Is this normal? LTC/Psych Ratio

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    Hi everyone,

    I just started my first job as a CNA in a skilled nursing facility. The floor is mostly dementia and a psych unit. The past couple of days I've had 17 residents on 3rd shift, about 12 are incontinent and all of them wear briefs. The other CNAs said usually the ratio is 1:21. Is this normal for a facility with residents who need such special attention?

    I guess the reason I'm asking is because I've had trouble managing my time with my rounds, getting my people up, doing my charting, and everything in between. I've had to stay almost an hour after my shift, and clocking out to finish charting.
    I want to do a good job and give my residents the care and attention that they deserve, but even if i start my last round at 4 I'm still struggling near the end.. I'm very discouraged and feel like I'm letting my residents down. Any advice is appreciated.
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  4. 0
    Normal, I don't know, but common? YES.

    My facility is severely mentally and physically handicapped kids and young adults...they are 100 percent total care, 100 percent incontinent, and 90 percent unable to position themselves. Some of the more physically able ones have a lot of behaviors and require a lot of attention. On a fully staffed night, we have 18-20 each. If we're short, which is not uncommon, it's much worse.

    And yeah, it's really hard sometimes, especially on certain rounds when it seems like every single person is a disaster. That's what the other shifts don't understand when they gripe that 3rd shift sits around doing nothing all night.

    If your charting is in paper form and not on a computer, it helps to do most of it at the beginning of the shift. I do that, and just add intake and output at the end. Saves me time at the end when I'm trying to get my kids up and dressed and make sure everyone else is dry.
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    I work night shift, and there are 60 residents divided by 3 cna's on a unit. That leaves us with 20 a piece. Usually 10-15 of my residents are incontinent. Others may ring the light if they need assistance to the toilet or bedpan. You'll notice some days may be harder than others. And in time, you will develop your own pace and routine.
  6. 0
    Quote from lscarecrowe
    Hi everyone,

    I just started my first job as a CNA in a skilled nursing facility. The floor is mostly dementia and a psych unit. The past couple of days I've had 17 residents on 3rd shift, about 12 are incontinent and all of them wear briefs. The other CNAs said usually the ratio is 1:21. Is this normal for a facility with residents who need such special attention?

    I guess the reason I'm asking is because I've had trouble managing my time with my rounds, getting my people up, doing my charting, and everything in between. I've had to stay almost an hour after my shift, and clocking out to finish charting.
    I want to do a good job and give my residents the care and attention that they deserve, but even if i start my last round at 4 I'm still struggling near the end.. I'm very discouraged and feel like I'm letting my residents down. Any advice is appreciated.
    I work with dementia residents in an Alzheimer's/dementia unit housing 12 people with 2 aides on duty during most of the day. 3rd shift has only 1 aide and that person also takes care of 2 - 4 extra people on that shift, making the ratio 1:16. There are a couple of people in our unit who can never be unsupervised unless they are in their bed with an alarm on to alert if they try to get out of bed. One of the reasons our unit has 2 aides on staff for most of the day is because we are required to provide not only assistance with activities of daily living (everyone in our unit is incontinent to some degree and all wear briefs), but also diversional activities like singing, exercise, crafts, baking cookies etc., to the residents who want to participate. There's never really an idle moment.

    You WILL get better and faster and more efficient, all it takes is practice. Everyone starts out feeling really slow in the beginning because there's so much to learn about time management.
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    I am in the same situation with 60 residents split between 2 cna's. I am also a new CNA and I love the work but have never felt more discouraged about a job in my life. I have tried different ways to do all that I have to do but still fall short. I will go in again tonight and try again. I was happy to hear I am not the only one that feels this way. I don't know how management expects us to get all our rounds done plus washing chairs, filling ice doing linens, answering call lights, giving showers and doing vitals. I thought I was good at time management but this is ridiculous!
  8. 1
    ^Geez. At my facility, 3rd shift has 2-3 CNAs on a 30-person hall and they are not required to do any of that stuff aside from rounds and vitals. No washing chairs, doing linens, or filling ice and certainly no showers! They are not even required to do AM care on anyone or get any people up. So they don't. They read newspapers and magazines, clip coupons, do puzzles, etc. and leave the mess of papers for dayshift to clean up. I have even seen people reading novels. But based on what I've read here my facility is the exception to the rule. 21 total care residents does not sound uncommon in other facilities. It's just that everyone is slow when they first start out.
    sandcastle64 likes this.
  9. 0
    Now I realize there are so many more questions I should have asked. Next time I will not forget. Your facility sounds wonderful.
  10. 0
    Wonderful for them, not so wonderful for the other shifts.


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