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How many are too many?


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That's interesting.. I would be curious. I know as a nurse I felt like 4 was plenty to keep me busy but that was in hospitals. I think it makes it really hard/unsafe to be spread too thin. Mornique how many residents do you have on an average shift? 

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1 hour ago, Tanny said:

That's interesting.. I would be curious. I know as a nurse I felt like 4 was plenty to keep me busy but that was in hospitals. I think it makes it really hard/unsafe to be spread too thin. Mornique how many residents do you have on an average shift? 

On average about 16. I've gone to some facilities they give you a full double hallway with just you and the nurse to attend to 20+ residents.

I honestly think it's crazy TX doesn't have a nursing ratio to patient's. Which can be very overwhelming especially on first shift. With all the get up, meals, bathing toileting and answering call lights. 

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4 hours ago, Mornique Dicey said:

On average about 16. I've gone to some facilities they give you a full double hallway with just you and the nurse to attend to 20+ residents.

I honestly think it's crazy TX doesn't have a nursing ratio to patient's. Which can be very overwhelming especially on first shift. With all the get up, meals, bathing toileting and answering call lights. 

Yes that's insane! How do you manage your time and stay safe and sane? 

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34 minutes ago, Montana Hiltbrand said:

Yes that's insane! How do you manage your time and stay safe and sane? 

😅 when I go to a new or fairly new facility at the start of my shift if it's an AM. I ask the nurse who needs to be up for breakfast, the showers for the days, if anyone has appointments. Start there then take it one resident at a time. When I feel overwhelmed I kill that feeling with kindness and sing, "I'm trying my best, trying my best, doodoo that's all I can do." I'm a very positive outgoing person with high energy so it does balance out. Sometimes I do spend a bit of break charting just to get it out of the way.

Edited by Mornique Dicey
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15 minutes ago, Mornique Dicey said:

😅 when I go to a new or fairly new facility at the start of my shift if it's an AM. I ask the nurse who needs to be up for breakfast, the showers for the days, if anyone has appointments. Start there then take it one resident at a time. When I feel overwhelmed I kill that feeling with kindness and sing, "I'm trying my best, trying my best, doodoo that's all I can do." I'm a very positive outgoing person with high energy so it does balance out. Sometimes I do spend a bit of break charting just to get it out of the way.

I love this! So glad you shared. Hearing other people's routines/tips and tricks helps a ton. 

 

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I'd say even 10-12, often times at facilities I'm the one that shows up while everyone else doesn't. A few weeks ago I was stuck with 40 residents by myself, the nurses just sat there, I couldn't leave and who would I call at 10pm? They had about 6 hoyers and 10 with serious behavior issues, 5 sit to stands, and several female only resudents who felt uncomfortable with men in the room, saying nasty things all night to me. What to do right?

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I think you would have been able to contact nursa to let them know what was going on. This immediately doubles the people you have on your side. Once nursa knows, they will discuss your options.  They will also be the ones who can contact the admin of the facility. They will relay the information you have given and also can suggest to the facility what they could/should do in this situation. After that, if there continued to be clinicians just sitting there and capable of helping, but still didn't...it could very well turn into a reportable patient safety issue.

So, first if you don't get any help and it's so obvious that those people are "getting off" on watching you panic while doing the best you can, knowing you can't perform those cares where 2 people are mandatory (such as hoyer lifts), and it results in delay of patient care...at least you have made the effort. It won't be you in trouble when it comes to being neglectful...it may be helpful to log the names and positions of those sitting by and allowing you to do it all...i could see this also riding the line of bullying in the workplace/creating a hostile work environment.

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Also, don't be afraid after your shift to write up an "after action report" to give to Nursa. This will give much needed information that may lead to Nursa pulling our people out of there. It will help you emotionally as well.

Never perform tasks that are unsafe...if you don't have another person to help with the transfer (hoyer), you can not do it...bottom line.

I'm sorry this happened to you. They should be ashamed of themselves (but they probably won't be...anyone who had an ounce off decency would have helped you.)

Edited by Kimberly Griffin4804500565
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I have really only been to one facility in my entire career where they staff according to acuity. Depending on the requirement of attention and effort of others is computated into an equation. This is truly the fairest way there is. You could have an entire hallway of walkie talkies and the only thing they need is a reminder to use the toilet, stay out of other peoples rooms, stay on unit, easy peasy.

The other person with higher acuity patients would get fewer of them knowing their patients need more of their attention.

 

my point being its not the quantity of patients rather the acuity of the quantity is a better judge of dividing and allocating resources.

 

perfect example...med surg may have 6 patients whereas someone working ICU would have only 2 assigned patients they are responsible for. Acuity.

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