I need to VENT about work!

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Specializes in LTC/Rehab/SNF/Sub-Acute.

When I first started at the LTC/rehab. that I work at 5 months ago, there were 2 nurses and 1 supervisor on the pm shift. 1 nurse on the East wing (rehab) with a minimum of 14 and a maximum of 18 patients, and 1 nurse on the West Wing (LTC) with 36 residents. The supervisor did all the orders (transcribing and such), admissions, answer phones, supervise!!! I mean, there were days where no admissions took place, no new orders, and the nurse would just sit there and look like she's doing something. SOOOO... We (pm shift nurses) all talked to the D.O.N. and administrator about not having a pm supervisor but instead have 3 nurses diving the west wing into two, (1/18 ratio). They agreed, and we've had 3 nurses (when available) for nearly 4 months now.

Lately, we've had a shortage of nurses on the pm shift causing the facility to pay for nurses from the registry to fill in the spots. The am shift nurses complain that not all of the work on the pm shift are being done (BULLSH*T!). It's a cycle, the am nurses leave work for us, and if we can't get stuff done in 8 hourse, of course we leave it for the next nurse. It's NOT only the pm nurses! So now.... Starting next week, we are going back to 2 nurses and 1 supervisor.

That means, if I am working on the west wing, I have 36 patients under my license. That is 8 FS with Sliding scale.... Breathing Tx, tons of eyedrops, Treatments (prn, routine), medication administration for all 36, changes of conditions.. ahhhhhhhhhh! I mean, I've done it when there were only 2 nurses during our shortage of nursing times, but I was okay with it being that it was only once in a great while. But nowwwwww, it's going to be for good. Having that many patients is TOO MUCH! Lack patient care quality. Errors can occur (knocking on wood).

I really like my co-workers (except for the whiny nurses) and the residents, not very much the management staff (for their unorganized system), so I don't want to leave this facility. But now I feel like I should for the sake of my license, legs, and body lol.

What do you guys think? Is it better this way, 2 nurses and 1 supervisor, or 3 nurses (each nurse doing all their paperwork :admits, new orders, etc:: on their own)? I'm so stressed. I don't know how I'm going tosleep... ahhh..

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Fight for it.....3 nurse to divide the work....but now and days that want at least 3 nurse...(but make one of them a charge nurse...so she can be almost like a supervisior).

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Let it out !!! Lol

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If that 'supervisor' (is this an RN?) does nothing, than what is the point in having her?

If I was them, I would have it this way. But, I'm not really sure what type of nurses they have there. I know that you're an LPN but what type of people do ya got up in there? Do you have CNA's avaliable or anything at all? In any case, each wing would have:

- 1 CNA

- 2 LPN

- 1 RN (or change to 3 LPNs)

The CNA's could take care of the eye drops and rehab exercise and general supervision, while you guys (LPNs) and the RN's take care of the medication and supervise the CNA. I think if it's really this bad, it's time for you and a few other nurses to request that some other qualified people be hired to come help you guys. I know that LTC facilities are getting bad as far as P to N ratio goes. But having 3 nurses manage it as well works too.

Good luck!

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I currently work on the fast-paced rehab unit of a large nursing home, and could not imagine having 36 of these types of patients. 36 traditional LTC patients is manageable, but 36 rehab patients is entirely too much! I currently have anywhere from 10 to 16 rehab patients on any given shift, and the number of patients fluctuates due to admissions and discharges.

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At least one of our supervisors was a working supervisor. The others pitched in when needed. They never just sat there staring into space if there was something to be done. I really think that your mgmt should go back to having the three assigned nurses again. It makes more sense all the way around. JMO.

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I may take some heat for saying this, but I've worked LTC before on nights with no RN charge and I wouldn't do it again for all the money in the world. I am now in the hospital working right along side RN's doing basically the same job (In GA LPN's can do IV pushes with certification) and for the most part I have autonomy there, BUT and this is huge, if a problem arises and I'm not completely comfortable with my own assessment of the situation, I have an RN charge nurse to lend her clinical knowledge and support. I may go days without having to ask for "support" from my RN charge, but when I need that second opinion, I'm thankful that she is there.

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