tess16

I disagree with you. I am a new nurse. I work 12 hour shifts. Sometimes 5 in a row. My feet ache, my back hurts, and by the end of most shifts - I am ready for my ten hours to myself where I am not anyones nurse. But when I go back I give them everything I have. Most nights I don't get a break. My last shift, I had 2 nurse aids call in at 3 am. We get 3 nurse aids total for day shift. And one is only there till 9am. So while I'm calling our five full time staff members, and our seven other casual CNAs, I hear two feeding tubes alarm. And policy is that you don't change the bag until it alarms to prevent waste. And then two motion sensors go off. And my dying patient needed their morphine. And their family members where there and wanted it on the hour (which is fine - they are entitled to it for goodness sakes!) And two other patients needed to use the restroom. And when my patients are using the bathroom I'm leaving texts and voicemails to our already burnt out staff who I'm begging to come to work so I am not working 16 to 18 hours like I've been mandated to do in the past. I don't know any skilled nursing facility that allows the luxury of being lazy. I don't appreciate it being assumed, when majority of the days I go and give my all. And I still feel defeated, because none of our elderly get the care they really deserve. They get 10 minute baths, chats on the way to meals, and during personal hygiene and dressing time. They get care ratios that are so impossible that it allows some patients less then 10 minutes to get ready for bed. And for some of my residents, the nurse aid interaction is the only interaction they get. Our elderly deserve more. I'm sorry you have had issues with other long term care nurses, and I know I see the words "Not all" but it still really unappreciated in general, because I think ALL nurses and CNAs work hard! We all care for the physical and emotional needs for people when are the most vulnerable versions of themselves, and that will always be a job in itself. But I wouldn't have it any other way!!

I unfortunately am going through a similar situation. You seem to have a heart of gold and really care for your patients. Find a facility that appreciates that. Unfortunately from the sounds of it, a lot of SNF are taking higher acuity patients and increasing the nurse to patient ratio. I wish you the best in your future. Wherever you go next will be lucky to have a nurse like you! :)

Thank you both for your responses. I am so torn between resigning, and not resigning. At this point I feel as though I would be happier working doing anything else. And that is so saddening. I LOVE these residents. So so much. But I cry most nights because they beg me to not leave them alone after I finish their treatments because they're afraid nobody will come back for them. But then I think that if I leave, where does that leave the residents that I love so much? I also struggle with another nurse. She is extremely rude to me, and has several times called me "a stupid idiot" in report, in front of other staff, residents, and occasionally their families. I will suggest a Tx plan for a resident that I feel may work for them, and she laughs and says that's ridiculous. And then brings it to the DNS as her own idea. I am so conflicted at this time.

I agree with you to an extent. But at my job, we have HS pass. So we have from 630-1030pm to do the medications and tx. I took that as prioritize your important medications, and come back to your medications that don't need to be given as early. As for dressing changes, of course I'm going to follow the providers order with changes. A lot of times wound changes are scheduled for mornings, if it's 1x a day. If BID, TID, QID then prioritize those as well. Is the dressing CDI? Are they in pain? If both of those are a no, move along and come back to it. Doesn't mean not do it. Just how I took it. :-) I am still learning daily what I should do first. I am starting to get a routine, but a lot of times something happens that interferes with it (a fall, feeding tubes clogged, patients want to speak with me, bed alarms go off, etc.) and then I'm trying to jump back into where I was. Lol. But thank you both for the advice, and I can see where you're coming from, CapeCodMermaid. People do find it OK to skip things or take short cuts so often in the nursing homes, and that is part of what bothers me. The residents tell me they feel rushed, or they feel like nobody answers their lights in a timely manner. And it's sad.

Thank you! This really is helpful!! I appreciate it!

Thank you! I appreciate it!

I work for a smaller company. We are a 34 bed facility, and we have one floor nurse on at all times. More nurses are there during the day because the director of nursing is there, and the case manager. But I am the only licensed nurse on at night. There is also only one nursing assistant from 11-6. There are a lot more high need patients then before, and it is becoming difficult to provide care for all these residents.

Thank you! It has, very much! They told me it can be excused because technically there must be a licensed staff on at all times. But if time allows, I may take a break to eat at my desk, but I can't leave the floor. And I can't punch out.

Hi! I work 12 hours and am not allowed to clock out at all during those times, let alone leave the nurses station.

I am the only licensed staff when I work so I am not allowed to leave the floor. I can not take breaks or give baths. The CNAs are expected to do them. So they used to give 5 or 6 baths and put all 30 residents to bed. There are 2 aids on evenings and 1 at night. I used to put 4 or 5 residents to bed and help with lifts, but now we have so many high acuity patients that I am not able to help put residents to bed, do my med pass, and treatments like I used to. I am barely finishing my med pass and treatments at 1045pm.

About your comment about asking another nurse. I have asked the day shift nurse, and she has no complaints. But when I look at the charting, I see that the case manager has done several treatments for her. The other night nurse has called me for help four times in the last seven days. Thank you for your advice!!

Thank you for your advice! I have mentioned several times that we need more staff to assist on the evening shift as well as the night shift since we only get one aid then! They continue to tell me that the budget is exceeded and no other staff can be brought in. Not to mention there is no other staff at this time. I feel like I'm almost there already. I feel so sad that these residents aren't getting the care they deserve.

Hi all! I graduated from LPN school in May, and passed boards two weeks after graduation. I had a job at a LTC facility, and from the day I passed boards, I have been working. We have approximately 30 residents, and many right now are acute. PICC, IVs, Wounds, GJ Tubes, PEGs, NGs, etc! Typically, I get two aids if I'm lucky. We are required to do 5 baths, and sometimes I don't get a TMA. I end up putting 4 or 5 residents to bed at night, while trying to get them their medications and treatments. I recently had a few days off, and when I told them I wouldn't be able to work, they continued to ask about other shifts. 12 missed messages worth of begging me to work. I tell them no, and they continue to ask. Not to mention I only received 4 days of orientation as a new grad. Most nights, I feel so overwhelmed. I feel like I am a failure of a nurse. This facility is paying for me to advance my education, and I am very grateful. But my heart breaks most days because I feel as though I am failing my CNAs and residents, who I think deserve so much more. Any tips or advice from people who were in similar situations?? Did you stay or find a new job?