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

Specialties Geriatric

Published

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 is it acceptable to have ONE nurse to fifty patients? I'm job hunting now cause I'm over it. Maybe this is just a rant, but i'm not the only one in the building that is being staffed like this and several more nurses are leaving and Management only want to ***** about the stuff that doesn't get done... :madface:

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.

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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.

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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.

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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.

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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...

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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!

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Specializes in Geriatrics, Home Health.

I did one shift, and only one shift, with 60 patients and 1 aide. It was nights, but old folks wake up early.

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Specializes in psychiatric nursing.

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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I work at a facility that is classified as "assisted living", but is an Alzheimer's/dementia center; the level of acuity hardly feels like assisted living.

With full census we have room for 56, currently we are at 52. I have a med-aid who can pass meds to residents who can self-administer their meds, but any who require assistance the LN has them on their cart.

With tx and meds to do, managing the care staff, and not to mention assessments and incidents, I rarely have time for breaks; I don't mind that very much. Even if I get all my floor stuff done in a timely manner, it still leaves me with all my paperwork and charting to do, physician orders etc. I don't mind staying past my shift to complete everything, but should I be made to feel inadequate because I can't squeeze that all into 8 hours?

It's comforting to read these posts, because I was beginning to think it was just me.

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Specializes in LTC, Education, Management, QAPI.

Wow. That's all I can come up with. On the worst day, our ratios are LPN 1:30, CNA 1:12, and they complain. I should show them this. Now, I remember being on the floor as an LPN a while back with 30 patients. I am fast, too, and it took me from 645-11am to pass meds to 30 patients. They are mixed skills, too. On an average, I'd have 20 NF and 10 skilled, with IV meds, brittle diabetics, pegs, ortho, etc. Also, we have a wound care nurse for our heavy wounds 7 days/week. I cant imagine having 50 to myself on a SNF unit!?!?! I wouldn't go near it!!!

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