]I have been a LTC LPN for 10 years, I have dabbled in other areas, but keep coming back to LTC, I currently work in a facility 1 mile from my house (saves BIG on gas money) anyway, my question is what is legal as far as nurse to patient ratio? I work 3rd shift, and every wed. and every other weekend they have a QMA on the lower level with 43 residents, and myself on the upper level (skilled) with 32 residents, there are 4 total cna's in the building, sooo, not only am I responsible for 75 residents, I have all my skilled assessments, meds/tx's etc, to do, I have to go to the lower level and perform 2 in and out catheters, which can take up to 45 minutes, I also have to listen to lung sounds, bowel sounds check edema on the Q's weekly's, ATB charting etc, and then enter all of that into the computer, AND, if there are any falls, etc, I have to do all the assessments, Incident reports, etc, AND, not only do I have my own med pass, with a gtube, IV's, blood draws and so forth I have to go BACK down and give the insulin because apparently the day shift nurse (with 3 of them) are not able to do this, I have spoken with my DON about this and gotten no where! Furthermore if I don't get to do their insulins, say I have some sort of emergency upstairs, the day shift nurse (one in particular) will go crying to the DON about how I am not doing my job:madface: does anyone have any suggestions? I am getting really burned out:(HELP
Thanks to all who replied to my post, it makes me feel better that I am not the only one who thinks that this is CRAZY, my DON makes it sounds like I have won some prize because she says I am the only one she would "trust" to be in charge of the building, what happens if I leave? geez, even I know they would hire some other sucker and feed her or him the same line! funny thing is, I have no title as "supervisor" nor do I get paid any more for doing this, oh yeah, my DON also let me know that there is no reason why I should not get my 1/2 hour luch break on these nights! apparently she lives in a dream world!!I only missed 2 days last year, and none so far this year, I'm thinking of calling in one of these days, so that maybe someone else can see that putting all this on one person is INSANE!!!thanks again
That is abuse!
No, don't call in.......seems like they don't WANT to see the problem. I would definitely look into a job change and fly out of there.
I gotta tell you truthfully what I would do. If I did not have time to do day shift's insulins, I would tell them, I did not have time and set that precedent. They'll whine but so what? If they are too busy to do them, it's something they need to deal with. Also, it is a law that you are to get your breaks, and I would definitely take my break. If not, a call to the labor board might be in order. As far as your supervisor telling you that you are the only one she can trust, I am sure you are a good nurse and don't take this wrong, but managers in this position usually try very hard to give lots of compliments and butter you up so you will feel somewhat good and not leave.
But a good piece of advice is keep a notebook log of what you do and the times you do them so you have proof in black and white of how overwhelmed you really are.
]I have been a LTC LPN for 10 years, I have dabbled in other areas, but keep coming back to LTC, I currently work in a facility 1 mile from my house (saves BIG on gas money) anyway, my question is what is legal as far as nurse to patient ratio? I work 3rd shift, and every wed. and every other weekend they have a QMA on the lower level with 43 residents, and myself on the upper level (skilled) with 32 residents, there are 4 total cna's in the building, sooo, not only am I responsible for 75 residents, I have all my skilled assessments, meds/tx's etc, to do, I have to go to the lower level and perform 2 in and out catheters, which can take up to 45 minutes, I also have to listen to lung sounds, bowel sounds check edema on the Q's weekly's, ATB charting etc, and then enter all of that into the computer, AND, if there are any falls, etc, I have to do all the assessments, Incident reports, etc, AND, not only do I have my own med pass, with a gtube, IV's, blood draws and so forth I have to go BACK down and give the insulin because apparently the day shift nurse (with 3 of them) are not able to do this, I have spoken with my DON about this and gotten no where! Furthermore if I don't get to do their insulins, say I have some sort of emergency upstairs, the day shift nurse (one in particular) will go crying to the DON about how I am not doing my job:madface: does anyone have any suggestions? I am getting really burned out:(HELP
Well I don't want to say your crazy or you don't care about your'e license but give your head a shake and get the hell out of there. I don't know what state you arein but in florida it is legal for a staff ratio of one nurse to 40 residents and 20 residents to one cna. The facilities i have worked in try and staff more but sometimes it's not possible. Good luck.
Hi, Please don't feel alone. My facility has been working with 1 night nurse and 3 (or if someone calls in 2) aids. eve's either 2 or 3 nurses and same with days. The cences currently is 75. I was also only a mile away from home. When I got sick-pneumonia (wonder where I got that) I was terminated-so when I go back I will have lost my seniority and the month a year vacation I had finally gotten to.
So my feelings now are colored. I feel that when facilities start cutting staff--(cheats the residents) that their treatment of the employees matches up--
I am still recovering, but when able to work agai will look at several options. It is a terrible responsibility. I had to deal with mutiple emergency situations alone--the aids are your best assest, so teach, teach, teach, if you stay there. I also had to 911 myself which left the facility totally without a nurse. Good luck.
Sounds to me like this place is out for the money and not concerned with patient care and safety. Your license is important and there are laws concerning nurse to patient ratio. This facilty seems to have overlooked that fact. Look up your states laws on internet or other sources and find out for your sake and the patients. I have seen this type of situation all to many times.
This may very well be allowed by your state's mandate for nurse /patient ratio. Yes that is shocking, but true. The state will say to you, if you feel unsafe, it is YOUR responsibility to either get a new position or be held accountable if and WHEN things go wrong. Much reform is needed and it is up to US as staff nurses to make it happen. Management is not going to do ANYTHING to alleviate this situation, especially as long as nurses dont unite and become strong with one voice. First step , unionize( yes CapeCod, I am still saying the "U" word).Then work with your union to change law at the state and federal level. Change wont happen easily, there are Nursing Home Reform Advocacy groups nation wide that are working to this end, BUT we nurses MUST join the fight, for our own and our patient's sakes. The days of trusting your management to do the right and ethical thing is LONG past. The management answeres to the corporation, who's bottom line is and always has been MONEY. Get wise nurses out there, be strong, be brave, nothing that isnt worth fighting for isnt worth having, that includes self respect.
Well, I just got fired. Again. Doesn't look like I'm doing much these days!
How are you?
SO SORRY to hear about that, life in the dungeons definatly has its perils. I am fighting the good fight as you can see, read the DON forum.All I can say is hopefully one day staff nurses can do their jobs with moral conviction and not be fired in retaliation by unscrupulous nursing home corporations and their management that must do their bidding. My lawsuit is in the appeals process, will keep fighting up to the supreme court level if need be, say my lawyers. Good luck to you Suesquatch, hope you find something you can live with until things improve in this industry, OR more likely scenario, nurses get wise and get a STRONG union on board.
Nursing home reform advocacy groups?? Can you point me to one of their sites?? Also how do I find out how many patients one nurse can care for in the state of Washington?? You are all so supportive and it is so wonderful to hear all of your ideas. Thanks so much--
Nursing home reform advocacy groups?? Can you point me to one of their sites?? Also how do I find out how many patients one nurse can care for in the state of Washington?? You are all so supportive and it is so wonderful to hear all of your ideas. Thanks so much--
The group I have been in most contact with is called the National Citizens Coalition for Nursing Home Reform. http://nursinghomeaction.org . They can direct you to a local group in your area. I hope nurses realize that these groups are aware of the situations in nursing homes regarding the retaliation from the management and owners, that nurses face when they try to do the right thing by reporting illegal/unethical practices. They are willing to help us and we in turn can help them with their goals. We need all the help we can get. As far as staffing ratios in your state , why not go to the state website that is in charge of state surveys etc in your state, I dont know what they would call it in Washington, but here in WI its called the Bureau of Quality Assurance. Or go to the Medicaid site in your state, I beleive they post the state survey results and staffing ratios etc. Otherwise the Reform folks can direct you to where you need to look for your state. Good luck.
RosesrReder, BSN, MSN, RN
8,498 Posts
That is abuse!
No, don't call in.......seems like they don't WANT to see the problem. I would definitely look into a job change and fly out of there.
Good luck!