Overwhelmed by preceptorship patient ratio!

[earthflower]

Hey everyone. I am in LPN school, and I began my preceptorship at a longterm care center this week. The patient load for each nurse is between 25 to 27 residents, depending on the wing. At first I thought that there is no way that I will be expected to take so many patients since other students who were placed in hospitals or rehab units have a patient load of maybe 5 to 7. But I've since learned that by next week I'm expected to take over my preceptors shift, which means doing med passes and treatments for at least 25 residents. And I am on the skilled unit as well, so all my patients have quite a bit going on. I am sorta panicky about this, because this week I got half of her patient load, and it seriously took me all day just with 13 patients, working my butt off to get everything done. And I still had to stay after doing paperwork. All these people take tons of meds and with the 3 med-checks I'm required to do, plus hunting patients down, it takes me from 8 to 11 just to do accuchecks, insulin, and all the morning meds, let alone any assessments, treatments, or charting. Thank goodness there are fewer afternoon meds. And there are always labs to check on and tons of stuff has to get faxed to the MDs on a regular basis. Half the time I'm running all over the place looking for these patients to give them their meds or treatments. It is a large facility with tons of activities going on all the time, which is great for the residents, but terrible for me when I'm struggling with time. I'm thinking there is no way I can handle a load double this size. I'm watching nurses run around, who don't have any time for their patients, and who barely do one med-check, which is unsafe. Treatments are done in a frenzied hurry and nothing is sterile, not even wet to dry dressing changes. This is all so different than what I'm used to in the hospital. Granted, I was always busy with my 5 patients, but I never felt like I had so much to do I was unsafe. I know that longterm care is different in that you get a larger patient load, but 20 more patients... my God! I don't want to fail my preceptorship because of not getting all my work done. Please send some words of encouragement or advice! thanks :)

[weetziebat]

earthflower, not to make light of your predicament, but welcome to the world of ltc. i do think they should lighten up since you are precepting, and how do they expect you to learn anything if all you do is run your butt off? the only thing you'll learn at that rate is how to cut corners, which is certainly not what you need to know.

it is a scary situation and i personally have never seen any ltc facility that was any better, except perhaps a few skilled facilities.

have you spoken to your instructor and asked how you can learn in that situation? good luck, hon, you'll need it.

[grinnurse, RN]

You poor thing. Did you get assigned to LTC or did you choose it? I wasn't too worried about the preceptorship but am beginning to change my mind after reading this though :uhoh21: WOW, that's about all I can say? I don't know how you will learn a thing in that type of situation. I would definately talk with your instructor to see what to do..............

Good Luck

[unknown99, BSN, RN]

Have had up to 50 in long term care. That is why I do not work in LTC anymore!

[KrisRNwannabe]

For our preceptor since we are LPN student we have to go to LTC. thank god it is only 72 hours. where i am going they do 12 hour shifts. so i am going to do 3 per week and be done in two weeks. my instructor keeps telling us that if we do a good job these places will offer us jobs. I say no thanks. the only part of LTC i want is the 72 hours I have to be there!!

[earthflower]

Thanks everyone who replied! I finish this week, and luckily I have had a really great and understanding preceptor so I was able to get through it all okay. I'm glad for the experience now that it's over, but I definitely know I will not be working in LTC even if it does pay great. Well, now all that's left to do is study for boards!