Graduate Nurse In Charge of 47 Residents

Published

My first RN job is in LTC. I graduated in May 2014 and passed NCLEX in June 2014 and starting working LTC in July 2014. Just checking if this is the norm: I'm in charge of 47 residents. I typically have 4 aides working under me. When I work weekends, I'm the only RN or even LPN on the floor. Seriously scares me because I simply don't have the experience yet. So, is this the usual way LTC operates or am I just being a newbie whiner? I'm feeling overwhelmed and am contemplating giving me 2 weeks notice after only 1 month of employment.

Up Vote Up Vote ×
Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

As a new grad Lvn I was in charge of 45 residents. I had 4 aides. Yes, this is normal. There was no other nurse in the building after 4pm. I worked 3-11.

I do wish they spent more time in school teaching us how to be good charge nurses. But in spite of that, I learned. You will, too.

Up Vote Up Vote ×
Specializes in Critical Care, Education.

Take a careful look at your state's Nurse Practice Act to determine if they have any restrictions on new grad practice. In my state, new grads are not permitted to fulfill any sort of 'charge' role for at least 6 months after graduation. There must always be a qualified RN immediately available to supervise any new grad.

Just sayin'

Up Vote Up Vote ×

HouTx, thank you for the advice! Definitely something to look into.

Up Vote Up Vote ×

Just some thoughts...

Ethically, I believe that if you have any doubts about your ability to manage this workload safely, you must discuss this with your manager as soon as possible. Maybe they can arrange for backup for awhile until you feel more comfortable. I think this is our duty as a nurse -- to protect our patients, ourselves, our profession, and ultimately our employer from harm. Why add the stress of feeling like you are in over your head?

However, if you feel you can handle it, and provide safe and quality care, that is up to you. There are many nurses working in extremely challenging positions, if my guess is correct.

Either way, I think there is no harm in owning up to your honest feelings and asking your manager for her/his advice. Also, is there someone on staff who can mentor you, who you can trust and who has trod the same path?

Good luck.

Up Vote Up Vote ×

47 is too many unless it's 2300-0700 or your facility's equivalent. Ideally it would be 20 on 0700-1500 and 30 max on 1500-2300.

The above figures depend *greatly* on whether these are skilled patients or not. You can about half those numbers if they're all skilled.

Up Vote Up Vote ×

Ironically, the day I was intending to give my 2 weeks notice, I checked my phone during break and noticed a message from a hospital I interviewed with in June. They offered me a full time med-surg position! I really enjoyed my med-surg clinicals and completed my preceptorship on the med-surg floor of this very hospital, so I obviously accepted the position and did, indeed, give my notice at the LTC job. I do believe the month I spent in LTC provided me with a crash course in what nursing can be like. Thankfully, my new job gives me 2 months of on-the-job training, plus there's always other nurses on the floor to go to when I have a question. Thank you to everyone who responded to my questions--I appreciate it!

Up Vote Up Vote ×

Just be careful, 8 weeks is kind of short an orientation for a new grad in acute care. In other words, seize the opportunity but don't mistake it for generosity, because 12 weeks is far more appropriate for your experience.

Up Vote Up Vote ×
+ Join the Discussion