Nursing staffing

AnnemRN · Oct 19, 2009

HAHAHAHAHAHAHAHAHA!
Oh, wait, I'm dying here...
I just got some meds rescheduled for my 6 am med pass so I can give each resident an undivided 6 minutes of time.

They will appreciate you spending more time with them.

AnnemRN · Oct 19, 2009

My facility has 41 beds....day shift 2 staff nurses, a nurse manager, and 5 CNAs. Don't tell me that is not more than adequate staffing....never more than 21 residents and at the moment, there are NO IVs, no wound vacs, and no complicated treatments. I've done the staff nurses' job so I know it can be done.

What's it like when there are IV's, wound vacs and complicated treatments. How many patients would you have then?

CapeCodMermaid, RN · Oct 19, 2009

Nurses are licensed people with certain skills. As cold as it sounds, Medicare does NOT pay us to spend time with the residents/patients. And to answer the other question...21 residents even with IVs and wound vacs is more than doable...especially since not all 21 residents have IVs or vacs. By the way...a wound vac takes 5 minutes 3 times a week as opposed to a different kind of dressing done 3 times a day.

AnnemRN · Oct 20, 2009

I worked in a nursing home a few years ago and so many critical things were missed. Patients were dehydrated, many times labs were not checked. One patients INR was 10.2 and the nurses were still giving him his coumadin. The nurses were very busy.

I've performed many wound vac dressing changes, but have never been able to do them in 5 minutes. I just don't think these nurses are complaining just for the heck of it, that's just my opinion.

CapeCodMermaid, RN · Oct 20, 2009

If and when the nurses get too busy, it's time for the supervisors/managers to step in and help. I review all admission charts, review labs, write orders, read charts from start to finish to figure out why someone is sick. It's why we have a team.

noc4senuf · Oct 20, 2009

It all depends on each individual facility and how they operate. Very doable on a LTC floor for 21 residents. On a TCu, then it would be a bit much... all depends on the acquity. When i worked the floor, I had 65 residents at night and on day shift there were two of us and a ward clerk.,,, certainly doable and we were a great facilty, things got done!!

AnnemRN · Oct 20, 2009

If and when the nurses get too busy, it's time for the supervisors/managers to step in and help. I review all admission charts, review labs, write orders, read charts from start to finish to figure out why someone is sick. It's why we have a team.

Okay, then why do you think the OP's nurses are complaining?

CapeCodMermaid, RN · Oct 20, 2009

At the risk of getting flamed, perhaps it's because they don't think nursing is HARD work or that they are entitled to have just a few residents or they can't do the work or they have not helpful managers.

summerrose_10 · Oct 21, 2009

All of you make excellent points. I'm also in subacute LTC. I also can not do a wound vac in 5 minutes, it takes me almost that amount of time to get the old dressing off, especially if I don't want the pt. to scream:eek:. Not to mention, if that were me, I would appreciate more then 5 minutes of a nurses time when treating my wound.

I'm still fairly new, less then 2yrs exp. so I attribute some of my "slowness" to the learning curve. That being said, I find it difficult to believe it is possible to do cares/treatments on as many patients as some of you take care of. The most I have cared for is 10, no break, no lunch, no charting till after I reported to next shift, thank god no IV blew, PT/OT helped and no CNA had called off that day. Yeah it's "doable, but who could really work under those conditions every day?? :cry:

I did not come into nursing thinking it was an easy job and I've always been a hard worker, no problems there. What I have found, is exactly what others here have said; The DON/CRN is really not aware of the pt. load and the time involved. :angryfire Or, maybe they do look at the pt. load and think it only takes 5min for wound vac. 1 minute for BSX10-20 pts.,med pass 20mins,bathing 2pt 20mins.passing brfst/lunch trays10min.TPN 3min. etc...you get the picture.

All the nurses I work with, got into nursing because they "cared":redbeathe They want the best for their pt. What I'm finding is the "powers that be" expect more and more...and eventually...as some have posted...it is virtually impossible:angryfire. Sure the DON/staff should step in to help, but they have their meetings and schedules too.

I believe the nurses complaining here are good and competent nurses:loveya: Even in school, my instructors said the complexity of the pt. has increased significantly. What I see here is, my fellow nurse looking for support:redbeathe:yeah:If we don't support each other, there will be even more calling in "sick":sniff: At what point will the "powers that be" say "stop, the staff can not safely handle the pt. load?"????? Stop saying it's "doable", get rid of those who aren't team players, and support those of us out here who truely do care and aren't burnt out yet:up:

noc4senuf · Oct 21, 2009

I expect my staff to work as hard as I do. I also expect them to be able to get their breaks, which they do. I have one nurse that routinely can not get her work completed in the time frame that everyone else does, this is not due to the workload, it is her time management skills. Does it put her job in jeopardy? Yes. Every facility has a different "climate" and staffing set-up. It is not fair to lump them in one pile. I can and will say it is doable as I know what the acquity levels are for my residents and staff accordingly. My floor nurses do not complete weekly assessments or MDS's. I have a nurse manager on each floor and an MDS and Medicare Coordinators. I also have some ancillary staff to ease the load. Myself and my ADON are available to assist with work needed to be taken care of. I started in this career as a CNA and it is not beneath me to toilet, feed, make beds, etc. The last facility I was in I also helped clean out the garage of old equipment, went dumpster diving multiple times for dentures, got on a ladder to tear down a sheetrock ceiling, shampooed carpets, ran the kitchen and cooked supper one night when the cook did a No Show... the list goes on.

I work in this field to help with a better quality of life for those who need our help. I listen to my staff and do what I can to make it an even playing field for all of them. But, in the end, the residents come first and if that means I need to add the staff to take care of them, then I better be able to explain why I have and I do. Don't anyone ever tell me that what I expect of the nurses in our facility is not "doable".

mercy1975 · Oct 21, 2009

We have no IVs, wound vacs, complicated treatments, or catheters. We have 5-6 treatments to be done daily. The ADON and I are constantly asking them if they need help, what can we do, what are your ideas. They never think we have our work too. The ADON and I do all the admissions, completely. We have 5-6 aides on days, 4-5 on evenings, and 2 on nights. I have meetings to work on solutions to our problems. A few of them will give input. We do have approximately 50 % of mod care residents. The aides are great! They do want ever I ask of them without complaining.

mercy1975 · Oct 22, 2009

We have no IVs, wound vacs, complicated treatments, or catheters. We have 5-6 treatments to be done daily. The ADON and I are constantly asking them if they need help, what can we do, what are your ideas. They never think we have our work too. The ADON and I do all the admissions, completely. We have 5-6 aides on days, 4-5 on evenings, and 2 on nights. I have meetings to work on solutions to our problems. A few of them will give input. We do have approximately 50 % of mod care residents. The aides are great! They do want ever I ask of them without complaining.

I also work the floor 8 hours every week plus when there are call ins.