REALLY????!!!!!

[Younglpn87]

I work at a multipurpose facility on the LTC floor, I switched fro 7-3 to 3-11 for various reasons, when I switched the administration decided to start a new policy to have us go from three nurses per unit down to two, which would be fine if you know that was not almost 40 patients per nurse, plus all of their treatments, plus documentation of a few of the skilled unit residents we have on our floor. I and other nurses have voiced our opinion to the administrator about this, and he just shrugs us off, not to mention instead of five CNAs we are working with four sometimes three.....REALLY??? And now the families are starting to complain about it and we are catching it from the head boss, literally a week ago I told him and his office that this was going to cause problems, he says we should be able to do everything in the allotted time, I looked at him and asked him if he was ever a nurse or ever a CNA, it is more than passing medication, it is about caring for our residents who are not here because they need a place to stay, they are here because they can not remember if they took their medications or they will fall if they try to shower themselves, we are here for them not for the tiny paycheck or for the little benefits or to sit down and do nothing. My residents need me to be focused on them not on how am I going to get out on time so I do not get wrote up for overtime. All this weekend I was on the Skilled unit good experience for me, but we are supposed to have the more experience nurses on the skilled unit, this is my first facility job, ever, and I have been only working there since this summer. Does anyone else understand my frustrations?

[bluegeegoo2, LPN]

Not to sound cold, but welcome to Long Term Care. It's mostly about time management. Most LTC resident's are stable, so by default do not need much attention from us. You can easily "assess" your resident's as you're passing their meds. A quick visual assessment plus asking a couple questions (how are you feeling today? Etc.) will let you quickly know that that resident is in good shape at the moment then you move on to the next. If they're not doing well, but not emergent, you make a mental note to come back to them when time allows. Staffing is always an issue, and will likely remain that way. When I first graduated I used to chart these delicious notes will full assessments. Very time consuming. Now I hit the high points and move on, rarely charting more than 3 lines unless it involves a sig change or I/A report. It takes time to become efficient at getting through a shift. LTC won't change, (for the better anyway) but you will become better at handling your assignment. I have worked in at least a dozen different buildings between 2 states and while some are better than others, they are all basically the same. The grass isn't much greener on the other side, in other words. At least in my experience.

[Younglpn87]

Maybe your right maybe I should look at it from the business stand point but as a nurse its kinda hard to look at my patients as dollar signs

[bluegeegoo2, LPN]

It is hard, and remains hard to know that our primary purpose is to document for Medicare/Medicaid/pvt ins. reimbursement. I still routinely get irritated at things my facility (and past facilities) have said and done that remind me that it's all about the money. Census is the be-all-end-all buzzword of a facility. It kills me. These are PEOPLE for Pete's sake! Yet, they're herded around like cattle and largely ignored by staff but we are supposed to "keep them in the building." I remember having that realization, that it is about the money. All of the "care" and everything we do all leads to the almighty dollar. But, I still love my LTC people, so I keep trying. I hope I don't get so cynical that I give up on the whole thing one day. I am glad to know that there are other nurses like you who care as well. It helps.