Newbie Rehab Nurse Requesting Life Support

[HopefulRN7]

New to Rehab nursing here, and some days (most) I find myself looking around for hidden cameras, thinking I'm being Punk'd or a subject matter on some cruel nursing reality show.

I accepted a job at a LTC center on a skilled rehab unit a few months ago. With anything new, I expect there to be a learning curve, I understand that but lately my shifts and patients have been total train wrecks (acuity and needy, I'd like to ask you 528 questions and monopolize your time- oh and while I'm at it, my vitals are going down the toilet and I'll try to die on you).

On my unit, I'm on the med cart for 12 LTC patients and 8-10 skilled (lots of knee and hip replacements fx and repairs, post-CABG, pacer placements, loads of CHF'ers- just to name a few off the top of my head). I work with another med "nurse" (sometimes that's a med tech) who is on the cart for the other unit on our floor as well as a Charge who ideally should do vitals for parameters, step in if a pts status changes, etc...

We typically run with 4 aides (on a good day) but lately we've been average 2-3 after call-outs, scheduling errors, etc...

As a med nurse, we should be solely responsible for passing meds per my facility "rules". On my shifts, because Charge is usually tied up with working as an aide when we're short-staffed/administering insulin, giving controlled meds, for med tech, I find myself transferring pts to the bathroom to avoid falls, taking vitals, fielding phone calls and questions from multiple family members visiting, calling docs with pt status changes, etc...

No matter what I do on my shifts to prepare (yes, I've made a cheat sheet of how pts take their meds and even prioritized med pass based on times, type of med, etc) I continue to give 50% of meds an hour + late. I've looked back at past admin times by nurses who have been at this facility for years and they, too run into this "late time" issue on a daily basis.

I have spoken to the DON about these issues and even offered solutions (like using 3 nurses on carts and splitting the units up, eliminating the "charge" position), I've talked to other nurses who have stated they've done the same however, nothing has changed nor do I have the confidence it will.

This is not the type of "care" I expected to provide. Ive been a nurse for several years, but am new to this area of nursing so my glasses have lost their rose color- I don't think I'm expecting too much but this just seems ridiculous to me. Our rehospitalization rate is well above state average and now I understand why.

Anyone have any suggestions? Like "run far away from this place", "hang in there it will change", "welcome to skilled nursing"?? Anything? I feel like I'm on a sinking ship- someone throw me a life buoy!

[TheCommuter, BSN, RN]

I worked in the skilled LTC rehab sector for about six years at multiple facilities. Each time, I perceived it as a hellish experience. Skilled/SNF rehab entails too much backbreaking work without sufficient resources.

I left skilled rehab in a blazing ball of burnout and have no regrets at this time. I would only consider returning to this area of nursing to avoid homelessness.

[HopefulRN7]

I worked in the skilled LTC rehab sector for about six years at multiple facilities. Each time, I perceived it as a hellish experience. Skilled/SNF rehab entails too much backbreaking work without sufficient resources.

I left skilled rehab in a blazing ball of burnout and have no regrets at this time. I would only consider returning to this area of nursing to avoid homelessness.

eeeek! Thanks for your honest reply, it is much appreciated!!

[HyzenthlayLPN]

The last SNF/LTC facility I worked for changed their standard medication administration times schedule for once daily and BID meds. Instead of a specific time, most meds are now given in a time range. Many meds are not time critical (do you really need to take your multi vitamin within an hour of 9am?). For THOSE meds, the scheduled time was between 7am-11am (once daily and the 1st of the BID) and 7pm-11pm for the HS and second dose of BID). Of course, time critical meds were scheduled at specific times. Most of the medication aides were able to pass medications within the given time frames (where previously most were not).