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New to assisted living is this normal

Geriatric   (721 Views 5 Comments)
by Sam59808 Sam59808 (New) New Nurse

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So I was just hired to a new assisted living center. It will be the first assisted living center I’ve ever worked at. I’m wondering if what I’m experiencing is normal. A little background I will be the only Lpn on shift for 120 Assisted residences in the facility. I will have three cmas to help with med passes but still will have my own cart to pass meds for 40 of the patients. I will also have 4 cnas to help the residence with adls. I’m wondering if that’s a normal work load as I will have to do all incident reports and normal charge nurse duties as well as make sure the cmas and cnas are doing what needs to be done as they work under my license since I’m the only licensed person there. I will also be responsible for a set of assessments every month. I’ve never worked in this field so I just want to be sure I’m not being railroaded. 

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VivaLasViejas has 20 years experience as a ASN, RN and specializes in LTC, assisted living, med-surg, psych.

8 Followers; 142 Articles; 9,699 Posts; 249,099 Profile Views

A lot depends on what your facility's acuity level is. If you've got mostly residents who are fairly independent, the workload is reasonable. But if you have a number of dependent residents who need help not just with ADLs such as bathing and dressing, but with feeding and 2-person transfers, ALF nursing is hellish. Unfortunately many ALFs now admit people who are well down the dementia road and they wander, are completely incontinent and sometimes combative; they also take in residents who would be much more appropriate for the nursing home. It's all about the Benjamins in assisted living. Proceed with caution.

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LPN_Computer_Guy is a LPN, LVN and specializes in LPN.

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On 10/1/2019 at 1:33 AM, VivaLasViejas said:

A lot depends on what your facility's acuity level is. If you've got mostly residents who are fairly independent, the workload is reasonable. But if you have a number of dependent residents who need help not just with ADLs such as bathing and dressing, but with feeding and 2-person transfers, ALF nursing is hellish. Unfortunately many ALFs now admit people who are well down the dementia road and they wander, are completely incontinent and sometimes combative; they also take in residents who would be much more appropriate for the nursing home. It's all about the Benjamins in assisted living. Proceed with caution.

I don't want to discourage you but unfortunately, assisted living facilities seem to have gotten worse over the years.  From my experiences being a charge nurse as an LPN, if you have a good group of CNA's that are reliable and truly care about patients, then your shifts will go a lot smoother. The problem comes when you have one or two lazy CNA's who make it harder on everyone else.  Assisted LIving Facilities are not for everyone but hopefully the one you're at will give you some valuable experiences for your nursing career.

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In my area those ratios on an ALF would be pretty good.The ALF's in my area won't accept a resident who can't transfer on their own and there are continence and mentation requirements.

You are working with the elderly though and occasionally your acuity will increase. People in the early stages of dementia are eventually in the late stages of dementia. So patients who are in the process of losing their mobility, mentation and continence and shift to being innapropriate for an ALF sometimes faster than social services can find them a bed in a more appropriate facility. The Alzheimer's unit in my community has a wait list. I work in an SNF/LTC which often needs to take resident's from AFL's that progressed well beyond their acuity while they waited.

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amoLucia specializes in LTC.

5,192 Posts; 45,979 Profile Views

to Dave - your assessment is quite appropriate.

I do suggest that you change your screen name here. ABSOLUTE anonymity is improbable anywhere, but itwould do better to change it.

to OP - be aware that you will also most prob be dealing with families quite closely. SOME will be fine, but others will be HORRENDOUS. It most likely boils down to money and guilty consciences for them, so just a warning to be prepared for them.

Like PP Viva alluded to, ALFS depend on full census to keep revenue up. So your residents may or may not be appropriate LEVEL OF CARE for ALF community lifestyle. That makes all the world of difference.

Make sure you have your own malpractice insurance. (I say this to everyone who practices!)

Edited by amoLucia

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