horrible weekend

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Specializes in LTC.

I don't know, perhaps it is just me but this past weekend was awful. I work in a LTC facility where I am usually the LPN for two skilled halls that have a total of 32 residents. On a good shift I only have one hall. A little background on our current residents is that we have several with brain injuries. We have had a new DON since August and where our last DON screened our residents this one brings in any kind and doesn't offer us any kind of help. This whole weekend(Fri-Sun) I had all 32 of them all to myself. The other nurse had the NF end that has 28 residents. We had 3-4 CNA's working shift with us. Now let me start with the horror of Friday evening. I spent the first few hours running back and forth between the two halls(they are in the shape of an L) after residents with alarming Tabbs monitors, floor monitors, chair monitors and so on. I had one resident following me yelling at me about how the CNA had treated her. This resident gets 4.5oz Vodka nightly and every night after her drink she becomes belligerent or extremely sad. Another resident following me around demanding that she get her "asthma medicine" and her sleeping pill. Repeatedly explained to her that she had already had all the medicine she gets for the shift. She kept telling me that everyone else gives it to her when she asks for it. These are routine meds not PRN and she was in NAD. Several of the other residents that have dementia or brain injury were just wild and out of control this night.

Then the icing on the cake was when about 2200 I went to check on one of my ladies to get her VS I found her unresponsive and diaphoretic. VS WNL but BS 21. This same little lady had been sent out the previous Friday for BS of 29. All staff had been told then that she must be fed her meals and HS snack. I found out from a CNA that just happened to come to tell me that asthma lady wanted her medicine that the CNA that had this particular lady did not bother to give out any of her HS snacks and that she was long gone. I also found out from another CNA later that the

CNA feels that if the residents get Boost or Glucerna from the nurses at night that those are the HS snack:banghead: Anyway we started with OJ and sugar while my other nurse notified the MD who said to give her Glucagon but to hold off on sending her out because last time when she got to the hospital her BS was fine. Emergency box had not been refilled by pharmacy since the previous Friday when they had to use the Glucagon on her. They had been notified that day that we needed a new box. So we kept it going with the OJ and sugar and a few other things. I finally managed to get her up to 80.

Now during all this I had several residents that were wanting PRN meds, the other LPN stayed in the room with me. I finally got frustrated and when the residents BS started to move up I told the other LPN that hey even though I was busy I would go ahead and pass out the PRN's. Oh and once again notify pharmacy that we needed a new box. I was assured that they would courrier one over in the AM. This same LPN who has minimal work after 2200 did not offer to help me with my chart checks, txs or any of the other things I have to do between 2200 -0200 which is when I go home, I come in at 1400. No that is not a normal shift in our facility our DON just isn't very bright.

I managed to get it all done and got home shortly after 0300 to get some sleep and then be back in at 1400.

So I get there Saturday to find out that Pharmacy still did not send a box:madface:. I called again and faxed a reminder. Thankfully this time the box ended up coming around 2100:yeah: Now this shift was a little better. I only had asthma lady following me demanding those same routine meds that she had already had and telling me that everyone else gives them when she wants them. And also a few of the brain injury and dementia pts going nuts. Luckily no catastrophes.

Sunday night began to be like Friday night, I was threatened several times by one brain injury pt he tried to hit me a few times. He doesn't get any PRN meds to help when he is out of control and the few times that we have gotten something for him his wife complains when she actually comes in that it makes him to drowsy or it makes him to this or that. So he gets nothing and he is a threat to himself, other residents and staff. I also had more issues with Pharmacy on Sunday, we needed to start an IV on a MRSA pt but they didn't send the meds to us and when I called with questions they said the on call said that there was no one in to talk to and I would have to wait until the AM. I don't think so the AM was my day off. So I got an order from the MD to give the medication IM until the supplies came in.

During this whole weekend with all the craziness I became very fed up, one of the other nurses has complained and told the DON that she refuses to work both halls alone and since then they have made sure that she doesn't have to. So I wrote a two page note letting the DON know that I feel the same way. It is just way to much for one LPN to have to pass their meds, do txs, answer call bells, the phone, toilet people, change people, monitor the CNA's, speak with visitors for 32 skilled pts alone. I ended up getting out of there about an hour after my shift had ended. Then when I woke up on my day off there was a message from the DON wanting to know if I could come in early and then she was babbling about oh wait you don't work today, never mind pretend that I didn't call. Did she mention the note that I left? OF course not. I am on shift tonight and as of now it is just me and one other nurses scheduled. She really needs to make sure that there is a 3rd nurse before I come in or I will be looking for another job.

:bugeyes:Thanks for letting me get that off my chest

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Specializes in Med/Surg.

WOW thats all I can say. Now I have never done LTC as a nurse but have worked plenty as a CNA. But this sure doesnt sound safe much less feasible. I think I would have to run. Say what they want about hospital nursing but at least you dont end up with that many pts to be responsible for. Good luck and stand your ground. Remember its your license not theirs. They arent gonna protect it for you. Hope things get better for you and quick.

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Wow! You sound just plain overwhelmed! 32 skilled pts. is really too much. We have a skilled unit with up to 21 patients and that is very overwhelming at times with one nurse working 6p-6a. I would be looking elsewhere for work.

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Specializes in geriatrics / peds private duty.

And this is why I recently resigned my full time LTC position and accepted a much more quiet position caring for 1 child... on her couch... without 63 other screaming patients chasing me....AND with Barney and Sesame Street to keep me company! As an added bonus I get a set schedule, more pay, no more aching feet, and I keep my sanity (what little I have left!) I find that I get along with Big Bird and Elmo much better than I got along with most of my co-workers in LTC. My only regret is that I miss "my residents" and I think about them often. :redbeathe

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