Corkyme

I work for a small rural home health and hospice agency. I started about 6 months ago. i currently have 18 patients- 14 home health and 4 hospice. I really like the work! But there is no back up. If your 18 patients are all twice a week then you make every visit. We do all the OASIS recerts discharge admissions etc on top of the individual visits ourselves. Is this the norm out there now? I've worked in HHC before but there was a definite hierachy - field nurses - who were out doing visits vs case managers who were more office based. We also have no dedicated on call staff. We cover call in a rotation after working all day-What is a " normal" caseload for nurses when they also cover all the on call and all the visits? I am supposed to stay under 40 hours a week but I almost never do. Even if I manage to see all my patients in 40 hours, being on call will put me over...I just dont know if Im not budgeting my time wisely or if this caseload is excessive.

I'm not a woc nurse but I've never heard of a cna placing a wound vac. Our cnas dont do anything with them except report if yherebis a problem

This is my first post so apologies if this is the wrong spot... Im.in 4th semester precepting at a long LTC facility and someone forged my name on a narc sheet. I found a signature of mine that obviously was not mine. It was dated on a day I wasn't there. I did take it to the Don who blew me off. My preceptor then admitted to the Don that she "signed for me to get caught up" . The count was correct so the Don didn't seem to care at all. She has also documented that I gave meds when i didnt. (I may have forgotten to log out or she may have logged on as me. It was my first day using the charting so I'm not sure which it was I don't remember if I logged out.) She also cuts corners, ignored contact precautions, and tried to get me to chart things I didn't do. All because she says this is the real world not nursing school. I emailed and called my instructor about this but I've not heard back. Soooo am I overreacting because I'm freaked out by this? What should I do?