How is this acceptable? 50 patients ltc/skilled DAYSHIFT! - page 2

by CynicallyVexed

4,667 Views | 21 Comments

So obviously I work LTC/Skilled facility and the facility itself is nice all private rooms nice furnishings/finishings etc etc, even nursing has computer tars/mars/charts on the med carts.... All the floors have 50 patients. how... Read More


  1. 0
    I just interviewed for a SNF and was told I'd be responsible for 10-12 patients. At least 3 nurses and 2-3 techs on shift for 60ish beds. Is this unheard of?
  2. 3
    I'm actually an LPN in charge of doing medications/treatments/charting of 50 patients as well as charge nurse duties. Each floor is suppose to have two nurses and four months ago I had a second nurse and I no longer do and some of the other floors their nurses have quit as well or out on medical leave and they have yet to hire or replace any of them!!! Things get bypassed I will admit major treatments that require my initials are the only things I have time for. Med pass takes about two and half hours and that's only because I've been there so long I remember most of all of their meds. And I am looking I have applied at 7 other places as of now cause I'm over it and there is NO support, the only time I see management on my floor is cause they found something wrong and want answers. Sometimes I might get somebody that will help me for a total of an hour during a medpass to do a pass pull where I'll pull the meds and they give them, again another big no no I know. Which is another reason I'm leaving.

    Quote from BrandonLPN
    Do you actually have 50 pts all to yourself? Meds and treatments and everything?

    Or is this one of those "I'm the only nurse (RN) for 50 pts...... except for the LPNs who do all the meds and tx" posts?

    If you're really the only nurse, I agree that 50 residents is undoable. The med pass alone would be impossible, let alone dealing with all the little charge nurse "stuff" that pops up.

    If you have LPNs to work the floor, I'd say it's very doable. Not easy, but doable.

    If you're "it" for 50 residents, I'd leave, too. Seems like they spent too much money on all the fancy computers and furniture......
    PriscillaC, BrandonLPN, and Esme12 like this.
  3. 0
    Quote from dolcebellaluna
    I just interviewed for a SNF and was told I'd be responsible for 10-12 patients. At least 3 nurses and 2-3 techs on shift for 60ish beds. Is this unheard of?
    Well, the math isn't quite working out. Even with 4 nurses for 60 beds, that's 15 per nurse. While I realize SNFs don't generally run at 100% census, it sounds like maybe they're giving an optimistic ratio.

    I'd also expect the acuity to be higher with that sort of ratio, or for them to be more complicated patients.
  4. 0
    These facilities like playing with fire giving all these pt to one nurse, tells me that when not if the s--t hits the fan they'll probably throw the nurse under the bus.
  5. 4
    i put my notice in today, going to a different facility and I'm going to be trained as a floor nurse while they are opening up their new rebab/skilled area, when that opens up they are going to make me a restorative nurse coordinator. On dayshift tho the DON told me on bad days at the most I will ever have will be 35 patients, the very least I will have will be 15 and it's a mix of ICF/Skilled. better benefits and pay too. I felt so much relief when she told me I had the job today that I immediately ran back over to my other job and put in my notice. And I probably won't work my notice cause at this point I don't trust them.
    LovedRN, silverbat, snazzy-jazzy, and 1 other like this.
  6. 0
    I still can't figure out how you could go through all the mars, tars, pull cards, do chemstix, give insulin, change dressings etc. on 50 patients in 2 and a half hours. Our AM med pass is 6-10 although you usually can't start till 6:30 because of report and such. With 19 patients it usually takes me 3 hours. I'm on call so I'm frequently working with new residents and it often takes awhile to figure out the new people's meds. Not to mention the ones who will just flat out tell you not to give them meds except at breakfast. Stick your skin checks in there...I don't think its physically possible.
  7. 0
    Quote from dallet6
    I still can't figure out how you could go through all the mars, tars, pull cards, do chemstix, give insulin, change dressings etc. on 50 patients in 2 and a half hours. Our AM med pass is 6-10 although you usually can't start till 6:30 because of report and such. With 19 patients it usually takes me 3 hours. I'm on call so I'm frequently working with new residents and it often takes awhile to figure out the new people's meds. Not to mention the ones who will just flat out tell you not to give them meds except at breakfast. Stick your skin checks in there...I don't think its physically possible.
    My patients never change unless if somebody dies and I get an admit, so I always had the same patients. Which means I remembered their meds. We have computer charting so checking out our mars and tars. During meds I only do meds cause to me those are the most important and we don't have cards we have cassettes with individual dosing like hospitals have. I'm sorry but it is possible to do 50 people's meds in three hours cause me and four other nurses have been doing to for a couple of months now. Chemsticks are done before medpass, skilled therapy and crazy patients that sit on the call light for their narcotics get their meds first, people who take their meds the slowest get theirs last and I stand out side of the room and chart... And again only treatments requiring my initials on their body get done cause time is limited. Btw our med is suppose to be only 8am_10am. So with 25 patients they want you done within that period of time. Sorry it takes you three hours to do 19...
  8. 0
    50 patients to 1 nurse is unsafe! At my SNF I have 2 nurses for 34 patients on the day shift and if they are short or there is a call out I assist with the med pass. But it can get crazy. With treatments orders physicians families it at times is undo able! I agree I am also noticing a trend in not replacing nurses. Frustrating and unsafe! As a nurse manager I voice this concern on a daily basis but I go unheard!
  9. 0
    I did one shift, and only one shift, with 60 patients and 1 aide. It was nights, but old folks wake up early.
  10. 0
    At my facility, I am the only nurse on night shift for 35 people on the rehab side (with 2 aides), and if I am scheduled on the long term side then I have 65 people and 3 aides. I find that being the only RN in the building at night is a disaster waiting to happen, especially for a nurse with less than 1 year experience. Emergencies happen all the time at night on the rehab side, and they happen often on the long term side too. I'm looking for other work, but not finding too much in my area.


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