Is this reasonable or am I being a newbie?

Specialties Geriatric

Published

Hi-

I am a new grad RN working on a subacute/rehab unit at a LTC facility. Received 2 weeks worth of orientation and have some questions.

I average 18 pts. on the 7-3 shift. I was surprised that the CNA doesn't do vital signs in the am, was told that they are not "certified" (huh?) so it's my responsibility as the RN to get vs. Now, we all know that the majority of the senior population is on some type of cardiac or antihypertensive med, so that means I have to stop at each pts. door, wheel in the machine and take their complete vs, then give meds. First med pass is 8am and the seniors take a lot of meds! This process takes up a chunk of the morning. Oh yes, it's also the RN's responsibility to do blood glucose checks. Between the 8am, 9am, 11am, 12pm and 2pm med passes, I also have wound treatments, charting, follow-ups, etc. to do. At my clinical rotations in the hospital, the CNA or PCA always did vs and bg's. Is this job reasonable or am I just being a newbie? Don't know if I should start looking around for another job after getting some experience. Even my preceptor told me that she's lucky if she takes 10 minutes for lunch and gets to go the bathroom once a day. Thanks for your input!

:heartbeatwell...long story short...graduated RN May2007....worked med surg till jan 2008, currently work at LTC on rehab side...so roughly about 7 months of LTC exp...(not much i know)...patient load...umm 18 to 26 patients...work days 7a to 3p...sometimes just me and another nurse( admn people report census is low...) (bull :madface:in my workload)

dunno...i have gotten my 1st verbal warning about "not providing customer with quality care" by not completing documentation....well here's my piece...i dont smoke:smokin:(nothing against smokers) i barely take a lunch.:banghead:.i love helpn my customers(patients) but just doenst seem enough time in day...dont get me wrong i know the rule...if it wasnt documented it wasnt done:nono:....but when it comes to daily charting for medicare or medicaid...whichever...plus those on ABT or monitoring behavior..etc...had a fall...wounds..etc..my rule is i chart the priority ones and go from there...i feel that in time i will master an ideal routine...i even try to plan it out while driving to work...get report...do wat treatments(wound care) i can before medpass...we have some not so helpful "passport med machine" to get most of our pills...nothing like wats in hospital...then play tug of war wit PT/OT..whichever therapist comes to steal:argue: my patient away b4 making sure they have their meds...most of my aides get my vitals if told...(i do the med specific ones...of course) i have this one CNA who B**ches each time i give her some...yet she's starting :confused:RN program in Aug...umm good luck wit that...

then its just back and forth...new orders from ARNP or MD coming in...dealing wit family who follow your med cart just concerned wit their family...not the 19 or so other patients u deal wit....DUNNO guys ang gals...just having a moment:no:...will take any suggestions...i love helping people:nurse:..i am a wife..:heartbeatmother of total of 5 kids...no pets..and work fulltime...

i see some of my nurses cut corners...not my way...i work Mon-Thurs...i swear there are orders/issues..that sit and will still be there for me Monday when i come in like there are no other nurses that worked...:uhoh3:

well hope everyone else had a good day...

thx for letting me vent...promise next posting wont be so long:mad:

Specializes in nearly all.

At our facility (230 bed LTC with 60 Medicare certified beds) the RN or LPN does accuchecks. We have CMTs (certified medication technician) who pass all but parenteral and tube meds. CNAs may do vitals or the nurse may do them...it is up to the nurse. CNA does indeed stand for certified nursing assistant and one componant of the class is learning to take BP,P,R,and T however accucheck is in the licensed nurse scope of care.

Specializes in A&E, District Nursing, & Aged Care.

In australia, at my LTC facility we have the equiv. to a LPN (EN), they have 2 nurses for 60 residents. Low care facility with 35 of the 60 beds are now high care. Our LPN (Enrolled Nurses) do BGLs, VS, give opioids DDAs and run the show. The only RN on site is the director of nursing.....different to what you guys are used to? i'd love to hear another perspective..

MicStar, that's very similar to the states.

Specializes in sub-acute.
Hi-

I am a new grad RN working on a subacute/rehab unit at a LTC facility. Received 2 weeks worth of orientation and have some questions.

I average 18 pts. on the 7-3 shift. I was surprised that the CNA doesn't do vital signs in the am, was told that they are not "certified" (huh?) so it's my responsibility as the RN to get vs. Now, we all know that the majority of the senior population is on some type of cardiac or antihypertensive med, so that means I have to stop at each pts. door, wheel in the machine and take their complete vs, then give meds. First med pass is 8am and the seniors take a lot of meds! This process takes up a chunk of the morning. Oh yes, it's also the RN's responsibility to do blood glucose checks. Between the 8am, 9am, 11am, 12pm and 2pm med passes, I also have wound treatments, charting, follow-ups, etc. to do.

Sounds VERY familiar. Don't forget to add in a discharge and admission and you will have your standard 7-3 shift on a sub-acute unit in a SNF. :wink2:

Only having 2 weeks orientation is bothersome though. New nurses get 6 weeks at the facility I work at. Hang in there.

Specializes in A&E, District Nursing, & Aged Care.

Suesquatch,

That's interesting i thought it would be different.. We have multiple regulators 1. Aged Care Accreditation Agency 2. ACFI Review Officers (funding) 3. Office of the aged care quality & compliance (complaints investigation. 4. Dept of Health & Ageing - how does this compare with you guys, does it differ state from state? Our LTC facilities are managed on a national/federal level so state law or management does not come into it...

sorry for going off the topic...got diverted

Suesquatch,

That's interesting i thought it would be different.. We have multiple regulators 1. Aged Care Accreditation Agency 2. ACFI Review Officers (funding) 3. Office of the aged care quality & compliance (complaints investigation. 4. Dept of Health & Ageing - how does this compare with you guys, does it differ state from state? Our LTC facilities are managed on a national/federal level so state law or management does not come into it...

sorry for going off the topic...got diverted

State. Various departments, and they are all referred to as "State," as in "State's here!"

:bowingpur

:sofahider

Specializes in Did the job hop, now in MS. Not Bad!!!!!.
State. Various departments, and they are all referred to as "State," as in "State's here!"

:bowingpur

:sofahider

:yeahthat:

I can attest to that. As well as add that it doesn't even cause the folks at my facility to wrinkle their noses. Cuz they know that they (and I mean the CNA's and the mgt kissing their behinds) have the state snowed and the CNA's run the ship. Where are all those umemployed folks that would love to have their jobs?????

Chloe

RN-BSN, BA

Specializes in Med/Surg, Rehab, Burn, dialys.

Surprised to hear NJ does not require NA's to be certified. Most states do

Surprised to hear NJ does not require NA's to be certified. Most states do

All states do. It is federal law. According to the NJ site they do require NAs to be certified in Nursing facilities.

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