Never Again

The agency I work for talked me into taking an assignment at a nursing home about 50 minutes from my house. No big deal, one shift, and I like the time alone when driving. Anyway, it was a 3-11 shift. I was working with another nurse. She left at 7. I was the only nurse between 7-11. And I had 60 patients. I was floored! Now I have worked LTC facilities for 10 years, and have been asked to do a lot, but 60 patients? It would have been bad enough on an 11-7 shift, but 3-11!!! And these weren't rest home patients. This was a medicare skilled hall. I am steaming! And then, when I was going home, I asked for the code to get out the door (which was 10 ft. from me) and the nurse says "Hold on, I'll tell you after I'm done with report" I stood there 20 minutes waiting for her to finish report and counting just so I could get out the door. Arrgggghhhhh! And they wonder why they need agency so much! Sorry, just needed to vent :angryfire

I can relate, I worked LTC/Rehab floor and I had the same amount of patients on more than one occassion...I stayed in the position for 6 months then moved on to less patients. I still remember those nights, oh boy!...thank God no one went into distress... except me.

Sixty patients on 3-11, what a horror""" Where was your supervisor? I would have called my agency and told them right away and then list it for my personal DNR and alert other nurses as well. 3-11 is usually the busy shift and not easy for a "regular" staff member. In some places they will give 5 and 9's together, but they are iron, colace and the evening daily. that cuts down on the 9's when many are in bed or are asking for prn's.

i am an agency nurse and i would have been on the phone with the facilities on call nurse and then my agency. a facility i go to all the time tried this junk with me the other day and it ain't happening. you must stand up for yourself cause these facilities will run all over you.

I've been in agency work for about 15 years now. The majority of assignments have been good with places requesting me back, sometimes. But, if I walked into a place and got confronted with 60 patients to be responsible for, I would call my agency and let them know that it was dangerous for me and my license to work there. Put simply, I would refuse the assignment. There is no rule/law, at least where I work, that states that an agency nurse must accept any and all assignments, regardless of circumstances. There has been a couple of times, I remember, when I have called and refused an assignment. Both times, the places "scrambled" to settle the matter and things worked out well. Of course, don't accept the assignment then change your mind later. That's "patient abandonment". All in all, I love agency work. It's challenging and independent. Finally, do the best you can at an assignment and if you like the place, remind them that you're available. if they need someone again. Makes it nice (and scores points with the agency), when they call and request you.

You should have called your Agency and refused a 60 patient assignment. This would force the Supervisor to take on half the load with her superior to step in as acting Supervisor. That could have cost you your license and livelihood. Right away you should have called your Agency and made it known this is unacceptable. If you were to take this on, you would need two Nurses' pay for this. I still don't think that would be fair and worth the risk.

Don't you think the families of these residents should know about the substandard care, if there was only a safe and legal way to notify them. The NH charge the families a fortune for what they think is skilled care, how sad.

I had that happen to me only it was the whole shift with 65 pt. it was horrible there was no way. I manged to get my meds passed but only some of the treatments and I never took a break. It was crazy. I had been there twice before on the other hall where I had 12 pt a couple vents and feeding tubes since I had expirence on both thats where they put me it was great had plenty of time. I had no idea the other hall was that bad. They begged me to go back I said o way!

This has also happened to me as an agency nurse. I have told my agency no more nursing homes, I felt I was putting my license on the line. I feel that the regulatory state officals have caused some of these issues with their staffing guidelines. Then the next shift comes on and wants to know why you didn't do this and that you had no idea of, and how come you couldn't function as regular staff does without an orientation or one of two hours worth.

well I think my career is over. I am an agency nurse and I was sent to a home on the 11-7 shift. The nurse leaving just said that I only need to check one room during the night as every one self was pretty much self-care and would call me if they needed me . She took off before giving me a tour of where my rooms were (it is a huge place with several halls and the numbers do not follow a pattern. Accu check monitors were all over the place. same had names on them some did not. I was all alone Two aids were on the other side but made it clear that they did not want to interact with me as far as helping me find things ect. The nurse had left without doing her narc count with me. I wanted to run but I was stuck. I went through the MARS and flagged all my meds and accu checks, there were not many BUT I could not find a mans nito topical cream or appliance patchs.I called a nurse on the help list and wake her up and she said it is in his drawer .well it was not .I looked every where. I never found it. All during the night residents were calling and it was taking me forever to find the rooms which were all locked and several residents would not respond when I knocked. I used my master key and answered as many as I could. When the next shift came on an emergancy page came on and I was running tring to find the room. Everyone else was too busy to help me. Finally I did find the room .A lady had falling. I took v/s and assessed her. The other nurses came in and asked for the med keys so they could start their meds.With everything going on I had not finished the my meds. It was quarter to seven and The on coming nurses said they were taking over the meds now.(they did not say it nasty or anything). They did say that I had used the wrong accu check monitors.After I left they called my agency and said they had issues with me and they would talk about it Monday.So now I am so afraid the my career is over.If it is not I will never let this happen to me again.Wish me luck,

I put you on my prayer list, and please don't worry. Your career is not over. There are plenty of supportive institution to work at, and many other agency's out there also. Why we as medical personel are so cruel to one another is beyond me. Does everyone realize that as long as they keep us fighting petty arguments between one another that we cannot as a collective group changed the situation. Divide and conquer. We've got to quit throwing people away in this country just because they don't think or behave in a manner like us. Show your agency what you typed above and if they are still hard on you, find another agency or another job. If we no longer want to be slaves of the man, we have to act as free men and women with rights. Suzanne Gordon has written several book about what nurses go through, and she also gives solutions. Good luck and God Bless

Thank you. I plan to look into getting on a hospital full time.I think at this time it is a wiser choice for me.I will still work for an agency but I am only going to places that I have been before. I just will not let this kind of thing happen again.I wanted to be a nurse all my life and this whole thing taught me a lesson in reality.

The agency I work for talked me into taking an assignment at a nursing home about 50 minutes from my house. No big deal, one shift, and I like the time alone when driving. Anyway, it was a 3-11 shift. I was working with another nurse. She left at 7. I was the only nurse between 7-11. And I had 60 patients. I was floored! Now I have worked LTC facilities for 10 years, and have been asked to do a lot, but 60 patients? It would have been bad enough on an 11-7 shift, but 3-11!!! And these weren't rest home patients. This was a medicare skilled hall. I am steaming! And then, when I was going home, I asked for the code to get out the door (which was 10 ft. from me) and the nurse says "Hold on, I'll tell you after I'm done with report" I stood there 20 minutes waiting for her to finish report and counting just so I could get out the door. Arrgggghhhhh! And they wonder why they need agency so much! Sorry, just needed to vent :angryfire

OMgosh! You handled yourself much better than I would have. I think I would have seriously questioned that assignment. I guess I'm spoiled in the hospital. If we have an assignment that we are uncomfortable with or feel that we will not be able to give adequate care to the pt's...for whatever reason, we have the right to refuse the assignment. That happens to a lot of floor nurses that float down to the ER. They get dumped on too.

See this is the reason and the EXACT reason I refuse to work facilities with my agency. I will do homecare only....the only facility I've agreed to is Hospice.

I feel for you. That was outrageous! I've heard of like 30 pt's....BUT 60??? Are you going back to that place?? Omgosh...Bless your heart!