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New to assisted living is this normal

LPN/LVN   (954 Views 8 Comments)
by Sam59808 Sam59808 (New) New Nurse

135 Profile Views; 2 Posts

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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1 Post; 12 Profile Views

Unfortunately this is not abnormal. Some assisted livings are more appropriately staffed and some are dangerously understaffed. 

I    really think It depends on the acuity of the residents but 120 people for one nurse is insane to me. 

Settings like this are kind of why I    went into clinic positions. 

Best of luck!

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NurseQT has 10+ years experience.

344 Posts; 7,945 Profile Views

Are you the only licensed nurse for the entire community? If so, that is insane. I work in assisted living. There is the RN (Health and Wellness Director) and me for 32 assisted living residents (our acuity is pretty high right now) and we just took over the “independent” living building which currently has 10 residents but there’s 10 open apartments in that building. I don’t normally work on the floor unless we are short staffed. Each building has med passers and CNAs/RCAs. Over the summer I was the only licensed nurse for the assisted living building because the HWD was on maternity leave and I was drowning the entire 12 weeks she was gone and that was for 30 residents, I would have died if I would have had to be in charge of 4x that many! 

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104 Posts; 1,459 Profile Views

That's too many patients, especially if you have to take vitals and do finger-sticks. Even if you are able to wear roller skates and keep up with everything, if there's an incident, such as unexplained bruises or injury, your whole balance is thrown off and you'll be trying to "catch up "for the rest of your shift. 

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11 Followers; 3,596 Posts; 26,390 Profile Views

On 10/17/2019 at 4:22 PM, Floor_Nurse said:

if there's an incident, such as unexplained bruises or injury, your whole balance is thrown off and you'll be trying to "catch up "for the rest of your shift. 

Well that ^ would be best case scenario.

Worst case scenario would be that you are blamed for not having properly monitored the residents to begin with, and also that you will be in a position to be forced to de-prioritize other important matters while dealing with the immediate aftermath of the incident.

OP, this sounds entirely unreasonable.

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ocean.baby has 25 years experience and specializes in corrections and LTC.

104 Posts; 2,186 Profile Views

I worked assisted living with 80 patients.  There were always 2 nurses for med pass, plus 3-4 CNAs.  I am an experienced nurse who graduated in 1993 and have worked many long term care facilities.  I never seemed to have a free moment, but then I visited with the residents when giving meds/treatments, stocked my cart, did my charting, noted orders, etc.  I was not responsible for any monthly assessments.  I think that 120 patients for one nurse is far too many, especially since you have to pass meds to 40 people which is a full time job in itself.  Not everyone felt that way - many nurses were on facebook or playing games on their phones quite frequently.  They did not do their charting or note orders, did not stock  clean their med cart.  They did the bare minimum. 

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Savage94 is a LPN, LVN and specializes in Nursing facilities.

4 Posts; 78 Profile Views

No that's the way it is.  That's why there is so much burn out with LPN's.

They expect us to be able to do it all.  Wait til flu season! Or if you have 4 falls in a row.  I love my residents, but at age 62 there is no respect.  Hang in there.  Try to find a place with less residents.  Personal Care?

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Anthony O is a BSN and specializes in Case Management.

17 Posts; 474 Profile Views

You can send an anonymous complaint to the joint commission and CMS. They'll do a surprise reinspection. This needs to be reported. 40 patients means you have 3 minutes per patient on your med pass. Plus you probably have treatments for the rest. It's not possible and you will end up giving meds late and skipping mandatory breaks to keep up with the work.

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