Don't know if I can keep doing it.

2 At my new facility I am almost always on the Skilled Unit. With all the Alert and Oriented, walkie talkies, short term IV ATBs,Wound vacs, with a few demented LOLs and former marine who likes to beat up the CNAs thrown in for good measure. I don't stop from the moment I hit the floor. The majority of the time I have to finish what day shift didn't have time for before I can even start my first med pass. The computer won't allow my to accept the med cart untill everything from days as been "administered.' That unit has 9 4PM accuchecks, plus multiple residents who receieve neb txs with the first med pass. Everyone always wants the pain meds at the same time, I'm being paged to take a phone call a while trying to change a wound vac. It's 5:30 now, and I'm suppose to stop what I'm doing so I can go observe the dining room because there HAS to be a nurse there during all meals. Maybe 10 our of 30 take their pills whole. So I have to take more time to crush everything. It's 9:00 pm and now I have to look up my coumadin doses go downstairs and get them out of the pyxis that literally takes a minute between each screen. And waste 10 more minutes of my time. What's this? No one approved this order, let me stop what I'm doing and and go thru 10 more screens to be able to approve it. Oh yea Mr. Soandso has no oxycontin in the narc drawer, I'll have to go downstairs again, call the pharmacy and sign away my first born child so they will let me take a C2 out of the pyxis. Did I mention I still have about 12 skilled charts to chart in. Or that my failed hip replacemnt needs her 8cm tunnelling wound packed, JP drained and dressing redone. All while taking temps on everyone because you gave out flu vaccines. Plus 348 decided it would be a good idea to yank his foley out. And at the end of it all I still need to tape report, give report and do the never ending narc count. And at the very end you ask if me I want to work over.

It varies on these lines every evening. And someone help me if there is an admission coming, because if one does I'm not getting done till at least 1 am. I haven't taken a lunch break but a handful of times in the almost 2 months that I have worked there. They are severly understaffed and in denial about it. On Friday I worked till 3 AM, there was one CNA for a whole floor of 50 residents. I feel like I can not give these people the care they deserve and get done everything that "they" want done in 8.5 hours. I feel like I am drowning from the moment I get there. Add in taking off orders and entering them into the computer and sometimes having to draw labs. There needs to be another of me to get things done completly. I'm begginning to think that this place and I are not to be even tho I do genuinely like the people who work there and the residents.

I have to tell to the Supervisor when I need an issue addressed and hope they will take the time to call the dr. Sometimes they do,sometimes they don't. I have to throw other people under the bus when I chart,so that i can protect my own license so they can see that I had addressed the subject. That it wasn't me who didn't take care of it.

They expect me to have come in early at least once a week for some type of inservice where the repeatdly tell us how "crappy" the care is that these people are receiving. The DON is condsceding and basically plainly offensive in some siutations. I worked 105 hours last pay period and they still wanted more.

I feel myself getting burnt out already. There are too many things to get done and not enough hours in the shift to get them all accomplished to my standards. I consider myself a competent nurse and don't half do things. I don't know what to do.
I got burnt out just getting through the post. I don't even know what to say except vacation! Or new job?

I know what to do...GET OUT. NOW.

It sounds like a terrible place to work! I wish you could report them to the state for their obvious understaffing. It sounds like you need a new job, I know nursing homes are bad for staffing, worse than hospitals but this is ridiculous!We really need staffing ratios for the nurses and the CNA's and for the dignity and safety of the patients. They deserve treatment, you know the call lights will be going off unanswered with those type of ratios!The nursing homes are mistreating their staff and their patients in their care. I doubt that you can fix things and in the end you'll have to get a different job. I don't think I could last more than one day at that place. I'd have quit a long time ago!

I was about to ask why you would be taking temps when you can delegate but then saw 1 cna for 50 pts!!!! I think my license is much more important to me than the job at this point. You can't even really delegate as you have no staff. Place sounds awful and dangerous. Scary actually.

You can look on medicare site to see how your state nursing homes are staffed and if they are cited. lol, because they can change the staffing grid at any time and then how often do they actually staff by the grid they publish anyway! Also one thing I noticed, either a nursing home will have very high nurse turnover or very high CNA turnover. I always wonder why the difference? Any ideas?

Funny, I thought they were called "Nursing Homes" because you got nursing care there. These types of ratios make it impossible.Get out while you still have your sanity.

I totally relate to your pain, and to your feeling of not doing things half right. I can totally relate to the poor staffing, all of it.I WONDER what this country is really going to do, now that our budget problems are increasing and the amount of people aging into the system is going to increase. I truly see a disaster on the horizon. Totally wishful thinking here, but I wonder why no one takes care of their elderly folks anymore. Seems like so many are in nursing homes full time. What ever happened to families taking care of their parents?? I know it's unreasonable, but what is going to happen as budgets continue to dwindle and staffing gets worse and worse? I feel as if I sometimes bear the weight of the world on my shoulders, as a nurse. No one but nurses and docs can truly see this situation for what it is ...I think the rest of the world, the administrators, the bean counters, the politicians, are in TRUE and utter DENIAL.

soundofmusic, I don't think they are in denial at all. I think they are totally ignorant.

That staffing ratio is deplorable and ludicrious. What a shame.

sweetsleep, I feel your pain. I have been there and done that. Complaining to your administration will only get you fired AFTER they drag you through the mud and kill off every last shred of your spirit. The only way to save your sanity and your nursing license is to get out of there. Good luck.

Tell them to get a part-time QMA for 4 hrs/day. Cheaper than your overtime.

Think of your own license and your whole career down the drain if you will do a fatal mistake because of unsafe workload and staffing. Do you really want to risk what you have worked hard for? Your company won't back you up when you messed up and more likely will blame it on you. If I were you, I'd find another job. Good luck.BTW, I'd been there. I worked in SNF before and resigned due to similar reasons. I told my DON, I cannot afford to risk my license anymore. It's all that I wanted to be (RN).