Hello everyone. I'm new to this forum, have been an LPN for a year and a half, Work PT for OBGYN doing phone triage and PT at SNF. 3-11 shift: 1 LPN (myself) 4 CNAs, no other staff on unit, just us with 40 residents, many have acute respiratory failure, at least 20 have BP checks twice on my shift at 6 and 9, O2 sats for 15 pts, BIPAPs at 10 for two residents, then half the floor is assist x2 so if I need an aides help to turn a resident for assesment or such it would be a twenty minute wait at least, There are 12 with GT's currently, but have had 15 a few weeks ago, 10 or more residents with NEB TX some 6 and 9, and some 4, 2 at 6 and one at 9. Currently 2 residents on 2 different IV ABTs at 6 and 10, one resident on IVF, constant transfers to hospital for anything and everything, constant admissions and readmissions (we never have an empty bed for more then a few hours). Oh, and calling MDs for X-ray and sono reviews, calling to review labs, putting in new orders and d/c'ing old ones, ordering meds from pharmacy many of which need to be faxed over, labs calling me constantly to make sure I got the labs and to re-review them, running to other floors because we never have anything (neb machines break down constantly peg pumps constantly in error, never any IV lines, flushes,), always something not quite right with at least one resident who needs vitals to be monitored constantly, residents with supposed very abnormal baselines as told by Hospital Mds upon transfer, therefore we can't refuse them our care which also means constant monitoring of vitals, and then there's running to the bsement to put endless amounts of stool, sputum, and urine samples for pickup. And of course nurses notes and report, paper filing constantly, consults, psych ortho and podiatry coming in at end of shift to assess residents and then dumping orders on me, dealing with issues of alert residents who just want attention and to be heard, and dealing with family members who have concerns. And the occasional half hour in service.... And I'm sureI'm forgetting something..oh, BS checks and insulin for 7 residents, bs check only for 3 separate.... I don't feel safe for my residents. I've noticed how over the past year the admins have allowed the admittance of very ill patients who are on loads of meds that change constantly, with, at times, daily lab monitorings (I generally get at least four labs every shift and on PT/INR days I get up to 15. The floor is anything but stable. My CNAs are miserable and so am I. I've complained to the supervisor about the working conditions and even he hasn't gotten a response from administration. I've just recently joined 1199, what should I and can I do? I want to protect the residents that have lived there for years and are generally stable but are being neglected care just so the facility can make more money by having "sicker" patients who need much more attention and even skill, then what I alone have. I want to protect the new residents who are almost in a vegetative state from deteriorating even further, I want to protect my aides from physical and mental stress, and I want the same for myself. I also want to make it known that it is unreasonable and unsafe in the given time slot to perform all tasks responsibly with just one LPN and 4 CNAs. (I live in NY)