Refusing unsafe workload?

Nurses General Nursing

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I'm a new grad working in a nursing home. On nights, I have 120 residents under my care (with 4 CNAs). I can manage this relatively well on most nights. However, last night, I had 3 palliative residents (highly unusual), and I was asked to pick up an extra "area" of the nursing home, meaning I would have 165 residents.

I refused, telling the supervisor that I knew, especially as a new graduate, I could not handle this workload, especially with the 3 palliative residents that were receiving injections left and right to keep them comfortable.

The supervisor was speechless. I'm not sure anyone has ever refused extra residents before at this nursing home.

My question is: did I do the right thing? Is this something you all could get reprimanded for?

What are our rights in regards to refusing patient overload?

Specializes in Geriatrics, Transplant, Education.

I would run, do not walk, far away from this job. Scary.

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Thanks for your replies. I'm currently looking for another job while working here. Which sucks, because the pay is good, the benefits and pension plan are even better....

I like the job itself, but obviously feel quite unsafe at times with the patient load.

There's a medical clinic looking for a medical assistant...I'm thinking of applying. I live in a small town, so my options are limited for lpn jobs. I think it would at least be safer working there.

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Specializes in M/S, ICU, ICP.

i sort of understand. i was the only nurse for a 90 bed acute care nursing home with a 120 bed assisted living facility attached. it was always a blessing when the other nurse worked and we could split the facilty and get it all done. we had 5 assistants for the two areas and you would walk a good mile each time you did full rounds there and that was every 2 hours.

med pass on nights was steady with dressing changes, but there were nights somone would turn bad or fall and the transfer and calling the doctors could keep you swamped for a hour or more and get yu behind.

it was doable. but lord help us if we didn't all work as a team, and i mean the nurse had to have the hearts and trust of the assistants and work right along with them. you still being new made the right decision and bravo that you spoke up. :yeah:

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I'm a new grad working in a nursing home. On nights, I have 120 residents under my care (with 4 CNAs). I can manage this relatively well on most nights. However, last night, I had 3 palliative residents (highly unusual), and I was asked to pick up an extra "area" of the nursing home, meaning I would have 165 residents.

WOW! did i read that right? 120-165 patients! how scary! makes me almost thankful for my miserable 6 tele medsurg pts with zero tech position every night!:eek:

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Wow. 165 residents? Even 120 sounds like way too many to be responsible for, even on that particular shift. I had 60 when I worked the 11 to 7 shift, and I was busy the whole shift.

One thing I'm curious about is how only around 10 of them have scheduled meds on that shift. That's it? In my experience, almost every resident seemed to be on Synthroid or Prilosec, so most of them on that shift needed to be medicated.

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Specializes in chemical dependency detox/psych.
Thanks for your replies. I'm currently looking for another job while working here. Which sucks, because the pay is good, the benefits and pension plan are even better....

I like the job itself, but obviously feel quite unsafe at times with the patient load.

There's a medical clinic looking for a medical assistant...I'm thinking of applying. I live in a small town, so my options are limited for lpn jobs. I think it would at least be safer working there.

Let me get this straight: You are an LPN, and it's only you and 4 CNA's for 120 patients? Is there no RN in house? Holy crap. That would not fly in my state...you have to have at least 1 RN in the building at all times. How on earth do you actually toilet and turn that many residents in a shift...or I would imagine that you don't. How awful for you and the poor people that will likely be incontinent and/or develop pressure sores.

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Specializes in ICU/ER/L&D.

I would rather work minimum wage than someplace like that. I couldn't adequately care for 165 customers at a RESTAURANT, more or less 165 patients whose lives are in my hands. I like my license too well to agree to that. I hope you will find someplace that is more reasonable to work soon.

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Good for you! What happened? Did someone else come in to work?

I work in a 50 bed and there is one nurse and 2 cnas. I have a ton of 6 or 7 am meds to pass and a few 12ams and of the prns.

How is your load so light?

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wow 120.....amazing. My state also requires an RN in building for 100 pts. But i recently had a friend who is new grad RN accepted a job at SNF with 80 pts. A large portion of those had am meds, drsg changes and blood sugars. She found she couldnt handle it and quit. Guess what they hired two LVNs to replace her. That is an unreasonable workload, but employers know its a buyers market at this time. People are desperate and they are banking on our need to pay bills and keep a roof over our heads.

Good luck to you in your search.

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