I'm sad because I feel like I have been forced into a decision to leave the LTC facility and the residents that I love because of poor staffing. I work nights 11-7 and we have 2 LPN's and 6 CNA's (on a good night) with 120 residents including 42 on a locked dementia unit. On the other two units we have 12 tube feeders (3 continuous and 9 bolus,all nine of which are fed at midnight and 5 a.m.) 2 trach patients (one who is in a persistant vegitative state and currently as MRSA in her sputum). There are a total of 22 insulin dependent diabetics in the facility, several of whom are unstable. We give all the a.m. dilantins, place all the nitroglycerine patches, do all those feedings, suction the trach patients, give all the a.m. doses of lasix, give all the a.m. doeses of reglan, do all the finger sticks, plus give the a.m. doses of scheduled insulin at 6:30 a.m. in addition to any sliding scale that is necessary. We change out all tubing, clean all the equipment, order all supplies, do chart checks, MAR verification. In addition to this, we are currently charting on 26 residents between the two of us nurses, and obviously, if we are charting on them, then we are expected to assess and get vital signs on all 26 residents. Add to this, all the confusion of the residents on the locked unit. Fights break out nightly. Last night, I had a fall that resulted in a hip fx and wrist fx. In fact, in the last three weeks, there have been three fractures. Two hip and one wrist. I have also had a full code who died on me in the last few weeks. The other night shift nurse is going on medical leave for her second knee surgery in the last year. the facility (read DON) has known that this day was coming for three months now. She has done nothing to replace the other nurse, and now tells me that 'legally, one nurse can do it on nights'. Because, apparently due to the fact that there are 15 licensed nurses on days and 6 on 3-11, the facility falls well within the legal number of required nursing hours needed to satisfy state requirements. so, therefore, it is expected that i will accept a ratio of 120/1. Needless to say, I am exhausted, frustrated and feel like I put my license on the line every night I go into that place, and i refuse to do it alone. So, I have decided to accept a job on a post surgical unit at a hospital 20 minutes away. Does anyone here have a similar situation with such an outrageous resident nurse ratio, and if so, how do you handle it
I'm sad because I feel like I have been forced into a decision to leave the LTC facility and the residents that I love because of poor staffing. I work nights 11-7 and we have 2 LPN's and 6 CNA's (on a good night) with 120 residents including 42 on a locked dementia unit. On the other two units we have 12 tube feeders (3 continuous and 9 bolus,all nine of which are fed at midnight and 5 a.m.) 2 trach patients (one who is in a persistant vegitative state and currently as MRSA in her sputum). There are a total of 22 insulin dependent diabetics in the facility, several of whom are unstable. We give all the a.m. dilantins, place all the nitroglycerine patches, do all those feedings, suction the trach patients, give all the a.m. doses of lasix, give all the a.m. doeses of reglan, do all the finger sticks, plus give the a.m. doses of scheduled insulin at 6:30 a.m. in addition to any sliding scale that is necessary. We change out all tubing, clean all the equipment, order all supplies, do chart checks, MAR verification. In addition to this, we are currently charting on 26 residents between the two of us nurses, and obviously, if we are charting on them, then we are expected to assess and get vital signs on all 26 residents. Add to this, all the confusion of the residents on the locked unit. Fights break out nightly. Last night, I had a fall that resulted in a hip fx and wrist fx. In fact, in the last three weeks, there have been three fractures. Two hip and one wrist. I have also had a full code who died on me in the last few weeks. The other night shift nurse is going on medical leave for her second knee surgery in the last year. the facility (read DON) has known that this day was coming for three months now. She has done nothing to replace the other nurse, and now tells me that 'legally, one nurse can do it on nights'. Because, apparently due to the fact that there are 15 licensed nurses on days and 6 on 3-11, the facility falls well within the legal number of required nursing hours needed to satisfy state requirements. so, therefore, it is expected that i will accept a ratio of 120/1. Needless to say, I am exhausted, frustrated and feel like I put my license on the line every night I go into that place, and i refuse to do it alone. So, I have decided to accept a job on a post surgical unit at a hospital 20 minutes away. Does anyone here have a similar situation with such an outrageous resident nurse ratio, and if so, how do you handle it