[Ohnurse]

I recently had an assignment in LTC, MRDD for a state-operated facility. On night shift, I was the only nurse for 109 residents (LPN). Many of these residents were court mandated to this facility due to violent behavior. The others were profoundly disabled, and seizures occurred daily. There were few days a resident wasn't sent to the hospital for an injury or illness. Evening shift routinely worked with only 3 LPNs and a rare RN. Staffing was always short due to budget cuts/low pay and the resident population was frightening to most agency nurses due to their behavior.

There were two sets of narcotic drawers for each cottage (7 in all). One was in the main building and had all the routine narcotics, the other was in each individual cottage and contained PRN narcotics including Diastat.
These narcotics were not counted with the evening shift..often they had already left before night shift arrived, because they had been mandated from day shift and wished to leave an hour early. I had to count each box (15) and was told to leave a post-it note if there were any missing or not signed. Luckily for me, the two times there were missing meds on my shift, I found entries on the MAR telling me who gave them and when. The nurses signed them the next day after I left notes everywhere I could.

I now refuse to take any assignment that does not include two nurses counting the narcotics together. I would work with MRDD residents again, but not in the same conditions. I would like responses from anyone with similar experiences!

[MrsTina]

I worked for an agency once...One night they needed me to go to a LTC facility...I got there...and started passing meds...I did count my narcotics with the off going nurse and it was correct..so I started passing meds and I couldn't find a particulare residents meds, so I asked the other nurse that I was working with (She was a staff nurse) if she knew where they could be..she explained that there was a third count and that we both worked off that one for the last six of our patients ...Ok..now the narcotics I asked dont you think we should both count them together just in case there is a screw up...OMG she flipped out on me...she ranted and ranted about how I didn't trust her that the count was right and besides they could tell who screwed up me or her just by whichever residents narcs were off...but I tried to avoid confrontation I counted the narcs my self and it was right...so at the change of shift guess who's narcs where off ...you guessed it MINE ...I know in my heart and mind she did that on purpose...so I had to do a drug screen for them and the next day I had to do one for my agency...since I was a long standing agency nurse they sided with me they had problems from this place long before me and the only reason they sent me there was because this place said that they would not mistreat there nurses...BULL BULL BULL needless to say the agency never did business with them again and my agency helped me file a suit against them, and I won. But I learned you can never trust anyone and I wont accept the keys if the count is not right or they refuse to count..

[Ohnurse]

I enjoy working for the agency, because I have more control over my schedule and the pay rate is a little higher.
But the truth is, you'll spend most of your shifts working in places that cannot keep nurses on staff. I've also worked in places that give the agency nurse two assignments because they are being paid a little more.
I'm becoming more choosy, and will refuse to return to places that jeapordize my license, even if it limits the number of shifts I receive.
I would love to see a union for agency nurses in my state, but it will probably never happen! But it does help if your agency cares if you are abused on the job. Your agency should be applauded!

[lpn181]

I work in an MRDD/LTC facility and have for the past five years. There are times when I am the only license in our building of 65 with 9 of those being basically "forensic". On those nights, I usually still have to pass meds to about half of those individuals and all of the other "nursing responsibilities". More than once I have felt that my license was on the line because the staff on the individual units lies to me. I started out at this facility with an aide position and have since gotten my LPN and am working toward an RN. I truly do care about these people and most of the time they are cared for well, but the state is supposed to shut the facility down next year so things are getting pretty grim. We are shorter now than ever before as far as staffing goes, and most of the nurses, at least on my shift are becoming more and more uncomfortable with what is expected from us and the repercussions it could have.

[Ohnurse]

LPN181,

The facility I was assigned to is one of many large institutions the state is going to close. I've heard from a nurse on staff there will be pay cuts and less staffing, so things will be more grim there too.
They have begun to move many residents into small group homes, which is more homelike, but there has already been an incident between the local police and a former resident. She became violent in the group home, and the staff there, who are not trained to deal with these problems called the police. They tased her, and she died in jail from one of her medical conditions.
I'm afraid the rush to less expensive care will have an adverse effect in the long run.
I KNOW you work very hard! Bless anyone like you who can work with these very special people.

[lpn181]

That sounds terrible! I keep hoping that something will happen to make them change their tune here, but I don't thing it will happen. The governor is supposed to be coming sometime to tour the facility and I keep hoping that if anyone sees just how well they are treated and the quality of care they get maybe we will be able to stay open. We are scheduled to "close the doors" in mid-2006 but they have yet to begin moving individuals out. In fact we are still getting "emergency admits". I will have been there 5 years in just a few months and I think I will be looking for new employment after that, it's just becoming too much for me anymore.

[Aaron C.]

man, being the only nurse for 109 MRDD patients? How many other staff were there? I'd be scared as heck to be that nurse.