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12 patients for a new grad to much?

Nurses   (2,454 Views 43 Comments)
by Stitchcat Stitchcat (New Member) New Member Nurse

5 Likes; 126 Visitors; 7 Posts

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Hi all,

I was wondering if anyone felt 12 patients was a bit much for a new grad? I love caring for my patients, but after two weeks of orientation, the 3 days I have been on my own we’re not so great. 

I had 5 long term care patients and 7 skilled nursing patients. (2 with Q4hr neb treatments, all had a dressing changes, 2 with tube feedings). I am not complaining by any means, but I did feel very overwhelmed to the point of tears on the 15 min break I got. I worked from 7am-11pm at night to help out. (We work 8 hour shifts. I worked a double) I am new to this site and have seen ignorant comments on others topics. Please try and refrain from that if anyone decides to respond. 

Just looking for advice. Thanks all 🙂

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River&MountainRN has 3 years experience.

141 Likes; 1,621 Visitors; 159 Posts

I got dumped on with 40-80 residents immediately after graduating at the SNF that hired me. 12 is doable...hang tough! Don't be afraid to ask for help when needed! 🙂 

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mrsboots87 has 3 years experience and works as a RN.

20 Likes; 16,478 Visitors; 1,761 Posts

You’re in a SNF. This is actually a very light load for a SNF and you are lucky. For you to have less patients means some other nurse has to take some of your work and add it to theirs. New grad or otherwise, the facility will not be able to change the patient load. 

 

Youre going to feel overwhelmed for at keast the first few months to a year. Just power through and you’ll be ok. 

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Jedrnurse has 25 years experience as a BSN, RN and works as a school nurse.

507 Likes; 10,900 Visitors; 1,060 Posts

It's disturbing that this is considered a "light" assignment. Honestly, say you're working a truly 8 hr shift. Twelve patients with dsg changes, 2 TF, 2 with nebs, and we all know about the plethora of meds you're passing. Not to mention all the toileting, ADLs and incidentals that come up as well. Yes, this number might be light relative to obscenely bad ratios, but it's still not good. Not if you're providing decent care.

I've come to despise the term "Skilled Nursing Facility" because it's exactly that service that is in such short supply in so many places. Not because of nurses's skills, but because of how much average time they can (in reality) spend with their patients.

 

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Jory has 10 years experience as a MSN, APRN, CNM.

526 Likes; 1 Follower; 10,990 Visitors; 1,115 Posts

I'm sorry, two weeks of orientation for a new grad is unacceptable in any healthcare setting. 

This is what kills patients/residents.  

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Jedrnurse has 25 years experience as a BSN, RN and works as a school nurse.

507 Likes; 10,900 Visitors; 1,060 Posts

6 minutes ago, Jory said:

I'm sorry, two weeks of orientation for a new grad is unacceptable in any healthcare setting. 

This is what kills patients/residents.  

I'm not writing this to be a smart$$$, but is this provable? I know short orientations for new nurses is a bad thing, but does it (beyond anecdotal stories) result in patient/resident death?

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77 Likes; 9,198 Visitors; 1,371 Posts

In residential this is normal. I work in a setting licensed as residential (with a variance for higher acuity - we are essentially a sub-acute/psychiatric crisis stabilization unit) with 16 patients to 1 RN.

My own experience as a new grad in this setting is that the learning curve is very steep, but it does get easier with time and experience. I think patient care would be improved by more RNs (or at least regular CNAs and/or more highly skilled floor staff) but we are contracted the the county and the county says our current staffing matrix is what they will pay for and that we don't "need" more.

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172 Likes; 1 Follower; 494 Visitors; 79 Posts

As others have suggested, that’s a light load for SNF. Also working longer shifts (say, 16) will make it seem more stressful.  I might suggest NOT picking up extra hours until you feel more comfortable. Finding a routine that works for you will help. That only comes with time, however. Hang tough! 

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24 Likes; 622 Visitors; 49 Posts

I am really shocked at the comments that suggest this is a light load... and a tad annoyed to read that you are lucky because another nurse has had to pick up what you couldn't do.. you're a NEW grad, that is a ridiculous and unsafe assignment. I don't know what a 'SNF' is .. but 12 patients... that would have had me in utter meltdown, and I have had a year in acute nursing. I'm in a NICU, but even with our special care nursery babies, we only ever have four (or occasionally five) babies per load. 

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meanmaryjean has 40 years experience and works as a Nursing Faculty.

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9 minutes ago, bananas1 said:

I am really shocked at the comments that suggest this is a light load... and a tad annoyed to read that you are lucky because another nurse has had to pick up what you couldn't do.. you're a NEW grad, that is a ridiculous and unsafe assignment. I don't know what a 'SNF' is .. but 12 patients... that would have had me in utter meltdown, and I have had a year in acute nursing. I'm in a NICU, but even with our special care nursery babies, we only ever have four (or occasionally five) babies per load. 

SNF= Skilled Nursing Facility = Nursing Home. So 12 patients IS a rather light assignment. 

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Jedrnurse has 25 years experience as a BSN, RN and works as a school nurse.

507 Likes; 10,900 Visitors; 1,060 Posts

7 minutes ago, meanmaryjean said:

SNF= Skilled Nursing Facility = Nursing Home. So 12 patients IS a rather light assignment. 

Except the "old" definition/acuity of nursing homes are a thing of the past...

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Jory has 10 years experience as a MSN, APRN, CNM.

526 Likes; 1 Follower; 10,990 Visitors; 1,115 Posts

11 hours ago, Jedrnurse said:

I'm not writing this to be a smart$$$, but is this provable? I know short orientations for new nurses is a bad thing, but does it (beyond anecdotal stories) result in patient/resident death?

Yes, it is....when you don't teach a new RN the specifics of how to be safe in a particular healthcare setting, you are setting the stage for that patient to be harmed and yes, that can ultimately lead to their death. 

So you don't think that a short orientation is nothing more than an inconvenience for the nurse and cannot possibly harm a patient?  Wow.....just wow.  

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