Fran-RN

yea, now what can we discuss. HMMM?

Staffing ratios should depend on the acuity of the residents. Unlike a rose there arer esident s and then there are RESIDENTS. Passing meds to 40 residents seems unreasonable to me. you have a 2 hr span which leaves you 3 min per resident. I guess it's possible but not reasonable. The CNA ratio sounds fair but they won't be able to helpwith your responsibilities. My 2 cents worth.

We ( LTC nurses) do what the families and MD's tell us. Many people choose DNR status but when the family sees Grandma dying they demand you do something, any thing. and frequently after calling the MD, their response is" send them to ER for eval." We don't like it either , but kind of stuck . Many people still think we can keep people alive forever.

I have been MDS coord at 2 different facilities and am applying for that position at my current employer. I really like the job if they will let me do it and not expect 20 other duties. My last job I had 4 job titles with all the duties and responsibilities to go along with them. The current MDS coord ( where I am applying), never is pulled to the floor, no overtime, no extra duties. well, we'll see. I think the MDS is a great tool and I have seen results from the assessment, but most people do look at it as more busy work. LTC ,the job we all love to hate.

hello to all, in long term care medication aides have been used for years. Yes, the nurse is responsible for what they do. I'm not sure the public is aware of this, even some of the other CNA s are not aware that the QMAs have the same training they do except for a few hours of training in medications. they are usually trained for PO meds only. The CNA training is basically the same as the first semester in nursing training. Basic patient care. but all of that is crammed into 105 hrs. They also have to pass a written and skills test that is administered by an independent agency. They are trained to do vital signs and what normals are and to report abnormals to the nurse. Then it is the nurse's job to assess the situation and decide what to do. In long term care there is usually 1 nurse to 20-40 pts. so we have to have assistants. they are a valuable assest to the nurse. but as in any other profession there are good ones and bad ones. I don't think Qs should be used in acute care.

AnotherRN, don't give up. As Aimee said, you need a plan for your day. I have done the same sort of thing at several different facilities and it really helps keep you focused. I also try to do organization type work when we aren't as busy, so that when we are busy, we can find things. ie, filling out ID data on lab requisition slips on all the residents and keeping master copies. If you are crushed for time on lab days this can save your sanity. I also had to learn to attend to my duties first and let the CNAs handle theirs. I found that I was doing a lot of their work then couldn't get mine done! Of course I always help them if they need help but no one else can do the things I'm responsible for. Right now I am blessed with a good CNA crew. Good luck. Keep smiling, it makes people wonder what you're up to.

Long term care RN, work 8 hrs night on Fri, and 12 hrs night on Sat and Sun. Bring home around $1000/ 2 weeks. have $200 out for insurance and every tax imaginable out. This facility also has pay in leiu of benefits. If you don't want ins, vacation pay, etc, then they add 15% to your base pay. In this area there are places that pay a little more and places that pay a little less. As you have all said we are all underpaid for knowledge, and responsibility we have.

I agree with TIM , try working as a CNA. You get some good basic nursing experience. and it will give you a perspective on the cna's role when you become a nurse. good luck.

I would not change my charting. but the night nurse could possibly have checked on this resident more frequently than the original documentation showed. we do not always document every time we check on a resident as every one knows. If you are caring for 20-40 residents this is impossible. I work nights at a LTC facility and my residents are seen at least every 2 hrs but sometimes they are not charted on for a week except for flow sheets.