LTC 3rd day- help

[brown127]

I posted this over in the 1st year category, but that seems to be all RNs.

Anyway, I graduated from LVN school last month and was happily surprised to get a job in a little under 2 weeks. It's night shift (not a problem) 4 on 2 off (which is hard) and I'm a charge nurse over 60 patients with 2 cna's, 1 of which is great. The other disappears and is not helpful when she's there. The rest of the facility's halls are only 30 patients, but my hall is long, or something. One of my classmates started with me and was assigned to a shorter hall, and she's already quit. I've done 2 shifts by myself- the DON is off site and didn't return the one call I made to her after a fall, of which I've had 2 minor falls (one each day) and had to do neuro checks on another patient yesterday due to a fall.

I've gotten all my work done, but I've run behind on charting. Yesterday, I took an extra hour and a half after my shift to finish (notation by exception), and today it took 45 minutes.

Also, my first night state called asking for the lady I replaced (she complained to them about the ratio), then they asked if there was another nurse on my hall- which there wasn't. I didn't complain to them or anything, but I did tell them the truth. I'm a little worried that this will make the administrator mad, but I'm also not going to lie.

Mostly I'm worried about staying over for charting and not taking lunch. In my orientation, I was told that I had to take a lunch and unauthorized OT was bad. I'm seeing ways that I can improve- my problem tonight was largely due to a belligerent patient with a med order that had been changed in his chart but not in practice. That would have saved me a good half hour there. But I've got to get my work done!

So, any tips on getting through stuff quicker? Also, what experience do you guys have with OT and staying over like that? Is it usually a problem? Any insight about that ratio? I don't think it's illegal, but it sure does suck.

And yes, my plan is to work a year and find another place.

Thanks!

[purple10]

I would be worried about being the only nurse on a hall of 60:uhoh21: pt. and if state called and are asking about ratios, i would think about finding another job.... not that what you told state was wrong but because it sounds like what the facility is doing is wrong. at no time should a nurse be in charge of 60 pts at once in a LTC facility, too many things can happen and your only one nurse. as for the CNA that cant be found, I would write them up (if possible). I would not worry about the OT its not llike your sitting there doing nothing you are finishing a very important part of your job. Its unrealistic that they expect you to do a med pass for 60 people and get everything else done AND still get out on time.

Honestly look for another job, this place isnt worth your license

[mazy]

Sixty patients for one new nurse with only two CNAs is a catastrophe waiting to happen...and if State is calling the facility to speak to other nurses, without going through management, then that place is going to get taken down hard and soon.

My suggestion is you get out as soon as possible so as not to go down with them. I understand you want to get that year of experience and jobs are hard to find, but just my two cents is I would be out the door already; I suggest you do some very aggressive searching.

A year of experience in a place like that counts for nothing when all is said and done -- in the nursing home racket, everyone knows everyone else's business, and I am sure everyone knows that facility is in trouble and your reputation will suffer the longer you are associated with them.

As for meal break, I don't think I've ever taken a lunch in my life as a nurse, they make a big fuss about it, so if there are any complaints they can say "hey we told them they had to take lunch" and not be held liable, but what usually happens is you work through and they just dock your pay half an hour.

Sucks but that's the way it goes. I guess someone with a lot of energy could pursue it through the labor board, but it's like that everywhere so I don't see what good it would do. it takes more energy than most people have just to make sure that the patients get good care.

Overtime happens a lot, especially if you actually care about doing a thorough job. They will give you grief, but it's a complaint everywhere. I don't know what to tell you; I'll stay over and do my charting but I've learned to be quick and I usually hide out while I do it.

Just don't ever work off the clock, if something were to happen to you they would not be liable, and if something were to happen to a patient, they would find a way to make you liable (rather than take the blame themselves).

Seriously, from your description this sounds like a very bad situation. My opinion is run, run, run as fast as you can.

[NamasteNurse, BSN, RN]

You WILL get faster. I started in LTC 7 months ago and med pass alone took me most of the shift. Now I have time left over if nothing goes wrong, like a fall, death, hospital in or out etc. You will learn who takes their meds fast and who needs extra talk time. You will get faster at everything! Stick with it, usually OT is frowned upon but it happens. I used to stay about an hour and a half OT and now I'm out on time most nights. Best of luck

[MaraLPN]

Listen if I was you I will look for another job, because it is not right for you to handle 60 patients ( we work to hard for our license), so pray about it, and as for the CNA, most of them always vanish, or taking breaks. Look for another job.

[systoly]

Acuity is a bigger factor than number of patients. I have one concern about the call from state. How do you know who it was. I'd have told them I'm sorry, but I have no way of verifying your credentials, but I can have the administrator call you back.

[CNA2day]

I am not a nurse but at our LTC facility it is one nurse to 74 patients at night. There are 4 CNA's on at night also, sometimes 3 if we are short.