So done.

[rainbowsandsunshine]

Makes me sad, but I am so done.

Done with LTC, or maybe just this facility but it is making me sick. Mentally and physically sick. I have so much internal anger... and I am never able to express it at work, so it gets vented out on my poor family.

Our facility is WAY WAY overbudget for staffing. Mostly because they were so understaffed that they kept hiring agency to fill in the gaps (which costs more, of course).

Now their new cost-saving policy is that if somebody calls in sick, you just deal. Other people pick up the slack. Nobody is allowed overtime, and you can forget about picking up those extra non-staffed shifts.

This sounds like a good idea in theory, but not in practice. Today, my fellow nurse had to fill a lower, yet absolutely essential position, so I was the sole nurse for almost 60 patients. And we had 2 admits. In fact, I was so busy that 1 of the admits arrived, and I was not even notified (somebody else must have signed with the EMS). At the end of my shift, the night nurse said that the patient was in their bed... I was certain they had not arrived yet, since I did not know. Turns out, I walked down the hall, and there they were! Now, how is that safe nursing care?

I am so exhausted. I cant even talk about my day with my husband when I come home, because the expletives and cursing are not appropriate in front of my children.

Counting down the days until I find something new

[Nurzelady]

I am so sorry to hear this. How long have you been working there?

[alphabetsoup]

It sounds like it is time to move on if this is affecting your health and your family. Unfortunately, it sounds like this facility is also engaging in some practices that will sooner or later result in 1) an incident that results in a lawsuit 2) some issues with state regulations for safety and staffing 3) both a lawsuit and regulatory issues. It sounds like your regular staffing pattern is too bare minimum already. This is just my thought but do tell the LTC Administrator that you are not able to safely provide care under these conditions. You don't have to tell them that you are looking for another job and leaving, but they do need to be fully aware that you are not able to safely meet their expectation. This is to protect yourself in the event that something does happen and you owe this to the residents under your care. I am sorry if your LTC is having financial difficulties, but they are obligated to provide a safe environment to the residents.

[VivaLasViejas, ASN, RN]

I've said this before, but it bears repeating here: RUN, do not walk, from any employer whose policies put your health, your livelihood, or your license at risk.

Not all nursing facilities are like this, but there are enough bad apples out there spoiling the entire image of LTC that you must research your next potential employer thoroughly before you take a position with them. In the meantime, you may have to protest assignments to your DNS and your administrator in order to avoid being placed in a dangerous situation like what you've described here; there is no way that one nurse can safely care for 60 patients during a day or evening shift with all the needs of today's LTC residents. Accepting such an unsafe assignment without protesting it to the powers could wind up biting you in a VERY uncomfortable place if things hit the fan and someone is harmed as a result.

For instance: What if that new admission you didn't even get a chance to say "Hello" to had fallen out of his/her wheelchair and fractured a hip? Had an MI or a stroke while waiting for attention? Been disoriented and decided to go home, only to be hit by a car 20 feet from the front door of the facility? It's obvious the company that owns/manages your nursing home doesn't care, so it's up to you to look out for yourself because they certainly won't. And when State investigates the incident, your employer will throw you right under a bus because YOU accepted the assignment.

I cannot overemphasize it: As a licensed professional, you have to protect yourself, and sometimes that means doing something that upsets management or even costs you a job. Best to walk away from this one before something terrible happens that winds up costing you everything.

[SammiJoRNBSN]

OMG, that sounds wretched! And I thought it was bad to have 12 patients in sub-acute care and getting 2-3 admissions every night and having to write everything out by hand, on top of dealing with a group of folks that can be labeled as "addicts" or "drug seekers". I finally made the right decision to move to a different position and as soon as I made that decision, it felt like the weight of the world lifted off of my shoulders. I wish you the best of luck and hope you can find something that will better suit you and your family's needs!!! :redpinkhe

[chybabe]

I can totally relate to what you are saying. I'm so glad i'm done with LTC. Loved the residents, HATED the job. The stress was unbearable. Now,i love what i do and hope you find a job you love too :)

[soon2begrad2010]

I can relate,LTC is very stressful,I did LTC for 3 months after I graduated and I would sometimes be in tears from all the duties and having 30 residents,and a unit manager who dare not help any floor nurses at all on the wing I worked on. I now do home health full-time and I love it,and I don't have to constantly worry about losing my license when I go to work everyday because management used to put new nurses on the sub-acute side quite often.

[westieluv]

My heart goes out to you. I would have been in tears and I probably would have quit at the end of that shift and then thought about paying the bills later.

Why are the elderly in our society so undervalued that it's "okay" for them to get this kind of treatment when they are paying huge amounts of money for care that they can't possibly receive with the staffing that we are allowed? I'm right there with the rest of you, I love the residents, I love my co-workers, but I HATE with a passion working in LTC, because all it seems like I do is push pills into an endless line of little old men and ladies who do nothing but sit in their wheelchairs and wait to die. Shouldn't life end in a better way than the system that we have in this country? It's so depressing.

[wintersantanaRN]

So Sorry you are going through this, but sadly this is the case for most long term care facilities. I for one choose not to be a staff nurse at a LTC facitlity cause it is to risky for my license. "60 patients for one nurse" :eek:. Wow

[Forever Sunshine, ASN, RN]

This sounds like a dangerous facility. I would be livid if I found out that the admission arrived and I didn't know about it.

The second that resident gets off the stretcher, we get vitals. I will not pick up the pen to sign for that resident and no other nurse will in my facility.. unless we have vitals and have greeted the resident.

I know the staffing frustration all too well. Sometimes its nurses and I can do the 50 residents if I have to. But don't expect me to do anything at the desk besides CNA assignments and nurses notes. But usually its CNAs my facility is staffing to the below the bare minimum. They accept complex residents who need more care than they think, but with 4 CNAs for 50 residents. Its not working out. Like you said, if someone calls out.. oh well. Now we are 3 CNAs.

[elprup, BSN, RN]

I lasted 7 weeks in LTC and was let go (I believe) for saying toomuch asking to many questions. As a new grad I was told many things that did not happen. I loved the Pts but hated the job too. Sooo glad I am not there. I am in a clinic now with less pay but it is soo much better...and I am learning a ton of stuff. Keep looking. Sadly though somebody will be willing to take your place at the LTC when you leave. It's a vicious circle where the pt looses every time.

[gentlegiver, ASN, LPN, RN]

Makes me sad, but I am so done.This sounds like a good idea in theory, but not in practice. Today, my fellow nurse had to fill a lower, yet absolutely essential position, so I was the sole nurse for almost 60 patients. And we had 2 admits. In fact, I was so busy that 1 of the admits arrived, and I was not even notified (somebody else must have signed with the EMS). At the end of my shift, the night nurse said that the patient was in their bed... I was certain they had not arrived yet, since I did not know. Turns out, I walked down the hall, and there they were! Now, how is that safe nursing care?

EXCUSE ME!!!! I would have Never accepted count knowing I would be responsible for 60 patients during the 7-3 or 3-11 shifts! It would be physically impossible to complete the med passes within the 2hr alotted time (hard enough to do it with 30 patients), to say nothing of PRN's or treatments, answering call bells, answering phones, etc... and keeping your patients safe. And then throw in 2 admitts???? You seriously had your licence put in danger! I would rather lose my job for refusing to take the floor than to endanger my patients and livelyhood by accepting an impossible assignment. Even in LTC you do have the right (and responsibility) to refuse unsafe assignments. I ran into something simular the other day, I was scheduled for a 4 hour shift, (I work per-deim & was returning for an additional shift later that day) management told me to count off with the remaining Nurse, leaving her in charge of 58 patients, I advised her to refuse the assignment, knowing that I could be stuck there until they found a replacement. They "found" someone once she refused the assignment. I would quit that job if they expected me to do this on a daily (or more) basis.

Yes it is true that there are no legal restrictions to the number of patients you can be assigned in LTC. But this is where you use Nursing Judgement, if it seems to be unsafe then it is! Talk to your BON, they will tell you that anything over 30 patients per Nurse is unsafe. We seriously need to have comprehensive limits set on LTC's as to just what they can force on us.