LTC staffing problem - may I have your opinion, please?

merricat · Sep 20, 2004

your DON is smoking crack, it sounds like. Arkansas has a mandatory staffing ratio. go to the website for the National Citizens Coalition for Nursing Home Reform, go to Government Policy, and click on your state. That website may be able to advise you on how to file a complaint. They may even do it for you. This would be good because then there is a chnce you will not have to be involved. Good luck!

RNBSN1 · Sep 21, 2004

I used to work the night shift in nursing homes through the registry, my patient loads ranged anywhere from 24-114, and I routinely faced staffing problems. The most bizarre experience I had was being the lone licensed nurse, with 114 patients on a Friday night, and the other night nurse didn't call in sick until almost 15 minutes after the shift began. The nurses that I relieved just completed double shifts, and were scheduled for double shifts again, the following morning. The registries had noone available, and no staff ( including the DON, ADON, and administrator) answered their phones. On top of that, only 3 of the 7 aides reported for work and I had THREE CODES (half the residents were full codes) before the shift was half over! If there was ever a shift from hell, that was it. Needless to say, this was my first and last assignment at that facility. That was 10 years ago and sadly, I believe that the staffing problems in LTC are here to stay.

zippyLPN · Sep 21, 2004

i guess i'm never going to complain about staffing again...... i work in a ltc privately owned facility... we have 3 units, (ltc,dementia & rehab). all units have a capacity of 45 beds each. there are 2 nurses for each unit all shifts except 11-7 where there is 1 nurse each. i work 3-11 and have another nurse on the floor with me. i have 6 cna's and rarely 5, (when one calls out.) i have 22 residents assigned to me on my side of the unit, only 2 are full codes! i personally think that any resident who is a long term placement should be a dnr! where is the quaility of life if you have to keep coding someone, (but thats another discussion). i think tomorrow when i go back to work i'll give my don a hug (lol) for keeping us staffed!

Mister Chris, MSN, NP · Sep 21, 2004

I work in LTC in Arkansas. Not long ago, I started working 11-7 because we had 3 nurses to quit. I was working 7-3, and I like the increase in pay and the less-stress atmosphere. My problem is this: we have around 100 residents in our facility, basically split between 2 nurses stations. Each station has 3 halls of residents, with the majority of medicare skilled beds at the back nurses station. Due to our short staffing problems, I was asked if I minded to work for a couple of hours every "now and then" as the only LPN in the building, as they could get one nurse to work 3p-3a at the front station, then have another nurse to come in at 5am. I would be by myself from 3-5. ---------------------- I feel this is too much for me, but the DON tells me that even with 100 residents, they are only required to staff ONE lpn on nights. How can they do that?!?!?!?!?!?!?!:angryfire :angryfire :angryfire If they only staffed one lpn, these residents couldn't get the proper care. Is there anything I can do about this? I don't want to have to resign my job, but I am so tired of this.

And I thought that I was the only person caught under the "just-once-or-twice" thing! I have recently been called in to do a 12 hour shift and found after I had arived I was the only registered nurse(LPN) on the entire premises. And that was for the full 12 hours. I had 3 areas to cover 24+ clients per ward and drug rounds on each, 3 sets of keys and 3 sets of S8 drugs. 3 assistant nurses plus one float nurse halfway through my 12hrs. Each ward was on a different level with a lift one end and staircases!

I have checked and found that it was not exactly illegal, However, I vow never to be conned into doing that again. The 12 hour shift started at 6pm on a friday night!

What is the answer - it is all right to complain about it - but what should one do when put in a situation like Anndoodle, or me, or any of you others?

I have been told you just have to put up with it.

Mister Chris. :angryfire

lastkiss32 · Oct 7, 2004

Give them a choice no more assignments like that or you will look for another job- what a dangerous cituation that is-ouch

renerian, BSN, RN · Oct 7, 2004

That is very sad. I love the elderly but that kind of thing is horrible.

renerian

rlking · Oct 7, 2004

I find it hard to believe that it's even legal to have 1 nurse for 100 pts. Especially if you have skilled medicare pts. If your DON thinks this is okay, then maybe it's time you go to the Administrator. Maybe if he is made aware of the understaffing problem and about how many nurses are quitting he might do something. Try going to your HR person too. They can be a big help. That's her job. If things don't improve then let them know that you can't continue to work there and put your license at risk. Good luck!!

Robin, RN (rlking

I work in LTC in Arkansas. Not long ago, I started working 11-7 because we had 3 nurses to quit. I was working 7-3, and I like the increase in pay and the less-stress atmosphere. My problem is this: we have around 100 residents in our facility, basically split between 2 nurses stations. Each station has 3 halls of residents, with the majority of medicare skilled beds at the back nurses station. Due to our short staffing problems, I was asked if I minded to work for a couple of hours every "now and then" as the only LPN in the building, as they could get one nurse to work 3p-3a at the front station, then have another nurse to come in at 5am. I would be by myself from 3-5. I told them I was very uncomfortable with this, but would do it rarely and if they absolutely couldn't get anyone to come in and help. Needless to say, now they don't even ask anymore if it's ok to schedule me like this, they just take it for granted that I'm working that night and they can "split" the shift. This was only supposed to happen until they hired some new 11-7 nurses. Well, they hired 3. The first one wants to quit nights now and become the new care plan person, which is the job they promised her but told her they needed her on nights until more help was available. Then we hired another girl for 11-7. I oriented her for 3 nights, then her first shift by herself at the front station was chaos...and the 7-3 nurse literally chewed her head off the next morning because she was running a little behind. This new nurse called the DON that afternoon and said she quit, and wouldn't be back. THEN they hired a male nurse. I oriented him for 2 nights, was off the next night when the regular 11-7 nurse called in sick. (This is a new grad on a temp license) He was told by the nurse on call that he would HAVE to work the back station by himself (caring for 39 residents) by himself. I had previously told the nurse on call that in NO WAY was he ready to handle the station alone...told her this when she called me on my one night off, basically demanding that I come in and work, as no one else would do it. The new nurse walked out before he even clocked in, when they told him that he had to work the station alone. And he hasn't been back. The way I see it, I shouldn't have to continue to risk my license by working the entire building alone - even for 2 hours - because the day nurses keep running off the new good nurses!!!
The way our facility is built, the front station and 3 halls are up front and the back station and 3 halls are in the very back. At each station you can see down each hall, but not to the other station. If I'm at the back, I've no idea what's going on up front....I'm not supernurse, I can't be in 2 places at once. And what, praytell, do I do if there are 2 codes?!?! I feel this is too much for me, but the DON tells me that even with 100 residents, they are only required to staff ONE lpn on nights. How can they do that?!?!?!?!?!?!?!:angryfire :angryfire :angryfire If they only staffed one lpn, these residents couldn't get the proper care. Is there anything I can do about this? I don't want to have to resign my job, but I am so tired of this.

anndoodle · Oct 8, 2004

The admin is the one who told me they only had to have 1 lpn for up to 120 residents. But I anonymously contact the OLTC and they emailed me that it's 1 lpn for 80 residents, 81 res. and you must have 2 lpns. Don't think my admin believed me - they kept putting my in that position, so I resigned on the 4th. Wish me luck, I have an interview later today at the hospital!

I find it hard to believe that it's even legal to have 1 nurse for 100 pts. Especially if you have skilled medicare pts. If your DON thinks this is okay, then maybe it's time you go to the Administrator. Maybe if he is made aware of the understaffing problem and about how many nurses are quitting he might do something. Try going to your HR person too. They can be a big help. That's her job. If things don't improve then let them know that you can't continue to work there and put your license at risk. Good luck!!
Robin, RN (rlking

night owl · Oct 9, 2004

As my supervisor said the other night, "And it isn't getting any better!" then wanted to know if we were all working to our fullest potential? To the point of burn out? Yes.

TracyB,RN, RN · Oct 9, 2004

Hmmm, if only the administrator cared about the staffing ratios....the less salary paid out for staffing safely, the bigger the bonus.. Seen it waaaay too many times to not believe it.

One of the LTC's I worked at (intermediate) had only 1 night nurse (LPN) for 120 residents. And this was considered safe by the state!!!

Shell5 · Feb 1, 2005

Even Where I Work, Skilled, Medicare/medicaide Approved Ltc Facility. I Am Responsible For 50 Patients. I Have 1 Cma And Usually 3-4 Cna's. The Cma Is A Med Aide. She Is Responsible For Giving Out All The Meds.. However, She Cannot Do Chemsticks, Tube Feedings, Flushes, Iv's, Treatments. I Am Responsible For All That And Supervising. I Still Think I Need Help.