Looking for advice on how to how to get through my first off-orientation nursing shift with 50 residents. If you don't have time to read the details, I'll still appreciate your experience on making it through safely with so high a census. I've done LTC before, but at the other facility: I was oriented to the facility first, had received a better orientation to the actual floor, trusted the aides I worked with, and the census was smaller. Before this current LTC job with 50:1, I was working in an outpatient clinic setting for the past year, before that the smaller LTC, so this is like nothing I've ever faced before.
When I was hired, I was:
1) assured that I'd receive a thorough orientation. Instead, I was given two overnights on the cart, with a preceptor who told me "I'll be around if you need anything" and then disappeared off the floor without showing my how she manages a census of 50 or actually being around when I needed her. My second preceptor was one who never had worked that floor or shift, just another warm body, and had no clue on how to run 11-7 on that floor; in fact, I was showing her our tasks for 11-7 (glucometer checks, 24-hour chart checks, etc).
2) assured I'd have 3-4 aides on the floor. Instead, I have 2, who refuse to do first rounds because they're "too tired" and "don't want to deal with anyone who wakes up".
3) assured that the residents would be sleeping (HA!) most of the night and are stable. Well, on my orientation nights, they were setting off the alarms Q10-15 minutes and the aides "got tired" of checking on them so I ended up running all night so that no one fell (which put me behind on my other work responsibilities). Twice, we came close to having a fall, one of which was five minutes before 7-3 came on because one of my aides told me to my face "just leave it, 7-3 will be on in five anyway". And so much for being stable! We have multiple residents going downhill, two on hospice, one that had been sent out right before my shift, another who just came back---not in the best condition---from the hospital on O2, Q15 minute checks, etc.
I just don't know what to do. The scheduler is hassling me to pick up more shifts, starting to get an attitude, and I'm just at panic-attack-level anxiety about getting through the next one.
