Understaffing

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Hi I am a registered nurse at an LTC facility in Irvington NJ. I am writing because I need to vent about a recent event that took place. For the pass 4 months we have been severly understaffed in the subacute unit. We are supposed to have three nurses with 20 patients each but lately we have only had two nurses with up to 24 sometimes 27 patients a piece. The accuity has been very high with alot of trachs, g_tubes, IV,s blood sugar checks etc. This particular night on 10\11\18 I went to hang a IV for a patient and tried to flush the PICC line but it was clogged. The supervisor also tried but was unsuccessful. The supervisor informed me that they were having problems with this patients PICC line before. We tried several times to flush it but was unsuccessful. She told me to document it and let them know in the morning about it so they can take care of it. That is exactly what I did. That evening was so overwhelming. I felt so overworked and stressed. I didn't know whether i was coming or going. I did a double shift that night. I also had an emergency where one of my patients coded and died. It was a nightmare. Over a week went by and nothing was said about the patient or his IV not being given. Now today both the administrator and DON called me and spoke to me at the same time saying that what I did was unacceptable and I need to write a statement about what happened. They said they need to talk to me some more about it. I am really scared that I may lose my job. I told about the staffing situation and how overwhelming it was for me that night. They said that is no excuse not to give people the care they need. I told them that they can't expect patients to get good care when we don't have enough staffing. they just don't care. Could I have handled things differently. I appreciate any constructive criticism you have for me. It is getting very dangerous where I work at now. How can I go about this situation?

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I haven't done true sub acute in years, but 20+ seems like a lot.

As far as the IV, why didn't the supervisor step in and call the DR? We've had our IV team come out to check the line and do the declogging/ de-clotting. If there was a med that wasn't given then it would be a med error unless the Dr was notified and you got an order to hold the med until IV access is reestablished.

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I haven't done true sub acute in years, but 20+ seems like a lot.

As far as the IV, why didn't the supervisor step in and call the DR? We've had our IV team come out to check the line and do the declogging/ de-clotting. If there was a med that wasn't given then it would be a med error unless the Dr was notified and you got an order to hold the med until IV access is reestablished.

You are right about that. Thanks for the input. I know what to do next time. I'll be sure not to make that mistake again.

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Specializes in Gerontology, Med surg, Home Health.

24 is too many on a subacute floor. We have 20/1 and that's hard...IVs, trachs, 'special important people', fluid resuscitation, IV push....it's impossible to give good care under these conditions. We're doing med surg nursing with long term care staffing. Hospital nurses wouldn't stand for it.

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You are absolutely right? It is too my? Even 20 patients is too much in my opinion. I have complained many times and so have other nurses? They just do not care. On top of that we never have enough supplies to work. It is very disorangized. I think I just need to find a better place to work. There were many times I came close to punching out and going home but I am scared I will be accused of patient abandonment. I can't continue to have my license in danger. It is time to take a stand.

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