I need to vent please a little long sorry

yadda_yadda_yadda, LPN, LVN · Feb 27, 2006

:icon_hug: Deep breath!

Most LTC facilities unfortunately, require 'multi-level, multi-tasking'

If it's possible, delegate as much patient care to your CNA's/techs.

Are you lucky enough to have techs that could at least get blood sugars taken for you?

I'm sure you've got G-Tube feedings, as well. Some techs/CNA's can also help with this. Take a look @ what can be delegated to a team member you trust to carry things out for you--and simply manage your time the best you can. I've been 'exactly' where you are right now. I had 50 residents to medicate each morning. Each med pass took 2 full hours---I simply made certain that I always went in the EXACT same order (alphabetical, rooom-to-room...whatever works for your facility) with my subsequent med passes so dosing intervals were appropriate. Nursing homes/LTC facilities are aware of this. They know the census, they know the staffing ratios.

Regarding the new admission: I've had the same thing happen. Sometimes, things out of your control take over. Sounds like this definitely applied here. I'd have gotten a set of vital signs (or had a CNA/tech do it), looked over the transfer orders for anything urgent, gotten the meds taken care of & patient settled into the room----the rest can be(and should have been) taken over by the oncoming shift. Things happen.

All I can say is keep your chin up...don't let the politics interfere with your ability to remain in control. --- A nurse friend of mine experienced similar frustration, freaked out & left in the middle of a shift report. Her job had become so bad, on shift, she completely 'lost it'-- unattended call-lights were going off, 'code brown' was in the air, residents were wandering left & right (basic chaos)---and she snapped...Naturally, patient abandonment allegations came rushing forward. She ended up driving a bus for the city we live in. Tragic---and totally preventable.

Take a deep, deep breath. Remember that your residents rely on you..not to mention, LTC residents sure "pick up vibes" like sponges. If it's truly become too much to process, I'd be the first to suggest pursuing other career options. We all deserve to be happy, feel appreciated & be supported by management for our efforts. We also deserve safe work conditions.

Hope my :twocents: helps :nurse:

anniev · Feb 27, 2006

Thank you 1966,, No we don't have techs CNA can't do VS guess the buck stops here sad to say. Just feels good to be able to say it with out a reprimand thats all. later:D

nursesaideBen · Feb 28, 2006

Just remember, CNAs are working just as hard as you to get the work done. Trust me, doing total bedside care for 20 patients isn't very easy. I try to go out of my way to help the nurses at work with anything I can help them with. However, some nurses go a little too far and go from delegating to dictating. I find it very offending when a nurse comes in while I'm changing and drying a patient that I need to go "answer call lights right now". My favorite is the nurse who hunted me down to wipe up a bm on a patient so she could give him his suppository. She told me simply "I am your RN supervisor and cleaning up a patient is NOT in my job description". Of course I also find it offensive when CNAs intentionally don't do anything but sit at the nurses station or hide while I get to work the floor by myself. So, just remember, don't become a dictator and don't delegate things that are out of a CNA's scope of practice.

-Ben

bethem · Feb 28, 2006

Thank you 1966,, No we don't have techs CNA can't do VS guess the buck stops here sad to say. Just feels good to be able to say it with out a reprimand thats all. later:D

Wow, that sounds stressful! What do your CNAs do if not vital signs? I know there's plenty to do what with showers, changes, feeds and so on, but who can't they do the vitals?

yadda_yadda_yadda, LPN, LVN · Feb 28, 2006

Just remember, CNAs are working just as hard as you to get the work done. Trust me, doing total bedside care for 20 patients isn't very easy. I try to go out of my way to help the nurses at work with anything I can help them with. However, some nurses go a little too far and go from delegating to dictating.
-Ben

I certainly didn't mean my suggestion offensively. The tech I work with knows 100% + that I'd never, ever ask him to do anything I'm not more than willing to do myself (after all, my job description certainly does encompass all he does...I'm not exempt from wiping bottoms or cleaning up a mess)

I meant that the nurse should have tried to begin the admission process, while seeking as much help from her team members as possible. Dictating wasn't part of my suggestion. :nono:

I work by the 'one hand washes the other' philosophy.:thankya: -- it's a team effort from start to finish.

nursesaideBen · Feb 28, 2006

Oh I didn't mean to sound upset:icon_hug: , I was just putting in my 2 cents I totally agree with you, it takes every body in nursing, one person can't do it all I completely agree with the "one hand washes the other". I find it strange that the CNA's can't do vital signs there. Where I work we do all the vital signs including Neuro checks. As a CNA I would be insulted if a facility told me I could not do vital signs.

blynn · Feb 28, 2006

That's weird, I always did vital signs when I was a CNA. How can they expect you to get anything/everything done when they won't even LET you delegate anything out to the people on your team?

cuetorn · Feb 28, 2006

I AM SORRY YOU FEEL LIKE THIS, BUT I AM MORE CONTENT KNOWING I AM NOT THE ONLY ONE. IT IS UNBELIEVABLE HOW SOME LTC'S ARE RUN. I AM BECOMING VERY DISGUSTED WITH MY LTC POSITION. TO MAKE A LONG STORY SHORT, I HAVE WORKED IN LTC FOR 5 YEARS AND HAVE ONLY BEEN ABSENT FOR 4 DAYS AND THOSE WERE JUST IN THE LAST 2 MONTHS DUE TO STRESS-RELATED ILLNESS.

I LOVE LEARNING FROM THE LTC RESIDENTS, I MEAN I WORK WITH A TUSKGEGEE AIRMAN, MY GOD THE HISTORY THESE PEOPLE HAVE LIVED. BUT, THE WORK-LOAD AND RESPONSIBILITY IS JUST TOO MUCH. MORE THAN EVER, I AM SO AFRAID OF BEING NAMED IN A LAWSUIT:uhoh3: . I WOULD LIKE TO CHANGE JOBS, BUT I CANNOT EVEN FIND THE MENTAL NOR PHYSICAL ENERGY TO TAKE MORE ADVANCED COURSES.

anniev · Feb 28, 2006

Thanks all for suggestion My CNAs work right with me but some that have level5 certifications ( can do VS) are usually so busy just like me I would not dream of loading them down any more, OMG I need them to be with the residents, Lord knows unless there is a problem that these guys and gals see that is when I usually start assessing . They are my eyes and ears so many times.... the lowers on the food chain have to support each other.LTC feels like working in a factory at times , just get the produst out some one will let you know when it wrong no one tells you when it is right.

dawn1971 · Mar 1, 2006

I'm only a nursing student, but did clinicals at a LTC last semester. I am AMAZED at the work loads for LPNS. You guys RUN those places. I wouldn't do your job for anything!:)

dawnb70 · Mar 4, 2006

I was so happy to read this post. I thought I was the only one who felt this way. I've been an LPN for 4 years, and in LTC the whole time. I think I'm starting to get "burnout" big time. At least our CNAs can do the V/S for us, but the rest is on the nurses. And recently the powers that be decided that if an admission comes in right before change of shift the nurse that is getting ready to leave has to stay over until the admission is done. We are not supposed to leave anything for the next shift to do. Too many mistakes were being made when nurses would leave an admission for the next shift to finish. I love my job...but am seriously considering a career change. I hope everything works out for you. I definitely feel your pain. :sniff: