are they serious ?

Specialties Geriatric

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45 pts and I am by myself more than twice a week ? This means I have to pass meds and do txs and paperwork and call the doc for orders and keep our wandering pts from wandering .This can't be normal .:nono:

Yes we have aides . And I still find it totally unacceptable ! To be honest there is not time to do everything that is neccesary . I leave often feeling like I failed . Ah well time to buck up baby girl everyone says . I just started and feel like I am ready to quit .

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I work in a subacute facility - 11-7. Last night it was myself with 3 LNA's, not the usual two. I had meds at midnight, 2am, 4am, and 6am. I had 55 residents, 3 of them tube feeders, a chest tube, and the wandering sleepless sufferers of dementia thrown in. We answered 155 lights, and corporate thinks that people sleep at night? I had to insist on another nurse coming in at 5am to help. Luckily, I work per diem so I can or cannot work, my choice. I still manage to work full-time there. That is a typical 11-7 shift.

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Yes..our home uses the mobility alarms, tag alarms and wanderguard alarms. ( they signal if patient going out the front door. ) they do work well though and we find ourseves out in the parking lot quit a bit each week going after someone! as far as staffing, I am the night nurse for 70 residents on three wings.( both long term care and a Mediare wing) I have three very good CNA's, one on each wing full time. I never worked so hard anywhere in 35 years as I do at this job. Charting has been the big challenge for me...over the years I can see this has becocme a main issue for nursing homes...and I have been their worst night mare , as i love being out with my patients and not behind th desk charting! but I am getting there and they tell me my nurses notes tell a good story of what I do for them...it is all the other data we have to chart about, other than in our notes that bogs my mind! If I did everything I was suppose to do in charting, i wouldn't even get to see and assess the residents.

another big change i see in nursing homes...they are very high level care anymore...with patients coming back from hospitals with feeding pumps, IV's, nebulizer treatments..and so forth...I had 15 neb treatments one moring to start...and as you know, there is more involved in giving a neb treatment than turning it on..you do breath sounds, saO2's and how they are assessment wise after the treatment ..then to document it. Yes, it is a big job..but a wonderful place to work..these are such speical people I care for. .

Your work load is unreal. I don't know how you do it.

You must have an endless supply of energy.

15 NEB treatments would take half the night.

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Feel fortunate Marie.. I'm classified as "charge nurse" and an LPN. I share responsibility for over 60 plus residents, both skilled/non skilled, dementia/non dementia, ambulatory/nonambulatory. We are responsibile for med passes, treatments, incident reports, admissions and/or readmissions, nebs tx's. We have feeding tubes with feedings to hang and monitor, labs to be drawn with accompanying paperwork completed. We sometimes have to help feed, clothe, bathe, and change residents, monitor the telephones, meet with families, and supervise three cna's (if we're lucky to have 3). We have to do employee training, gather needed supplies, take phone orders, and take off any orders left by dietary, P.T., O.T. or the P.A. There are times a patient has wanted an ice cream and we have gone out and bought it. I have never seen any of the management R.N.'s come to the floor and help with a med pass, pass out a meal tray, or help deal with an irate family member.

One night, we smelled something burning, called the Director of Environmental Services to alert her we had called the Fire Department to come out and do a walk through. She simply asked that we call her back to tell her what they found!!!!!

If not me who?

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I didn't mean to insinuate the DON works the floor a lot, but she has worked a night shift on the weekend when were are really short. We are down 7 nurses right now. I worked 10 to 2 as the supervisor today, and may have to go in tommorrow. All administration nursing staff (MDS, Unit Managers, Infection control/restorative, and the weekend and evening supervisors) have to take turns being the on call nurse a week at a time, and this week is my turn. It's been horrible with so many nurses out. Any one want to work in Ft. Myers fl???

Sorry, couldn't resist. When we are on call, we have to find someone to work, or cover the shift ourselves. It really works most of the time. But there are times no one else is available and we have to do the shift. I don't mind, at least the residents get what they need.

I can't believe the ratios of nurse to staff I am reading about on this thread. Florida must have stricter staffing standards. It's based on hours required for the nurses and CNA's to care for the residents. We have a 107 bed facility, and 4 nurses on days and 3-11 and 3 on 11-7. CNA's are 12 to 13 for 7-3 and 3-11 and 5-7 on nights. Plus on days we have unit managers, staff developement, and others who all pitch in to help. I feel real lucky now to be where I am.

Marie

WOW I'm impressed with your staffing. I am a DON in a facility of 123 beds and we staff 3 nurses on days, 3 on PMs, and 2 on nights. (granted 24 of these beds are assisted living and we only pass the meds). I have many nurses come and go because the stress is too high. I have it in my budget to add 1 more nurse a day but you have to get them in the door first. I was until recently working ALOT of hours. Many of the staff asked if I lived there. But I will not let the residents go without. One payperiod of 2 weeks I worked 172 hours. Just shy of a double a day. But it was every day for about 21 days in a row. And just for all my hard work the state came in and sited us 10 tags because the "paperwork" was incomplete. I told my administrator that I will always put the residents first in all that I do and the paperwork can wait. In response I have been instructed that I can no longer work the floor AT ALL. I must get the "paperwork" back in order. The problem I had was that I was not just nursing, I was dietary, housekeeping, and occasionally maintenance advisor. We are currently in the Plan of Correction period and it is stressful. And to add to the stress. Staff is dropping like flies because they don't like our new owners and the things that we have to do to put the building back into compliance.

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Specializes in Geriatrics/Med-Surg/ED.

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Specializes in Geriatrics/Med-Surg/ED.
Why is it ok for people to get personal phone calls at work if its not an emergency? If they were working manufacturing or another job, they wouldnt have that luxury. Take a message and let the staff get back to them on their break. You have more important things to do than be the staff switchboard operator. If your busy, they should be too and its not time for personal calls unless someone is sick, injured, dying or their house is on fire.

That said, i know there are a lot of latch-key kids out there, i was one and my kids were too, but there has to be a limit on why they call. A phone call to make evening arrangements isnt necissary. Calls from daycare about next weeks fundraiser arent necissary. Calls from friends about the fight with their husbands and/or boyfriends arent necissary. Come on people why do we allow this kind of bulony.

I think there should be a limit to the number of personal phone calls you can receive at work. We have one nurse who gets an average of a phone call every hour to hour an half all day long!! Our manager made a new rule that personal phone calls be limited to one/day unless there is an emergency or family crisis. I think this is more than generous!! It's really annoying & unprofessional to have someone you're relying on always on the phone everytime you turn around. It's also unfair to patients. The last hospital I worked at specified no phone calls unless an emergency- our secretary took a message and we could call the person back on our break/lunch, whatever.

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Specializes in Gerontology, Med surg, Home Health.
I work in a subacute facility - 11-7. Last night it was myself with 3 LNA's, not the usual two. I had meds at midnight, 2am, 4am, and 6am. I had 55 residents, 3 of them tube feeders, a chest tube, and the wandering sleepless sufferers of dementia thrown in. We answered 155 lights, and corporate thinks that people sleep at night? I had to insist on another nurse coming in at 5am to help. Luckily, I work per diem so I can or cannot work, my choice. I still manage to work full-time there. That is a typical 11-7 shift.

You need to call your pharmacy consultant. NO ONE should be woken up at midnight or 2 or 4 am. Cripes..these people need to get sleep to recover.

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I never allowed personal phone calls. I put an end to it very quickly. I had enough to do without policing the rest of the staff. The nurses station got phone calls for the entire facility if there was no one at the reception desk or in the office to answer, particularly after hours or on the weekends. Calls came in from people inquiring about residents, hours we were open, directions to the place, and other business calls. It seems like they always came in groups and always when we were farthest from the nurses station with the med cart in tow.

Daytonite - that was one of my real irritations when I still worked - personal phone calls - when I worked at the hospital, I would see people go searching thru the whole unit for someone to take a personal phone call. I would ask to take a message - if they didn't want to leave one, it wasn't important.

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Hospital nurses think that the "toss aways" end up as SNF or LTC nurses but guess what-- LTC/SNF nurses rock and have to do much better assessment, organization and priotization than hospital nurses. YOU guys really do rock the world and your residents love thier nurses.

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Our DON said she got in trouble by the state for scheduling herself as part of the staff once at another home..she is not to be working on the floor in place of another nurse that should have been there. she is great about helping with the orders and pitching in but pretty much sticks to her responsibilities...which is a good thing too...she has many!

DON's in CO who have liscence for 120 beds or more are not allowed to work the floor. When I help out on the floor I am there as an extra set of hands and eyes and ears. I do assessment, chart and am available for the staff always. When I am on call I cover for CNA's just not officially as a member on the schedule, JUST DO IT.

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Specializes in Licensed Practical Nurse.
Boy am I glad I work were I do. We have 2 nurses for 50 residents, and 6 CNA's. The unit managers help out on the floor, as do the MDS staff, and myself. I have seen our DON out passing meds, and she told the administrator to butt out or go get his nursing license. i sometimes feel as if I work in a zoo and the inmates are running it. But we all work together. Not a perfect paradise, we do have our problems, and we fight amongst ourselves, but heaven help the person who messes with one of us since we will all take him/her on!!!

Marie:lol2:

Boy you're lucky, 2 nurses!!, Its just me and 40 resident's meds, huh! lucky, lucky!!

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