's plane landed. (she died as soon as he got there but if i tell yall how bootiful the story is you'd cry so i wont)
then ya got the families who think their family is the only pt and they demand to see "the rn" constantly.
between all this you have staff calling in left and right and have to cover those shifts. staff members fighting as always. god forbid one person have one more patient than someone else! *picture me rolling my eyes cuz im too lazy to find the smiliey*
somewhere in all that you gotta draw the stat labs, get the xrays obtained...remember to call for the results cuz you never get them faxed to you on the weekends.
it's overwhelming at times to be the only rn on the weekends to coordinate the care for all 90 pts. but then i think of my poor nurses on the floor trying to care for 25 patients and i shut my whining cuz they are the ones working their hindends off!
but i wouldnt trade it for the world! i love ltc. i hate the politics and the administration fighting you because they want to make money and you want to take care of patients....but you cant ask for a more satisfying job, imo.
but do i recommend it to other nurses who've never done it? heck no! (im afraid they'll come back and keel me dade:p )
thanks - i was waiting for the positive quote.
as for the earlier poster who feels like she'd rather work at mcdonalds you do realize what they pay at mcdonalds - right?
With the exception of some brief time as a medication nurse in a small psychiatric hospital, I have spent my entire nursing career in LTCFs.
I have had up to 70 residents by myself during night shift with no other nurses or medication aides to help. I was responsible for passing medications, feeding and flushing PEG tubes, dealing with unruly CNAs, calibrating glucometers, checking the crash cart, doing treatments, Medicare charting, incident reports, collecting specimins, hanging IVs, and mountains of various paperwork. On many nights, I had only 2 techs to do rounds on these 70 residents. You better believe I had to take some shortcuts to get it all done.
I have had up to 40 residents on day shift. If anything out of the norm occurs (chest pains, falls, a code, physical contact, etc.), your day is totally ruined. There's absolutely no time for unusual occurrences in LTC.
The family members can sometimes be hostile. Paramedics and EMTs have gotten nasty with me, and I've had to bite back. Some of the physicians and medical directors in LTCFs do not want to be bothered by you because "these patients are old." Some of your fellow colleagues in other specialties will look down upon you because you're a nurse in LTC. As far as respect is concerned, LTC trends toward the bottom of the barrel.
In addition, the stress is magnified by the fact that we have so many patients.
I agree with all of the above 100%! I will never go back to LTC.
I didn't graduate from H.S and go straight into nursing so I am certainly aware of the pay rate at McDonald's.
Remember a supervisor is not a floor nurse so while they to are stressed out it's not the same as being on the floors.
it's overwhelming at times to be the only RN on the weekends to coordinate the care for all 90 pts. but then i think of my poor nurses on the floor trying to care for 25 patients and i shut my whining cuz they are the ones working their hindends off!
I'm sure as a student you think that you would put up with anything for what I get paid to work in LTC/SNF. I won't argue the point with you because experience is the best teacher and if you ever have to work under the conditions that I work under then maybe you will have a different perspective of things.
Until that time please reserve your judgment.
Thanks - I was waiting for the positive quote.
As for the earlier poster who feels like she'd rather work at mcdonalds you do realize what they pay at mcdonalds - right?
I agree that LTC is quite stressful. It takese a certain kind of nurse to handle it IMO. I would have about 40pts on night shift after 11pm and 2-3 cnas. The med pass takes 2hrs at night. I had to do 14 7am blood sugars and most were receiving coverage. We would be short-staffed often and had alot of slack nurses that only gave out the narcs..if that.
I do enjoy the geri population though. Now I work on a medical floor in the hospital as an RN and it's quite different but I sometimes see the residents I cared for when they are admitted to our floor. I don't THINK I would return to LTC as a floor nurse but you never know. Good luck in your decision.
Specializes in Onco, palliative care, PCU, HH, hospice.
Thank you all for your feedback, experiences, and opinions. I'm still not sure what I'm going to do, more than likely I will just try to "hang in" there since there are many positives with my current job. Several of my friends work in LTC as nurses and they love it. Once again I thank you all for replying !
i've spent my career in LTC. thus i feel i have the right to say this....
HAVE YOU LOST YOUR EVERLOVING MIND?????
:chuckle LMAO
I am a new grad who actually did leave my hospital setting and work per diem at 2 LTC facilities and part time as a case manager for hospice and home health. I love the case management and pick up LTC just because the pay rate is so good. Good luck.
If I leave I know I would stay PRN, but still the thought of leaving somewhere that is pure hell some nights to somewhere that is hell every night is very scary for me. Ultimately, I want to do what will be most conducive to attaining my goals. I keep going back and forth on what I should do, I hope any of you who have any thoughts or feedback will please post, I would greatly appreciate it! :wink2:
PeacefulHeart
18 Posts
Where do I begin....first go check out the thread that I started in How to get out of LTC need insight Please. I am a RN and have been in geriatrics for about 4 plus years. I hate all of it. I am frustrated by the lack of time I have to spend with my residents, I am pulled here and there all the time, how no administration wants to hear the truth or even understand that we have licenses to preserve. On a med cart you could have up to 60 residents. On one of our floors, we get all kinds of short term stay residents like hip replacements, knees, all fresh with IV's and antibiotics and drawing vanco levels.
I worked in a variety of settings in the hospital and I have to say that my worst time there doesn't even come close to an ordinary day in the LTC. It isn't nursing.....its not even close. Try keeping track of just 10 kids, and get an idea. Then do all the meds, treatments, calling all labs into doc who won't call back, doing your own pt/inrs, reordering meds, following up on every consult, ect.....it is too much.
Now I have been assertively trying to get out and so far no hospital seems to think I have worked. Go figure..