how is your facility run?

[Heartsofangels]

Hi! I am an RN of a facility with a main floor of 60 pt's and a subacute unit with 10 vent and trach pt's. I've read the posts about depression and I have to say some of our nurses are on antdepressants and I myself have been depressed (not on meds). The problem I have is even though it is short everywhere, I feel like the DNS and the administrator do not care about their staff. With 10 vent and trach pt's, they will leave one nurse and one CNA for the floor, with pt's ringing. I need to do meds, teatments, doctors orders, admissions, and respiratory duties, then I have the CNA needing me to help with pt care b/c most of our pt's are heavy. I had an admission at 3pm (I work 3-11) the other day. I had the family of another resident coming into another pt's room behind the curtain to get us. I was so overwhelmed all I did was cry for 2 days, then I finally spoke with the administrator and told her I won't do that again. She said they are trying. On the main floor, sometimes it's me and a med tech til 7pm, then another nurse comes in for 7-11. And that's for 60 people. Please tell me if you all are experiencing the same kind of thing. Thank you.

[VivaLasViejas, ASN, RN]

That is nothing short of unsafe staffing, and YOUR license is at risk! Don't accept excuses from administration---if you continue to put up with these working conditions, they'll have absolutely no reason to change them. And if your facility is like mine (and just about every other nursing facility in this country nowadays), the top dogs are far more worried about their bottom line than they are about patient care. So you have to set some limits.

First of all, you need to think about how this workload places your patients in jeopardy. There is no way on earth one nurse can care adequately for that many people, even if they all are relatively stable. You've got people on vents; what happens when you're down the hall dealing with some crisis, your CNA is in another room, and one of them crashes?! Guess who's going to be held liable? Yes, the facility will be responsible for poor staffing, but YOU will also pay, big time, because you accepted this assignment, knowing staffing levels were unsafe.

The best thing you could possible do for yourself and your pts. is to tell management, in no uncertain terms, that you must have another nurse, and no fewer than four CNAs, on 3-11. Give them a deadline--say, 30 days--and if they tell you "we're working on it", or that they can't afford it, get yourself the hell out of there, and then call your state surveyors, senior services, or whoever monitors facilities in your area and report these unsafe conditions. Your patients' lives, and your sanity as well, may depend on it!!

[jemb]

I feel like the DNS and the administrator do not care about their staff. With 10 vent and trach pt's, they will leave one nurse and one CNA for the floor, with pt's ringing. I

Sounds to me like they don't care about their patients !

Think JCAHO might like to make an unannounced visit?

[sjoe]

Hearts--They are trying, for sure. Trying to keep their labor costs down as far as possible so they will look good (and probably qualify for a financial bonus). So long as the staff RNs will pick up the slack, they'll continue to do this, believe it.

To answer your posted question directly "how is your facility run?", this IS the way most facilities are run these days, in healthcare and in other industries.

[Heartsofangels]

Hi. Thank you for your responses. I did tell them I wouldn't do it anymore. I do feel like my license is on the line. What's funny is the Dept of Health was just there, but I heard they put more staff on while they were there. One night the woman from the Dept of Health came to my wing, she handed me a chart she was done with, then asked me how many CNA's I had. I told her one (I was on the 10 bed unit), she said ok, then went to the administrator and told her I was going crazy down there, so the administrator came down and asked me if everything was ok. I told her yes. I told the administrator that yes sometimes it's crazy, but I was fine at that time.