gingah828

Hi all, Just wanted a little advice. I am still a fairly new nurse and have been mostly in home health, private duty. I just started a new position with sub acute rehab facility. I have been working only PRN as this facility is going through the start up phase of opening , for the past several weeks I am scheduled once or twice weekly for 8 or 12 hours. I can go 5 days without being scheduled and in the meantime, we will have at least 2 or 3 new admissions. Last Sat I was scheduled as the only nurse with 2 CNAs for 10 patients, one being on hospice and at least 3 bordering on instability, fluid overload, kidney failure, stroke recovery, etc. This is with virtually no additional assistance from other units as this is the only operating unit in this new facility. I get that I will not only be responsible for being charge nurse plus med pass and assisting with transfers, toileting, etc. I also understand that the ratio in sub acute rehab is 15:1. We are now at 15 patients as of yesterday and the overwhelm just continues for me as these people are really sick. I understand this is the way it is but we are also expected to run to the kitchen and deliver hot food, water, fulfill demanding requests from guests who are told they are going to be admitted into a "resort" facility. We even use glass carafes and glasses which seems like a significant safety issue to me. The long and the short of it is that I am wondering if you have any advice on how to approach management as well as just basic survival tips. I have already let management know I am no longer comfortable with being the only nurse on the floor especially since we are now at the cut-off ratio of 15:1. Corporate is being greedy in terms of scheduling, hours, etc. So, I am not given enough consistency especially as a new nurse to this setting to feel like I am even getting a strong enough foothold to provide safe nursing as well as protecting my license. Thanks in advance for any thoughts, suggestions.

I am planning to keep my foot in the door if all goes well. I have been working with a Lennox Gestalt patient for 9 months now, I will likely stay with him as I continue to move forward with other pursuits. I do appreciate your insight as it confirms what I have been thinking myself.

Thank you! I trust that is the truth. Those were my thoughts exactly. Although, I am not sure how the agency feels. Time will tell. I'm not PDN is for me.

Thank you for your insight, caliotter3. I have taken your suggestion. It was really helpful. I appreciate the time you took to respond. I have decided to forego this case.

Just wondering what are reasonable expectations that family should have of their nurses. For example, first day on the job had to jump the father's car to transport the patient to his appt for the day, unless that is a recurring problem, not unreasonable. Second day, dad forgets patient has school and has to be out front for the bus on time, leaves the home. Normally, he will take the chair upstairs (we're in the basement) to use the ramp through the garage door. I called his cell and he told me to take the child's wheelchair out the back and push it up the hilly and unstable yard through the gate to the front of the home. This is unsafe for the kids and not exactly safe for me either. Any experiential input is appreciated. I have enough experience in home care to understand there is a certain amount of psychosocial nursing involved. Anyways, thanks in advance for your help.

Thank you for your response. This would be on the side and it is for service that my current agency does not provide. I will check in with my current agency before I decide to move forward with it. Thanks, again!

Hi all, Is it a conflict of interest to provide private duty nursing for a client that I know from a home health agency I currently work for? The agency I work for does not provide private duty shift nursing service, only intermittent home visits. Any assistance, shared experience is appreciated. Thank you in advance.

This morning I typed in nursing school and depression and found this post. Thank you. I am struggling big time with this and today is my final exam in mental health. Well, I know what I don't want to be and that is a psych nurse. I was already depressed before this rotation and I am finding that I lack motivation and I really just want to quit at times. This post helped a lot. It is good to know that I am not alone.

Hello Fuzzy, I can really relate with your situation. Although, I have not been 'diagnosed' Bipolar, I struggle with the highs and lows, PTSD (like many people on this planet) and anxiety/depression issues. I am also 49, going through the change. I realize you posted a couple of years ago, just thought you should know that it is appreciated and you're not alone. I am taking it a day at a time, trying to be honest with myself about my limitations, practicing journaling/meditation, and slowing down. Writing down my fears helps too, so that they don't unconsciously run my life. Succumbing to the fact that I need help and seeking it with an open mind also helps. One day at a time. I have been in the healthcare profession as a CNA/MA for 15 years and have found that making the transition to 'thinking like a nurse' is more challenging than I realized going in. I am in my first year of a BSN program, one more year to go! Just taking it all in and working to be own BFF is helpful, conserving my energy and being as flexible as I can helps too. I am not always good at all of these practices, I just try to utilize the different tools I have at my disposal (in my little bag of tricks, so to speak). Anyways, thanks again for your post and best wishes to you! Fuzzy and Frazzled