LTC facility trying to fire me over refusing to take on 50 residents

Specialties Geriatric

Published

I have to get opinions, i cannot find much about the GA law against LTC facilities and nurse to resident ratios. So, my situation was basically an employee called out for the unit that is on the same floor as my unit. I get to work and they tell me that I have to take on both units all night! Both units contain 49 residents and one of the residents is very violent and has attacked many nurses. Management even threatened that if I did not take the keys to other hall that they would report me to state for abandonment, yet I was NOT scheduled to work that unit, and there and the day Nurse was still there. Also, I work 12 hr shifts, I had gotten called in on my day off just the day before this mess happened. This happened on a Thurs. I had already worked Mon, Tues, off wed, Supposed to work Thurs, Friday, Sat, and Sun. and they wanted me to take on 2 units by myself. Is this NOT crazy!!!

How long ago? I did a whole house a few times, only the two lower levels of care were housed there. (~ 70 patients, on two floors, with 5,6 aides) but that was a long time ago. and 60 on a basically custodial care unit with 4 aides. again a long time ago. this sorts of units don't exist, as far as I am aware, any more. again, the OP was talking about 7p to 7a, a whole kettle of fish different than 11-7,QUOTE=VANurse2010;8048290]Actually, yes I did. And like everything in nursing the manageability of the assignment is based on acuity. I had 54 residents on an ICF floor and it was fine. I've had 30 (on night shift) on a skilled wing and it was doable but it sucked.

Regardless, I know of what I speak, whether you agree or not.

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2012, not exactly ancient history.

How long ago? I did a whole house a few times, only the two lower levels of care were housed there. (~ 70 patients, on two floors, with 5,6 aides) but that was a long time ago. and 60 on a basically custodial care unit with 4 aides. again a long time ago. this sorts of units don't exist, as far as I am aware, any more. again, the OP was talking about 7p to 7a, a whole kettle of fish different than 11-7,QUOTE=VANurse2010;8048290]Actually, yes I did. And like everything in nursing the manageability of the assignment is based on acuity. I had 54 residents on an ICF floor and it was fine. I've had 30 (on night shift) on a skilled wing and it was doable but it sucked.

Regardless, I know of what I speak, whether you agree or not.

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Specializes in critical care, ER,ICU, CVSURG, CCU.

in just spring 13, census got to 75, one nurse on 11-7, some 24 skilled, 3-4 tube feedings, ton of treatments...... i had to explain to manag. that i was going to have to declare safe harbor, and they would gave to show that to state every time they walked in the door for a total of five years (requirement)

& further after I filed safe harbor my lis would be protected from the unsafe staffing, and liability would then fall on the young DON, making the assignment......thankfully she listen and lobbied and acquired very quickly second nurse at night, good thing as census quickly grew to 110+.........acuity in

LTC is increasing due to stricter DRGs in hospitals, residents are sicker...... hospitals sending 24/7.... medicare reimbursement down 11%in Tex. hospital practice of keeping a resident sent for like pneumonia or uti sepsis in "observation" for 3-5 days so they wont get dinged if this chronic very sick resident has to come back for same diagnosis within 30 days.......this reduces the golden medicare skilled % residents, which strangles company profit and operating cost, medicare not paying for special follow up visits as complex wound care, and ems transport, while the actual resident is on skilled services.

IT IS A VERY DOUBLE EDGED SWORD, profit, operating cost reduction vs safe care...........my advice do as I did..........it the assignment load is unsafe, review your BON safe harbor proceedure, and most are a specific proceedure......explain to mgt. what you will have to do.....

give them a small chance to evaluate the consiquences....... they truly do not want state to see, these nurses demonstrated unsafe staffing and assignments every time they walk in door.........for five years, at least the way it is in Tex. I have been mgt.Don, and I have been the staff nurse

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I worked in LTC with these amazing staffing ratios. I've often wondered how many nurses leave LTC permanently mostly because of this issue.

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