New Grad RN- Drowning in overloaded LTC setting- LOW STAFFING!

Jaimie.RN · Oct 31, 2011

I just don't want to work somewhere where I feel I can't give safe care to my patients and I can't be fair to myself. I don't mind hard work, but I don't want to kill myself to do the bare bones minimum for my patients because they refuse to safely staff.

Thanks a lot guys. I will be going there this afternoon.

Jaimie.RN · Oct 31, 2011

My other job just basically offered me a spot on days too. So why stay at this place. Makes me feel like a failure/quitter

But I can't do that to myself and I don't want to be the nurse with 30 patients and no time for any of them.

Gaga4googoos · Oct 31, 2011

Run FAST! Think about your license.

FutureRN_NP · Oct 31, 2011

I just got hired into a LTC/REHAB/SNF and I HATE IT. I want a hospital job but no one wants new grads. SO I took this job, got basically no orientation at it, and get thrown out on a floor with 33 patients all by myself. No other nurses on to help (afternoon, evening) and have to pass at least 3 upwards of 15 meds to each one. How can anyone do this? It was a 4 hour shift but they wanted me to do 8 so I said no. I had less than 8 minutes per patient. That includes all charting, all med passing, crushing, feeding the slow ones, waking people up, taking vitals, doing blood sugars, drawing up insulin, EVERYTHING. How can anyone do this? It's so not safe! I was prepared to get like 10 patients leaving school but 33!? I don't know what to do. I have an interview at a hospital and orient for a PRN position soon at another SNF. I want to just quit this place. Their turnover is ridiculous and they're never properly staffed. I got no orientation and there's always meds that don't come from the pharmacy, not enough supplies, patients getting admitted without rx's or continuity. I wanna cry every day at work. I have nightmares about getting new admissions. What can I do? What should I do? I am worried my license is in danger working here because it's too much work for any one person to do and especially me, greener than grass! How do I quit? What do I say to the DON? I feel like the worst nurse in the world.

Woo! Wait a minute! You are a new grad and they didn't give you any orientation you before putting you on the floor? I just recently got a job offer at LTC too but I will have three to five weeks orientation time. I have 60 pts but I have at least 4 LPNs to help me. That what I was told.

SnowboardRN · Oct 31, 2011

I FEEL THE EXACT SAME WAY!!!!! I only have 14 patients on my rehab LTC floor but I work 8 hrs M-F and am the only nurse on the floor, tons of meds, NO training (1.5 weeks where the trainer was so busy. I just did the vitals & assessments on my own while she did everything else!) During my interview they told me there were 5 patients I would take care of, well then they got 9 more admits!! I told them I needed more training esp being a brand new nurse & they told me they didn't have anyone to train me. My 8 hour shifts have turned into 12 hour shifts because if I leave anything for the 3rd shift nurse to do she gets ******. The girl who trainedme told me the two people they hired before me quit, but that she thought I was doing an awesome job and I really like her so I don't want to let her down. But I'm so tired, and like you, having nightmares about new admits!!!

Jaimie.RN · Oct 31, 2011

My training was following another struggling nurse for one night then I was on my own. I am so fed up with it.

samirish · Oct 31, 2011

I would get out of their ASAP! That place sounds ridiculous. Good luck to you.

linsmirn · Oct 31, 2011

You have another job so you probably dont even have to ever bring up the LTC. Im happy you are leaving and have something else lined up.

Jaimie.RN · Nov 1, 2011

I put in my two weeks today and she didn't even want it. Too bad I guess. I already have been hired at another LTC facility where I start tomorrow and have a hospital interview. She was ****** and told me that "33 patients per nurse isn't short staffing." The other nurses there say there used to be 2 nurses on each hall but now that "census is lower" there's one nurse for both halls. This med pass is literally like 500 meds in 4 hours. It's impossible. No one could do it properly. Not even a machine. Doing the math I had 7.2 minutes per patient. Not a chance that is safe. Takes longer than that to do a sugar and take a manual (they're too cheap to buy an automatic) BP. I feel guilty but relieved I don't have to spend another night crying when I leave work. I may be new but I know what's not safe, and that was a great example. I feel bad for the residents there.

newtress, LPN · Nov 1, 2011

I had to quit a snf position for the very same reasons you have stated. And this is what I told the DON when I gave notice. I said " me and my license had a talk last night and we decided it was in our best interest to depart this facility. I thank you for the opportunity to come on board here, but it's for the best." Just like that. She smiled and replied "haven't ever heard of it put to me that way, but I appreciate your honesty and good luck in your future." No bad feelings or leaving on bad terms. So I say to you, it really is the best choice for you to leave this Ombudsman train wreck waiting to happen. Poorly run facilities make nurses look bad.. no matter how good you are or how hard you work.

Forever Sunshine, ASN, RN · Nov 1, 2011

I put in my two weeks today and she didn't even want it. Too bad I guess. I already have been hired at another LTC facility where I start tomorrow and have a hospital interview. She was ****** and told me that "33 patients per nurse isn't short staffing." The other nurses there say there used to be 2 nurses on each hall but now that "census is lower" there's one nurse for both halls. This med pass is literally like 500 meds in 4 hours. It's impossible. No one could do it properly. Not even a machine. Doing the math I had 7.2 minutes per patient. Not a chance that is safe. Takes longer than that to do a sugar and take a manual (they're too cheap to buy an automatic) BP. I feel guilty but relieved I don't have to spend another night crying when I leave work. I may be new but I know what's not safe, and that was a great example. I feel bad for the residents there.

33 patients is normal for LTC but its a lot for 1 person.

The secret with the med-pass is that the more you do the it.. the quicker it gets. What once took you 4-5 hours cuts down to about 3.

I'll send you our automatic B/P machines. I hate them. They are worthless pieces of ****. I prefer to take the time and get the manual B/P. I'll end up doing it anyway because the machines give you horrible readings that are way off.

Jaimie.RN · Nov 1, 2011

I know automatic machines are a pain, but when you have piece of garbage manuals and no time to do them or patients who fight you or who seize, it gets a little old trying to take manuals.

It'd help if my aides did sugars or vitals, but nope, it was all me. Each patient had tons of meds, too. And it didn't help that it was all paper, falling-apart MAR and a lot of the meds were not available and I had to hunt them down.