New Grad and Nursing home

[Olga]

I recently got my first job, long term care and rehab, as a new nurse I do not know what is… reality, as I don’t want to use the word “normal’ because I know it is not normal. I had 7 days buddy up and I started on my own on rehab floors, I have 32 patients, mostly PO meds, insulin and heparin, gt tube and some IV’s. Some of them need fluid restriction, some on dialysis. The other floor I worked on are more acute and maybe 20-25 patients. They also have long term floors with 48 patients to 1 nurse. But the reasoning is that 32 is better than 48, no matter acuteness. I had to do wound care once and they don’t have any sterile supplies, no field set up and sterile gloves like in nursing school, but if I am giving meds I don’t have to do wound care… with meds I’m always late, someone is asking me something every 3 minutes, sometimes I get a line of people waiting for their meds because a lot of them need to go down for therapy or appointment. I try to prioritize, but I am ending up being very late with many things. It is 7 to 3 shift. Everyone is telling me that this is normal because I’m new. Is this really how it is, or it’s just not a good place?

[Jedrnurse, BSN, RN]

60 min x 8 (hrs) = 480 minutes in a shift. 480/32 = 15 minutes per resident. Of course this doesn't include you getting phone calls, admissions, patients going sour, having the chance to go to the bathroom, getting an actual break etc.

From what I've heard over the years, this kind of staffing ratio is normal. Is it proper? No way in hell, but that's how it is.

I wouldn't do LTC if my life depended on it.

[FloForLyfe, BSN, CNA, RN]

Olga, I am sad to hear your story. I hope to see that you respond with an update regarding where you are at right now. One bit of advice I will offer you is remember the concept of "inhibition" in higher functioning as a nurse. Last year I was employed at a facility with similar ratios. Several months later, I am still having trouble remembering the patient's fear(s) before my own (that is just the God-honest truth). Use your off time to complete CEUs, sweat it out at the gym/studio (without inappropriate emotional displays!), and stay in touch with your spiritual practice.