What do you do when......

Specialties Geriatric

Published

You run out of time at the end of the day and your work is not done? I will work a 12 hour shift, and stay an hour late and things are still not finished (mostly the little treatments, like creams and skin preps).

I don't want to falsify documentation, but I know the bosses will be mad if I leave it blank or circle it. If you do circle it, what do you write on the back as a reason? "Ran out of time, too much work, too little staff" seems inappropriate! LOL

So what do you do?

I run my butt off the whole time I am at work.... no smoke breaks, no personal calls, no sitting idle at the nurses station. I take a 30 minute lunch because it is required by corporate and my sanity.

Seems like every new admit we get is another AC/HS blood sugar check with QID neb tx.

I have tried talking to my supervisors about this, but I am always brushed off. They always respond that I just need to "improve my skills". And no, I am not the only nurse who struggles with this at our facility. Actually, I am pretty much the only nurse who even looks at/signs the tx book. Sometimes I will give a treatment to a patient and they tell me that I am the only one who ever does it (not surprising). And everybody else skips doing things like changing foley catheters, so I have to catch up on that during my shift.

I just dont know what to do. Its the classic LTC situation of having too much work for too few staff. I feel so bad when I am rushing through my blood sugars, and the residents want me to chat or help them with a little chore or give a PRN med. I am just frantic to get out of the room and onto the next person because its pretty much impossible to finish 22 blood sugars in 1 hour (especially when half the people are across the building at bingo)

GRRRRRRR!!!!! SO frustrated!! I am really ready to get out of LTC and into a better work situation.

Help me!

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Specializes in Trauma/Tele/Surgery/SICU.

Rainbows,

I think this is a situation many of us nurses deal with whether it be in a hospital setting or a LTC or anywhere. I tried at first to fight it and complain to managers etc. until I realized that they really do not care. It is not the actual care they are concerned about it is the appearance of the care. We are stretched to the breaking point for a reason. Somewhere in an office some bean counter has devised an equation showing just how far you can stretch staff and figured out a tidy cost analysis of which is cheaper: lawsuits vs. nursing staff.

Maybe I am paranoid or bitter or both but I just here it from too many nurses not to believe this is not done on purpose. They used to be able to say hey theres a nursing shortage, but that is no longer true. Reference the mulitple posts on AN about new grads that just cannot find jobs.

22 blood sugars in one hour? I don't think it can be done unless you line the patients up like cattle and do one after another, with a no talking rule in place.

This comment from you really broke my heart " I take a 30 minute lunch because it is required by corporate and my sanity." You deserve that 30 minute lunch (And a lot more, I might add) and you do not have to justify why you took it. Why is abuse of staff so interwoven into the culture of nursing? Improving your skills, or improving your time management skills is management speak for "your the problem" which is another way to make us feel guilty and create self-doubt. You see how the other nurses in your facility are getting there work done...they just don't do it so the problem is not that you need improved skills, you need a reduced load.

Will a change of job help? I don't know. I would tell you to investigate very diligently the next facility you apply to. You may end up finding what a lot of other nurses find when they jump ship: it is just different scenery but the situation is largely still the same.

I wish you the best of luck on your journey.

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Specializes in Vascular Neurology and Neurocritical Care.

This is the problem with LTC. They are too cheap to hire enough nurses and expect that nurses can somehow be in millions of places at one time. It is shocking how stupid some nurse managers can be! They act like they don't understand the stresses of being a floor nurse. They're just so out of touch with reality. I am sorry you have this experience. Management should realize that when people don't have time to CHANGE A FOLEY, there is something seriously wrong. The longer you have a foley, the higher the chance for an infection, requiring more meds, which requires more expenditures to pay for the meds. It would be a much cheaper option to just hire more staff.

Hope you find a better job. This is why I am determined to stay away from LTC (unless of course, I'm fired and the only people who will have me is LTC).

Best wishes,

JE

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Specializes in LTC/Skilled Care/Rehab.

If the residents have consistenly good blood sugars I talk to the MD or NP about reducing the number of accuchecks per day. Why poke someone 4x a day when they are never over 150? I often feel the same way as you. I never have time during my day to finish everything that needs to be done. And the dayshift nurses generally don't take a lunch because there is absolutely no time! After I am finished with my 9 am med pass it is time for accuchecks and then insulin and then 1p and 12p meds and then 2p heparin and then relaying labs and carrying out orders the MDs have written. I really love most of my coworkers and residents but my sanity can't take this anymore. I have told management that this job is literally impossible. There is no way to pass all the meds we have to pass in 2 hours. They keep saying they are looking for more help but it shouldn't be that difficult in this economy. With more and more people going into LTC something has to change. Just wanted to let you know that you aren't alone (((HUGS)))

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Specializes in Vascular Neurology and Neurocritical Care.

My question is this... Don't any of you work at facilities where there are PCTs, CNAs, or some sort of nurse's aid. At the hospital where I work, the PCT (patient care tech) checks blood sugars, vitals, does bathing, cleaning, toileting, turning, and can, if the RN is comfortable, D/C foleys (only the PCTs who are nursing students do that).

I am so surprised at the number of nurses here that are so bogged down with things that management should be having the aides do. Not that nurses are too good to do them, but at some point, something has got to give, and it can't be med passes, assessments, patient education about meds prior to discharge, etc.

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Specializes in LTC/Skilled Care/Rehab.

The CNA where I work at don't do vitals or accuchecks. I'm not sure why, they just don't. Once in a while I will ask a CNA to check a residents temp if we are keeps a close watch on the temps. We don't have a unit secretary either so the nurse are responsible for answering the phones (even during med pass). I don't feel like I'm too good to do any of the above things but it is almost impossible with 25+ residents to pass meds to. No wonder there is such a high turnover rate!

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Specializes in Vascular Neurology and Neurocritical Care.

Wow, a CNA not doing even vitals! What does he/she do, then? That's a major part of the job.

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Specializes in ICU & LTAC as RN. FNP.

It's frightening how I read so many posts by LTC nurses who have the same common complaint...not enough time, too many patients, etc. It's a common theme in most places. When are nurse managers ever going to help correct this problem? Do they even have the authority? I know the same situation applies in pretty much all healthcare facilities too.

I really hope one day that nursing will not be the resources that companies feel they can just keep cutting and cutting. Working someone to the point of exhaustion, no bathroom breaks, missed lunches, and having to decide which corners to cut does nothing but lower morale, and eventually forces good nurses out of bad situations. That goes for CNAs and others too.

I wish you well OP!

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Specializes in Med surg, LTC, Administration.

Nurse managers in LTC are there for paper compliance. They really have no power over schedules, work loads, staffing, etc. Back in the day, nurse managers were Managers, but that has slowly changed in the last four or five years.

Edit: this is directed to above post.

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Specializes in Vents.

It is very common in the place that I work to have too many tasks and not enough time. I have often received help from other nurses who have finished with their tasks. It is also very common for us to stay over passed our shift to finish any tx, paperwork, or admissions that we did not finish during our shift. It doesn't seem fair to have to stay over but we do what we have to to ensure that we get the job done. As for a CNA not getting vitals, I have never heard of that! Our CNAs do not D/C F/Cs or do FSBS but they do assist in many other tasks. Just hang in there and hopefully things will get better for you. Best Wishes!

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Specializes in Geriatric/Sub Acute, Home Care.
You run out of time at the end of the day and your work is not done? I will work a 12 hour shift, and stay an hour late and things are still not finished (mostly the little treatments, like creams and skin preps).

I don't want to falsify documentation, but I know the bosses will be mad if I leave it blank or circle it. If you do circle it, what do you write on the back as a reason? "Ran out of time, too much work, too little staff" seems inappropriate! LOL

So what do you do?

I run my butt off the whole time I am at work.... no smoke breaks, no personal calls, no sitting idle at the nurses station. I take a 30 minute lunch because it is required by corporate and my sanity.

Seems like every new admit we get is another AC/HS blood sugar check with QID neb tx.

I have tried talking to my supervisors about this, but I am always brushed off. They always respond that I just need to "improve my skills". And no, I am not the only nurse who struggles with this at our facility. Actually, I am pretty much the only nurse who even looks at/signs the tx book. Sometimes I will give a treatment to a patient and they tell me that I am the only one who ever does it (not surprising). And everybody else skips doing things like changing foley catheters, so I have to catch up on that during my shift.

I just dont know what to do. Its the classic LTC situation of having too much work for too few staff. I feel so bad when I am rushing through my blood sugars, and the residents want me to chat or help them with a little chore or give a PRN med. I am just frantic to get out of the room and onto the next person because its pretty much impossible to finish 22 blood sugars in 1 hour (especially when half the people are across the building at bingo)

GRRRRRRR!!!!! SO frustrated!! I am really ready to get out of LTC and into a better work situation.

Help me![

Up Vote Up Vote ×
Specializes in Geriatric/Sub Acute, Home Care.
You run out of time at the end of the day and your work is not done? I will work a 12 hour shift, and stay an hour late and things are still not finished (mostly the little treatments, like creams and skin preps).

I don't want to falsify documentation, but I know the bosses will be mad if I leave it blank or circle it. If you do circle it, what do you write on the back as a reason? "Ran out of time, too much work, too little staff" seems inappropriate! LOL

So what do you do?

I run my butt off the whole time I am at work.... no smoke breaks, no personal calls, no sitting idle at the nurses station. I take a 30 minute lunch because it is required by corporate and my sanity.

Seems like every new admit we get is another AC/HS blood sugar check with QID neb tx.

I have tried talking to my supervisors about this, but I am always brushed off. They always respond that I just need to "improve my skills". And no, I am not the only nurse who struggles with this at our facility. Actually, I am pretty much the only nurse who even looks at/signs the tx book. Sometimes I will give a treatment to a patient and they tell me that I am the only one who ever does it (not surprising). And everybody else skips doing things like changing foley catheters, so I have to catch up on that during my shift.

I just dont know what to do. Its the classic LTC situation of having too much work for too few staff. I feel so bad when I am rushing through my blood sugars, and the residents want me to chat or help them with a little chore or give a PRN med. I am just frantic to get out of the room and onto the next person because its pretty much impossible to finish 22 blood sugars in 1 hour (especially when half the people are across the building at bingo)

GRRRRRRR!!!!! SO frustrated!! I am really ready to get out of LTC and into a better work situation.

Help me![

LilDolphin I can totally relate to the frustration you are going through. I am an RN and have went through the ringer trying to get my work done. And its so true, you always seem to GET MORE when you are just coming around the corner to completion.

I have 17 years of LTC/Sub acute experience with some home care behind me. I dont want to discourage you but I have had it with that side of nursing. My bosses were deaf to my complaints. They just walked around most times not giving a helping hand. Most of their jobs were paperwork and contact with family and outside resources. But......I have moved from my homestate recently which I couldnt find a different job in nursing for a long time. And plus most facilities require a BSN now........I dont have the time nor the energy or money to do that. I am all ears if you would like to continue our chat. I can tell you stories man.!!!!! lumbarpain

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