passing meds for 57 residents??

Nurses General Nursing

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Specializes in LTC.

is this too much?? My job is getting rid of the med techs so some of nurses will have to pass meds for 57 residents. There will be a charge nurse to do care and treatments and etc. But I still think this is too much. I can barely handle passing meds for my regular 30 residents. I scared for my license.

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I have many times in the past passed meds for 64 residents at a LONG TERM CARE facility. They do have LPN's for the meds because the RN's do not pass meds at this facility but sometimes due to call-offs or just being short staffed the RN's would get bumped into passing the meds while another RN was in charge and did all the TX's, it can really get overwhelming at times but you have to get a "system" going so you can judge your time management skills. But I do feel for ya.

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Specializes in LTC.

Thanks for the reply. I'll just have to get a system going, the hard part is that I work in alzhiemers alf and the residents wander, just to find them is a hassel.

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Specializes in Neuro-Surgery, Med-Surg, Home Health.

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Having to pass meds for 57 patients is not safe of course. The administration must know about this but they are more concerned about the bottom line... $$$. They are shortsighted and shows no care for the safety of your patients. It is understandable that you are afraid that you might lose your license if something bad happens to one or more of your patients because you are so overworked.

The "charge nurse" should be in 'charge', and not given so many other duties that she/he cannot do what a charge nurse is supposed to do.

Granted that my background is acute care nursing, but I have worked part-time in LTC's so I know what you are talking about. What I have experienced in LTCs may be shocking to nurses who have not worked in them. You gain experience, you learn to prioritize and I have heard of nurses who do 'shortcuts' in order to finish their work on time. "Shortcuts' may or may not be safe, but they are a fact of life in LTCs. We nurses could be patients in LTCs someday.

Scary isn't it?

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I have been there and done that also. That unit can definitely be a challenge, with the residents roaming around, taking off the ID bracelets and the pictures on the MARS don't even look like them! :no: LOL Good luck with your meds, remember these people need you! Rhonda

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Specializes in Ortho, Neuro, Detox, Tele.

I can't even imagine.....it's tough enough when there is a call off and passing meds to 31 skilled residents....my job has been sending nurses home at midnight....responsible for 31 skilled, 27 modifed skilled(think just needing minimal assist, but too much for assisted living), and 29 assisted living for the last 6 hrs of shift. everyone except the 31 does not need much execpt monitoring....have not been comfortable...what if I'm passing a med and someone codes on the other side of the building? I think you should be right to be worried....time for a job search methinks....

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Specializes in LTC, Med-SURG,STICU.

This is too much to expect out of one nurse! I work in LTC and I am telling you this is too much. Nurses that do not work in LTC do not realize this is not the LTC of old. These people live longer and sicker than they did years ago. Look for another job ASAP.

When the poo hits the fan and you get sued the facility will fire you. Then you will be dealing with a law suit and no job to support yourself.

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Specializes in LTC,Hospice/palliative care,acute care.

You can't possibly pass meds to that many residents and remain compliant.We used to have 1 med nurse on our large units until the DOH called us on it-we now have 2 med carts and always 2 or 3 nurses on day shift. In LTC (not skilled) our population is stable-we don't have non-working charge nurses.We also have many LPN's who are charge nurses on several units.We all pass meds,do treatments,etc.. I'm lucky to be in a good facility-there are some pretty crappy ones around...Sounds like you happened upon one...Good luck.Short cuts can cost you your license and you worked way to hard for that..

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Specializes in Med-Surg, LTC.

Our ratio is 1 nurse:30 patients during the day and 1:60 at night. Depending on the shift, 57 would be alot. Can you talk to admin? There are state mandated ratios that need to be met. You could probably google them easily for your state.

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What shift do you work, NurseLoveJoy88? Having 57 residents on the 11 to 7 shift seems to be near the number (60) nurses have on that shift. If this is the 7 to 3 or 3 to 11 shift, then that is a lot more than many LTC nurses usually have. Most nurses I know have around 30 to 35 residents, and even at that number, it's difficult to get residents their meds within the 1-hour-before-1-hour-after rule.

Plus, you mentioned a charge nurse who does treatments. Will you have to do admissions, incident reports, taking off orders, and calling MDs on top of your med pass, or will the charge nurse help out in those situations? I don't see how, even with the best of planning, anyone can pass meds to 57 people on the first two shifts within the time frame, unless each person only takes, say, 3 pills (with no fingersticks, IVs, tube feeds, etc.) for each med pass.

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As a former LTC nurse I can tell you that 57-60 at any time is not safe. Yes on the night shift you will haev down time but there are care plans that can be done and audits ect.... there is no safe situation where there are that many residents to one nurse.

The department of health woudl love to hear from you. look for a new job and CYA

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IMHO, this is way too many residents that you would be responsible for! I would first try and talk with your managers but if that didn't work, I would look elsewhere for a job! Life is too short to be stressed out. Also, it's your license your working under, not your supervisors. I could see a lot of negligence involved if you had that many clients. Poor residents! Find another job!

Just a personal story here. I had a friend who worked for a long term care facility for all of about 3 months. She only had 1 year of nursing (LPN) experience. At first she loved this facility. She was telling me that she was learning so many new things. When they turned her loose, she revealed to me that she had 60-64 patients some days (she worked 7a-7p), since call offs were common. I asked her how in the world she managed that many patients. She said that half of the medications (including insulins and such, just did not get done!!!:eek:). She complained non-stop to her supervisor and DON before finally giving them a notice and quitting. I told her that was the smartest thing she could have done. I felt sorry for the patients foremost, and worried about her license. I don't see how any facility can operate like this.

I mean, if all you had to do was pass medications, that would be a little better. You have so many other things to deal with though in your shift. I would not risk my license and especially wouldn't be subject to neglecting those poor residents who need much more care (more nurses and more CNAs). I would hate to be a resident in a nursing home and knowing my nurse had 60 other residents.

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