Is this risking my license?

Are you completely by there by yourself? Any LPNs that help with med passes or charting?

It's just me and 3 CNA's.

Yes I do think you are jeopardizing your licence. So many of these SNF are unsafe, understaffed and overcrowded and the owners, administrators want RN's to be responsible for everything even things which are beyond their scope of practice or simply beyond their physical abilities. What a terrible place to get started being a nurse. I'm sorry for what you are being put through. Unfortunately this is the state of nursing today. No training because corporations don't want to pay for nursing's training as they don't see as their responsibility. Be proactive and don't accept conditions that will eventually put your licence, or yourself in danger. There are hundreds of SNF's out there and some are better then others, particularly the small ones. Good luck.

OMG- are yo working in a third world country? GET OUT!!!!

Run, don't walk! How can this even be legal?? Yikes!!

OMG- are yo working in a third world country? GET OUT!!!!

This!!!!! That's crazy!!!

Anne, RNC

I doubt this is true LTAC. Did you mean LTC?

For a Long Term Acute Care facility, a 1:70 nurse/pt ratio is insane.

For a nursing home, it's difficult but doable. Provided they don't pile a lot of extra duties on you. With 70 residents you shouldn't be doing dressing changes or very many meds. Honestly, the 3:70 CNA ratio is more worrisome in LTC.

The ratios you are working with aren't anything out of the norm. The job you have isn't that far off from mine, but because you're a new grad and haven't been exposed to situations that you would probably want direction or help with, it isn't ideal.

5 days orientation is ridiculously low. Having no one accessible to you in an emergency is extremely concerning. Having no computer downtime backup is illegal.

I can totally relate you. I'm also a new grad nurse. I've only got 3 orientation: one nocte, one am, and one pm shift. So it was my first time alone as the only RN, and it was my first ever shift. I was doing nocte. There were some discrepancies in the medications that were prescribed. Also, one of my patients died (he was already dying and not for resus). What was troublesome is that there are no after hours doctors. And I couldn't find where the main doctor's contact is. I phoned my clinical manager and my fellow nurses. Mind you that it took me about 5 hours to finally contact one of the nurses and my clinical manager. They told me what to do, where the papers, death checklist and doctor contact are kept. Just imagine those 4 hours of no RN support - I was totally anxious and lost; but I thank my team (CNA's) for being supportive (they too didn't know what to do at that time). To make story short, I finally sorted out some things and the next RN duty did the rest. It was draining and exhausting indeed.

So I learned from that experience and since then, I always orient myself during my free time - like checking where the papers are kept, where the emergency equipments and meds are placed. I also think of questions relevant to my work after I get home from work and then ask them to appropriate staff when I get to work. Also, I try to remain positive and keep the morale of my team intact. Although I was nervous and lost during that time, I just smiled, kept my calm and remained collected so my team/ CNA's wouldn't worry too.

70 is a lot even for NOCs 3 doesn't seem like enough CNAs to have on, but the red flags are the lack of paper MARS and lack of contact from management when you try to call them. Is there a MD on call for you?

there should also be a DON(DNS) to contact, or an on-call Nurse to contact. You also pass meds for 70? that sounds wrong to me, sorry, but it does. I have workedin several LTC in a couple of states and the worse ratio I have seen is 60 to 1 med nurse and 1 charge nurse with 3-4 CNA's for days. Is this day shift? or nights. Nights, I can see this, if there are few if any meds/treatments.