I can't do it all

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I recently started a new position in LTC, after 3 years of working in a hospital setting (critical care float pool)... I was burntout from working nights, wanted a change, closer to home, etc.... so I took a .8 day position on a 64 bed skilled unit in a privately owned nursing home...... okay so now I am responsible for 32 people and not only am I the nurse... I am also the TMA, secretary, housekeeper, babysitter (where are all 6 aides anyways?!), waitress, kitchen supervisor, etc... I am supposed to find time to do everyones job as well as my own, take a lunch break, and leave 8 hours later. I have to deal with NP's who don't give a two cents about the residents, incompetent nursing staff... (no, you don't SHOVE a spoonful of food into someones tightly closed mouth.... it means they don't want it... NO you don't pull people backwards in their wheelchairs... NO you don't leave someone sitting in their own crap for an hour while you take a break)

I took a 10 dollar an hour pay cut so I could join the world of the living and enjoy my kids while they are young and that part is great... but how am I supposed to do it all AND provide the quality of care to my residents???? When I come in at 6:00 am to discover that 1. a resident has been rectally bleeding for almost 24 hours and has a Bp of 68/32, lethargic, etc... and no arrangements for either hospice or hospitalization has been started :no:... and 2. the chest x-ray that I ordered two days before for a resident (ethel) was done, found that resident had right sided pneumonia, and placed in ANOTHER residents (bonnie) chart and the WRONG resident (Bonnie) is started on ABX, while the one with pneumonia gets nothing for 2 days.... and I am left to clear it all up with the docs, family, etc:bugeyes:... even though at the top of the Xray report it clearly states Ethel's name....... UGH!!! frustrating... I feel like this LTC has an abnormally concentrated amount of unprofessional people there........ like housekeepers who empty garbage cans in bathrooms while residents are using them, or secretary's who think I can perform 15 tasks at the same time, recreational aides doling out medical advice, etc...... :banghead: How do I manage to give the care I want to give to 32 people while performing all of these other tasks???????????? :cry:

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By the way, I wanted to mention that while I have only been an RN in the hospital, I spent many years as an aide in both nursing homes and hospitals and I know it is hard work so I am the first to help out.... but i cannot do it all

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Specializes in ICU/ER.

This is what is so frustrating about LTC facilities, they need good -competent staff like you---yet odds are you will be leaving there.

Major changes need to happen in LTC settings, I believe it needs to start at the top with mgmt and the 1st issue that needs addressed is adequate staffing!!! in my opinion they keep CNAs "that SHOVE a spoonful of food into someones tightly closed mouth" simply because that CNA showed up for work.

I hope the changes take place before my self or my loved ones need their services!!!

God bless you for trying to do it all.:bowingpur But it cant be done.

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Specializes in Hospital, med-surg, hospice.

I'm so sorry to hear this, I know how you feel and the frustration you have to go thru on a daily basis; this same situation is true also (to a lesser extent) on some hospital floors...the RN's are the ones who have to clean up the mess, help the patients the aides neglect while they go on breaks, "errands" etc. I work on a med-surg floor and laziness is unbelievable...secretarys on personal calls, staff on the phone and NO one will answer call lights, phones, draw stat labs etc..the Doc's always come to me..I have thought many times of leaving but I like my patients, and have 15yrs might as well get 20..

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Specializes in telemetry, psych, LTC.

I had similar experience in LTC.....things will only get worse as the baby boomers age.

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I recently started a new position in LTC, after 3 years of working in a hospital setting (critical care float pool)... I was burntout from working nights, wanted a change, closer to home, etc.... so I took a .8 day position on a 64 bed skilled unit in a privately owned nursing home...... okay so now I am responsible for 32 people and not only am I the nurse... I am also the TMA, secretary, housekeeper, babysitter (where are all 6 aides anyways?!), waitress, kitchen supervisor, etc... I am supposed to find time to do everyones job as well as my own, take a lunch break, and leave 8 hours later. I have to deal with NP's who don't give a two cents about the residents, incompetent nursing staff... (no, you don't SHOVE a spoonful of food into someones tightly closed mouth.... it means they don't want it... NO you don't pull people backwards in their wheelchairs... NO you don't leave someone sitting in their own crap for an hour while you take a break)

I took a 10 dollar an hour pay cut so I could join the world of the living and enjoy my kids while they are young and that part is great... but how am I supposed to do it all AND provide the quality of care to my residents???? When I come in at 6:00 am to discover that 1. a resident has been rectally bleeding for almost 24 hours and has a Bp of 68/32, lethargic, etc... and no arrangements for either hospice or hospitalization has been started :no:... and 2. the chest x-ray that I ordered two days before for a resident (ethel) was done, found that resident had right sided pneumonia, and placed in ANOTHER residents (bonnie) chart and the WRONG resident (Bonnie) is started on ABX, while the one with pneumonia gets nothing for 2 days.... and I am left to clear it all up with the docs, family, etc:bugeyes:... even though at the top of the Xray report it clearly states Ethel's name....... UGH!!! frustrating... I feel like this LTC has an abnormally concentrated amount of unprofessional people there........ like housekeepers who empty garbage cans in bathrooms while residents are using them, or secretary's who think I can perform 15 tasks at the same time, recreational aides doling out medical advice, etc...... :banghead: How do I manage to give the care I want to give to 32 people while performing all of these other tasks???????????? :cry:

If you stay, you're probably headed for major burnout. You seem as though you're a good nurse. This is far too much for one person. Sounds like a very unsafe facility: for you and the residents.

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Specializes in Geriatric/Psych.

Wow, you do have your hands full! I understand where you are coming from, I deal with this every day but to a lesser extent now. You can't do it all at once; take one thing (prioritize) and start doing something about the horrid situation. We need good nurses like you in LTC, to make a difference. Don't attempt to do it all...impossible= burnout. But you can make a difference and clean it up. That way you can say you did the best you could ....before you leave. All nursing homes are not the same. But one bad one makes an ugly shadow over all the rest of them. If you want any suggestions...let me know. :redpinkhe

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I had similar experience in LTC.....things will only get worse as the baby boomers age.

Just a thought but, maybe things might get better. I am thinking of the very demanding generation X. It is their parents that will require care. And they can be VERY demanding.

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Specializes in LTC and med surg.

I'm so sorry your LTC experience is like this.

First of all I have to ask where is your DON, ADON, or SDC to help you? Second, has any one filed a complaint (ie family, other staff) to the state about the job?

I have to say my very first experience in a LTC was just as you stated. I had to leave. I cried beacuse I grew so cloase to the resdints and I felt like no one else there cared and I was letting them down if I left.

After changing to another LTC, I saw a big difference. I love my job now. Iam the ADON and SDC. I go out on the floors and help my unit managers and nurse when they are drowning and so does our DON. I love my job and would not trade it for anything.

I hope you find a great spot in LTC!

Michelle:heartbeat

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I am also new to LTC and have a whole new respect for those in this field. I am depressed, feel like I am not doing all I can, got inadequate orientation, and am on a hall that has many total care pt who are extremely sick on full codes to boot. If anybody has any advice please share....I too have thought about leaving but I am going to give it a little more time to see if I can adjust without becoming one of those "don't give a crap" nurses. I would rather work at Burger King than not take good care of my patients.

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Specializes in Post Anesthesia.

What you are describing has always been my impression of LTC nursing- that's why I have never even thought about applying for a position like yours. I'd rather work a busy med/surg floor where I at least have the backing of another RN or two if things go to pot. It can't possibly be less stressful where you are than it was on nights. With the pay cut and dropping to .8 couldn't you consider a part time hospital night shift position and still make enough, at least until you can bid on a day position somewhere sane.

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When I changed jobs I actually got a pay raise, but it is getting easier. What I had always heard about LTC nursing was that the nurses didn't do anything...lol....well, there are some who don't do much but hand out pills, I've even heard of people who were fired that didn't give out the meds at all, just signed them out if you can believe it. And, as far as writing the phone orders goes, it's for things such as ordering a chest xray if you suspect a person it getting sick, labs like ua's things of that nature. Anything big or anything I am uncertain about, I always call first. And the doc has an APN who we can call almost any time. But thanks for the advice. I was told if I called the doc about everything that he would be calling the nursing home giving the administrator a call about it.

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