Is this nursing home typical - first night?

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I've only worked in home care. Last night I started at a nursing home, the 3-11pm shift.

Most of the staff are agency not employees. Everyone commented on what a lousy place it was to work and how understaffed it was. Regular staff didn't show up. The hall I worked on had at least 20 people and almost all incontinent. Most people cannot stand by themselves and have trouble even with support. The person training me kept breaking down and crying, saying she was stressed (she was a great CNA however). I felt uncomfortable being left alone on the hall my first day when she took her dinner break - I don't know the patients at all. The nurse yelled at me to answer the call lights faster. Is this typical to be left alone the first night?

We had no time to take even a 5 minute break. Of course, being new I am slow and the trainer was very short with me - I had just been sprung on her with no warning.

2 people fell during the shift and one had to be taken to the hospital.

Yikes! Should I stick it out?

Sorry to be so long. I enjoy taking care of people and don't mind the details of the job - I really just hate being left alone the 1st night when I don't know the patients.

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Specializes in LTC.

Was it just you and your trainer to 20 people?

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Hi Casi:

Yes just the trainer and me.

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Specializes in RN- Med/surg.

Sounds typical for work load. Shortness of staff...typical. I can't imagine that they'd leave you alone first night though! When I worked 3-11's in LTC we usually had about 20 people per person...BUT each wing covered the other wings for breaks anyway..so when someone was training...the trainee went on break with the trainer.

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i recently started a few weeks ago. I have to say at first i was VERY overwhelmed at the work load of LTC. Most of ours are also incontinent also. They did not leave me alone the first nite, but i must say my orientation sucked because the first 7 nites we were understaffed, which has almost become normal. Stick with it long enough for you to get over the SHOCK of it all, and dont make any decisions about staying for at least 30 days. i have been there since june11 and im adjusting a bit better now. My biggest problem is the people i work with, not the patients !!!!

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Specializes in LTC.

I'd run far, far away from there. As a CNA you CAN NOT perform all of your duties properly and safely if you are caring for that many people.

If you can't take your 1/2hr unpaid break, I would demand that the facility pay you overtime for it. Stand up for yourself and your residents.

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Specializes in Nursing Home/Subacute/LTC.
I'd run far, far away from there. As a CNA you CAN NOT perform all of your duties properly and safely if you are caring for that many people.

If you can't take your 1/2hr unpaid break, I would demand that the facility pay you overtime for it. Stand up for yourself and your residents.

Exactly I agree with you 100% because you will not be able to do all of what you suppose to do with that many patients. Especially if they are unable to help themselves at all. It's hard I know I am in that situation right now and don't know how to get out of it.

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Thanks everybody for the feedback!

Well so far I have worked 5 nights. But I don't want to continue there.

There are some new admits - a husband and a wife. They both have dementia. They put them in rooms next to each other because they don't have a room for them that isn't covered by Medicare - apparently the only room available is a non-Medicare room. So naturally they are upset at not being in the same room - they were also committed by the court/DSS against their will.

The husband was verbally belligerent and kept coming up to the nurses station and yelling about stuff and was rude. The staff made fun of him right to his face and he could tell what was going on. I can understand people being frustrated with him but not to his face! The CNAs and nurses also went on a couple long smoking breaks - I asked who is watching the halls - they said "Oh the patients will be ok".

Believe me I know how hard the CNAs work, they do esp. for the low pay! And they are good about doing their rounds and making sure the people are dry. But you can't even find a higher paid nurse and a person needed medication as they were in pain and there was no nurse out of 7 to be found - it seems at least 1 should be available.

This place is chronically short-staffed, there are never enough people to make their goal of 2 people on a hall. As others have said, this isn't good for the workers and definitely not good for the patients.

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Specializes in LTC.

Fire Fly, though staffing shortages are extremely common in LTC facilities, hospitals, etc, it sounds like you just picked a not so good LTC facility to work in. Some facilities do mandation. Meaning if not everyone shows up for the 3-11 shift, some are mandated to stay from the 7-3 shift. I've worked in LTC facilities with mandation policies and I currently work in one without a mandation policy. I see good and bad to both situations. However, I think this particular LTC facility you're working at may be the exception to the rule. Before deciding not to work LTC, consider finding another facility. Some aspects will be the same but not all facilities are the same. True, you may still work with nursing shortages at the next facility, but it may not be as bad or as chronic of a problem. Also, there are facilities where the staff are truly happy to be there. That makes all the difference. Good Luck to you!!!

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Specializes in Geriatrics/Family Practice.

I work LTC as a LPN and let me tell you we are always short CNA's. I was a CNA years ago and I know what your job includes. CNA's are my eyes and ears for my residents. But my problem is how can you be my eyes and ears when you are spread so thin? The only advice I can give you is to do your best and know that atleast on the days you are there the residents are getting good care and if all else fails, call the state in on their butts. When I work and we have 2 nurses on 3-11 for 78 residents, I will even try and help the CNA's in between med passes because I know you guys work your bu_ts off. I usually can't do a whole lot because right around that time someone falls or needs to be sent out the hospital. If in your facility you feel that there is definitely poor care and less than professional staff, report them all. Good luck in whatever you chose to do.

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Some more thanks are due, really appreciate everyone's input.

wrobelchic, I've not heard of mandation before. That seems a heavy burden to put on those who are only making 8.00/hr (the CNA I rate around here in LTC).

kstec you sound like the kind of nurse a CNA would be glad to have around. The facility has about 1 nurse to 30 residents on the 3-11 shift, don't know if that is good or bad.

I think I will look into other facilities as the staffing situation is not improving, they are trying to hire new people but people don't want to work there because of the short staffing reputation.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
The facility has about 1 nurse to 30 residents on the 3-11 shift, don't know if that is good or bad.
1 nurse to 30 patients is very normal in LTC...
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