nursing homes and large patient to nurse ratio

[bargraphix]

I just started a new job in a nursing home and I am having a hard time. I have about 26 residents to take care of and I basically spend the whole time giving meds. I have no time for treatments or documentation. All my documentation usually gets done after my shift is over. They also expect us to check each medication 3 times before giving it to the patient. How am I supposed to do that? I hardly have time to check it once. They also wonder why so many patients have pressure ulcers. I can tell you why. It's because we have so much to do that there is no time to turn and re-position patients.

Any advice and encouragement is really appreciated.

[dream'n, BSN, RN]

MedSurg is tough because even though the nurse/patient ratio is lower than LTC/SNF you are more intimately involved in the nuances of your patients care. Patient's are less stable, more closely monitored, having more tests and definitely more PRN drugs. Medications can be given at all hours, sometimes one patient can get meds every hour, or vitals every 15 minutes. You are also closely following labs and testing results. Head to toe through assessments are done on each patient.

That's why ICU has even lower ratios; they are even more closely monitoring their patients. Like minute to minute sometimes. ICU nurses know their patients backwards and forwards, in and out. It's all about the minute details.

SNF/LTC can be so difficult too. All the medications and crappy ratios. And sometimes your patients there can be pretty ill too, without the staffing levels to follow them as closely as needed.

Darn, it all stinks; just depressed myself