LTC questions

nsgnva · Oct 14, 2008

I'm a nursing supervisor and work weekends only. I wonder if I get on my nurses nerves? lol, i am going to ask them.
a few months ago our facility was sold to a huge LTC company. they have reduced our staffing numbers. we used to have 3 nurses for 50 patients on days/evenings and 2 at night with 5 cnas on days, 4 on evenings. now we have 2 nurses on both shifts and 3 cnas. and they wonder why our complain rate has skyrocketed!
all they have time to do is get the meds out and the charting. theres just no time for anything else. thats where i come in. i work the desk, answer the phone, call the docs, write and take off the orders, deal with the families and patient complaints, act as buffer for them when needed, i deal with the daily scheduling and call ins, i draw all the labs, start all the IVs and run all the IV med orders. in between all this i do infection control and do all the PAEs for the building, do weekend inservices and anything else required for my position.
the majority of us have worked together over 5 years so we are a very cohesive team. they yell what they need from me down the hall and i go do it, lol, like a good flunky, is what i tell them, lol.
but thats what it takes for all of us to get the patients taken care of. i went on vacation for 2 weeks this past summer. it was my first vacation in 5 years. i have now been forbidden to take any more vacations, lol.
our facility is such a high acquity. this past weekend alone, i had 21 different IV meds to hang on 7 different patients. when are the floor nurses supposed to find time to do all of that, get all the other meds out, chart on every sick patient, all the incident charting and snf documentation and get done by the end of their shift. not to mention on the evening shift it's common to get 8 admissions a shift. God love the evening shift supervisor's heart...she works hard! she has my admiration.
i dont understand the staff ratios, i just dont get it. LTC companies havent changed their ratios for years! i know for me, ive been in LTC since 92 and the staffing numbers are the same as they were then. yet the patient aqcuity has increased by leaps and bounds due to people getting pushed out of the hospital earlier! and the LTC corporates expect us to just deal with it or leave. they think they can just replace us. the mentality of "theres always someone to fill your place" needs to go!
i think i just went way off topic didnt i?

Would you be my supervisor?!! I had an admission on the weekend, in addition to all my regular duties, and the supervisor said "oh, I'm sorry to hear that" ( on the phone, no less ). There are only 5 units in the entire bldg. and I never even see her the whole time I'm there.

nsgnva · Oct 14, 2008

You sound like a great "hands on" kind of manager. Yes, I would be very grateful if I had a manager who helped out. But that's not the case where I work. We have a wound nurse for the bldg, two MDS nurses. The manager does not answer the phone, do admissions, do orders or pretty much anything else "on the floor". She is in meetings or in her office the entire day.We might see her 2-3 times in a 10 hr day.

Candyheart · Oct 14, 2008

It's hard to believe but true, that seems to be the ratio in LTC. On top of the meds there's the treatments, wound dressing, new orders to be charted and faxed, labs to be called in, behaviors etc to be charted, family members to deal with, and God help me, I am going to talk to that resident that is feeling down or scared or "just not myself" How are we supposed to know if any or our work is doing any good if we don't have time to talk to the residents? No wonder I'm dead tired when I finally go home. Still, I love my job and I feel I make a difference every day. It's the thing that keeps me going.