I need advice

[Stephienic]

I am an RN and have just reached my 1 year mark of nursing. I work at a long term care facility and need some advice. During my first year of nursing at times I have been by myself with 20+ residents and no CNA. I've had to pass my medications, complete treatments, and then immediately go and provide incontinent care to all of the residents. To me this felt unsafe but I felt like I had no choice. Staffing has continued to get worse. My LTC facility has a separate facility that is rehab with around 20 patients and approximately 1/2 of the residents are full codes. At this facility you would be the only nurse in the building with one CNA that has no CPR experience. Recently due to lack of nurses they are floating nurses from LTC to that separate facility. I don't feel comfortable due to lack of experience. Do I have the right to refuse that assignment? Also, my shift is from 7p to 7a and they don't tell you you are getting floated until around 11pm when you have already clocked in. They have the day shift nurse stay until 11pm. Would that be abandonment?

[TriciaJ, RN]

Are the CNAs not required to be BCLS certified? Are you saying you are the only staff member of any description and responsible for 20 patients with high needs? Who looks after those patients after 11p when you get floated?

You've got a year under your belt and they'll run you into the ground as long as you let them. This wouldn't be a bad time to start scoping out other opportunities. Good luck.

[Stephienic]

At 11p another nurse would end up with around 40 residents. The other nurse would take my residents and I would be expected to go to the other facility. The CNAs are not required to have CPR (scary) and it would be myself and 1 CNA for 20 residents in the building, no one else. I really don't feel comfortable. If I do try to get floated I am going to refuse. I may lose my job but I just don't feel comfortable with the situation.

[spowell16]

I too work for a SNF and have for several years. I hate to be the one with bad news but depending on the state you live in that ratio may truly be legit. With that being said, yes it is scary and yes you have the right to refuse anything. Just dont take the keys or get report first. You also need to look at the acuity of your residents. One facility I worked for allowed one nurse 2 cnas for around 55-60 residents. Yes this is insane as I know how chaotic it can be but our governemnt seems to think that because it is actually like their residence that they dont require as much care.