Are most LTC understaffed? Are most nurses in LTC overworked, understaffed? - page 2

I am a recent grad and my first job was in a LTC facility..I have to say that the facility was understaffed..The nurse who worked there even told me that it is an understaffed facility..I know the... Read More

  1. by   Bala Shark
    Quote from CHATSDALE
    the ratio would not be bad depending on the type of patient

    i have worked in a mostly mental ltc, the aides would make sure that the residents took a bath, made thir way to dining hall..
    we had a lot of meds but the txs were few except for an occasional resident who would need post surg care

    i have also worked in facilities where there were numerus tube feeding, residents who had difficulty swallowing and pills had t be crushed. and decub tx which were very time consuming...charting was done on all iddm
    tube feeders, res with tx, and any with out of line sx like temps, diarreha etc.. the aids were good about working together on bed baths and cllean ups but on spoon feeding we always tried to help when it was possible because of the time factor

    yo can't compare ltc c ltc too many varibles
    Yes, I believe you are right..The place I worked at, there was so many things to do..And as I said before, I knew the place was understaffed if things that suppose to be done were not done..That involved all the nurses and not only me..Actually the PM shift was a lot easier and 2 nurses to 49 patients was adequate but things were not done that suppose to be done on that shift also..I guess the LTC vets would know what I am talking about..
  2. by   butterfly26pn
    I onced worked in a LTC facility as a CNA and CMA where the nurse/pt ration was 1/60 now that is too much! They did have a treatment nurse and a CMA to pass meds and do treatments but still you know there is always something going on with the patients to keep you tied up. The nurse was always running and staying late to finish up. I love LTC and would jump right back in as a nurse if I could find one with a 1/25 ratio, sounds like heaven , that is if your not passing meds and doing treatments.
  3. by   withasmilelpn
    We have 56 patients between 2 nurses on a LTC unit. However it seems like only about half are stable. We have constant admissions and discharges, many skilled patients and some of the rehab people that they don't have room at the moment - hip replacements, knees, picc lines, psych patients, etc. They now expect us to keep people here that we would prefer to send out, because we are 'capable' of taking care of them-ie: start IVs, nebs, portable xrays etc. All of these things I am more than capable of doing (and have done). But if they are really in distress, I can not monitor them. That is not safe and not LTC! But our corporate office apparently grills the DON about 'unnecessary' discharges. I was told the ambulance ride was our 'bonuses'!
    Hey its my license and my patient that matter to me!
    'LTC' has totally changed over the ten years I've been doing it and not for the better!
    Last edit by withasmilelpn on Jan 13, '07
  4. by   WahooRN08
    In the LTC facility I work in PRN, on the SNF/Intensive Rehab-Sub Acute unit we have 3-4 nurses (LPN's/RN) for average 40-60 patients, plus 6-8 CNA's on 7-3/3-11. On 11-7 there are 2 LPN's and 3 CNA's. For the NF floors there are 3 LPN/RN's for 7-3/3-11 sometimes 4 on 7-3, none are including nurse managers. with adequate CNA coverage. This is a rare find though. Most industries in healthcare are understaffed, just comes with the territory. You have to think of the work load....meds to 30 people may sound like a lot, but if that is your only responsibility during the shift it's not too bad. Just from my experience though. It gives you time to hit the floor and help the aides with the level of nurse coverage you have.
  5. by   enfermera3
    So your saying there are no state mandated min.-max nurse/pt. ratios?
  6. by   TheCommuter
    Quote from enfermera3
    So your saying there are no state mandated min.-max nurse/pt. ratios?
    California is the only state that has ratios for nurses. In addition, the California state-mandated nurse/patient ratios apply only to acute care facilities (hospitals). Nursing homes and other extended care facilities do not have ratios.
  7. by   CHATSDALE
    smile, if they said that the ambulances were your bonuses, did you really receive significant bonuses etc whether or not your residents required hospitalizion
  8. by   withasmilelpn
    Chatsdaleur facility was just taken over last march by another corporation. The DON that made the comment just started 3 months ago. (She's lasted longer than everyone else they hired so far!) Now she had worked for them before, so true or not I have'nt seen a bonus or a raise yet. I'm taking a wait and see approach with them. Some of the changes the company brought are good. But I've been told they have justify to corporate every day their census...Regardless, money isn't everything!
    Last edit by withasmilelpn on Jan 15, '07
  9. by   CapeCodMermaid
    Quote from CHATSDALE
    there was an article in readers digest that addressed this problem a month or so ago...apparently this is a problem all over the country
    i have worked at ltc and they USUALLY had staffing problems...if someone quit they took their time replacing, if someone called in there was some limp efforts to call someone but basically staff were expected to cover
    as long as their are money hungry owners/don/administrators...the owners offer the don and the administrator bonus if they come in under budget
    and they will cut corners that do no good to residents or staff
    Please do not paint all DONs with the same broad brush. We spend literally hours trying to fill call outs and most DONs I know do NOT get a bonus based on staff budget.
  10. by   withasmilelpn
    :wink2: CapeCodMermaid I just want to tell you that I definitely know all DON's aren't the same. In fact I've noticed from your posts that you are someone I would like very much to work with! Being a DON has got to be one of the most frustrating, thankless, scary jobs there is!
  11. by   CapeCodMermaid
    Thanks..I quit my job today! I have had it with LTC and the rules and regulations and stupid administrators and the list goes on and on...but I appreciate your kind words.
  12. by   Lizzy6
    Quote from ingelein
    Until there are state or federally MANDATED nurse patient/ ratios in place, LTCs will allways be understaffed. Corporate GREED wont get any better.Human nature.
    Yep, totally agree. I worked as staff many years ago, then went agency, & pretty much worked all the LTC facilities in my area. Love the pt's, but each & every one all seem understaffed and most were out of supplies. Sad isn't it.
  13. by   Plagueis
    Yep, most LTCs are understaffed, at the nursing and aide levels. It's pathetic that there are around 17,000 nursing homes with over 1 million residents depending on them for care, but most of them are not getting the adequate amount of attention from nurses and CNAs because of the lack of staffing. Why aren't there federal, or at least state-mandated ratios for nursing homes? Do people, for example, really think that a CNA can take care of 20-30 residents on a 8-hour shift? I have a hard enough time with 12!

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