Nursing Home ABUSE...TOWARDS STAFF!

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I am fed up with my 1st nursing job at a nursing home!!! As a new LPN, I don't know what's legal or not and how much I should take. Here's the 411 with this facility....any help/suggestions????

* 40 Residents, 1 LPN (me), 4 CNS's. I can't comprehend how they (Administration) want me to give AM meds (many of which are crushed, do Finger Sticks, Give injections, Do treatments, AND WORK THE DESK ALL IN 8 hours! Working the desk = picking up orders, like D/C this, start that, write up this consult, do that labwork, etc. Is it just me or is this insane??????

Also, I feel for the CNA's because there are times when there are 4 CNA's instead of 5 in the AM shift...that's 10 total care for each CNA....is that cool? Not too concerned about them since they manage to leave at 2:59pm but is this the norm for PT/CNA Ratio?

Speaking of ratios, how can I find out if 40 Residents for 1 LPN is acceptable? Sure, I'm not bathing them, but do EVERYTHING else for them ...AM MEDS & TX ARE A LOT TO DEAL WITH, aside from ppwk. And when the Md comes in , forget about it.... Keep in mind I don't get paid past 3pm :uhoh3::angryfire.....HELP!!!!! :crying2:

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I can't speak to the nurse ratio other than that sounds pretty high.

As for the CNAs 8-10 is pretty decent. Heck, I remember having to care for 16-18 back in the day lol.

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It takes two to tango.

Get the hell out of there asap and don't look back. You have other options.

(and yes, that is insane.)

As for a 40:1 ratio being acceptable, I think you know the answer. Regardless of acuity, that is nowhere near acceptable.

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We have 2 CNAs for 26 residents, so that's not unusual for 4 CNAs for 40 residents. Therefore, I (the LPN) also have 26 residents. It can be tough, yes, but time management is everything. I had 7 residents with accuchecks and sliding scale insulin and it made it very insane! First and foremost, make sure you get your med pass done in the allowed time frame. Sign your MAR as you go, and then go back and do tx's later. I usually try to do my tx's between morning med pass and lunch. And then catch up with my paper work in between there. I have heard of 40 residents/for one nurse, but I think officially your state has set pt/nurse ratios.

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i can tell you right now, that ratio is OUTRAGEOUS!!

ESP on days and eves.

it is just not doable w/o some serious harm being done to pt(s) and/or your license.

please, leave now.

i mean, like yesterday.

and don't ever look back.

best of everything.

leslie

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Specializes in LTC, Acute Care.

First of all, they have to pay you when you're working, no question. I'm sorry, but I've known day shift nurses NEEDING to stay until 4 p.m. or later every once in awhile and evening nurses until 1 a.m., and these aren't the clock milkers doing this. I think it's beyond abhorrent if that is a threat. If that is their way of keeping you from working more than you need to, I'd tell them where they can stick it.

In my state, what you have described is the norm for all 3 shifts...1 nurse to 40 people. All you can do is push pills and try to do the treatments the best that you can. It's horrible. It's also accepetable legally for facilities to do that here (I'm in Iowa). I don't know about other states.

:angryfire

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Welcome to the wonderful world of LTC and SNF....your situation is so the norm that I didn't even bat an eyelash. Your options are to look for that rare gem of a LTC/SNF with decent ratios, get into some other area of nursing (if it's even an option for LPNs in your area), or get your RN so that you have more options for employment.

I'm a new nurse and I have been busting my hump with the same ratios as you for over a year now. I picked the third option, graduate in a few weeks, and can't wait to get the heck out of dodge. You can survive this job but you need to learn how to make it work for you. Check out the LTC forum for some tips.

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Specializes in Home Health, PDN, LTC, subacute.

I think the CNA ratio is fair but I struggled with caring for 30 residents on second shift. We had a unit clerk until 4 pm weekdays too. Sounds like mgmt doesnt care.

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Specializes in Er/ICU/Med-Surg/Home health.

:twocents:Each state may be a little different. You can find it by searching the internet for "longterm care facilities regulations". Here's one, for example: http://www.pacode.com/secure/data/028/chapter211/s211.12.html

Also, check with your poicy and procedure manuals. It might be listed in there. Either way, they arent going to change the way they do things. This argument is as old as nursing itself. You might want to consider a another job.:twocents:

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Specializes in LTC, Other.

The CNA ratio you describe seems to be pretty standard at most facilities we are pretty luck at ours as we run 4 17 bed houses and each house but the tcu runs at a ration of 3 CNAs to 17 residents. 1 house (all dementia residents) is one nurse to 34 (that nurse cares for two houses of 17) residents however he/she does have a tma. the other house has one nurse to 17 residents and no tma and the other house (the tcu) has 2 nurses and 2 aides for 17 no tmas on days and one nurse one tma and two aides on eves. Nights is one nurse to 34 on each house with only 3 cnas for the whole building. Each house has a nurse manager who does all the MD rounds and the end of month med sheets. I am not sure what state you work in but in minnesota it seems that the options are slimmer for LPNs not many hospitals hire lpns anymore so as an lpn you are pretty much limited to long term care, clinics or home health. every facility is different and if i were you i would start looking to see what else is available esp if you are unable to go back for your RN. Good luck.

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Well, I bet that would be heaven for my mom who is a CNA. Where my mom works, it's 2 CNA's to 40 patients. She has to work a double 1-2 times a week on top of her regular schedule (normally work 7 days, off 2). Nursing homes treat their employees like crap pretty much and they refuse to hire enough help. It's why so many patients come out with pressure ulcers and other problems.. simply because there is just not enough people there to provide good care. Also, the nurses and LPNs at the nursing home my mom works at refuse to answer call lights. They look at the CNAs and say "Why aren't you answering the call light?". All of these conditions are the same at all 5 nursing homes my mom has ever worked at.

After seeing how the conditions are first hand, I could never work at a nursing home. More power to ya, lol. Good luck with everything and I hope things work out in your favor.

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Are you paid if you are there p 3pm? Overtime can be declared by policy, ie: over 8 hours/shift or over 40/hrs/week. If you are expected to clock out and then finish your work I think your state's labor board would declare that not to be legal. I agree with other posters, CNA ratio not bad, Nurse ratio awful and dangerous. Good luck sorting this out.

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