How many CNA's work

  1. on your units? I am applying for a job at a ltc facility and I want to know what I am in for. I have heard scarry stories about being the only cna for 30 patients or worse? How does this work out ? I was taought never to turn a patient on my own but if their is noone else available to help, what do you do? I want to do a good job but I also know how important keeping my back in good condition is. I need my back for a few more years yet. Do the nurses do rounds with the cna's. What is expected of the cna's in your facilities? thank you for the information.
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  2. 19 Comments

  3. by   CoachCathy
    In our area, you can see staffing at 8-12 patients on days, 12-15 patients on evenings and 15-20 patients on nights. We strongly inform our staff to use the "lift alerts" to protect their backs. Alot of times on nights, the aides will do as much as they can with the resident, and then will "buddy up" with either another aide or the nurse to finish up. Be sure that you protect your back!!
  4. by   Paprikat
    Hi. At my work: 2 floors 58 intermediate, 72 "independant"
    Days/Evenings - 4 care aides 58 intermediate level
    Days/Evenings - 2 care aides 72 independant level
    Nights - 2 care aides/58 residents (intermediate level)
    Nights - 1 care aide/72 independant level

    These are absolutley ridiculous levels. Bare bones staff. These girls work their butts off! These so called independant people are worse than the intermediate ones!! Some of these people are very demanding of the care aides. They are excellent team workers and help each other out all the time. There are two nurses on days and evenings, one per floor and we just don't have the time to help the care aides much, but I will never walk past a call bell, though, I will answer it, some nurses won't. Night shifts are worse! One nurse to the whole building. She is supposed to help the care aide with the 72 people with rounds.
    If a resident becomes a mechanical lift, they are considered extended care. We do not to two person transfers anymore, they will use the lift and then they will be assessed and transfered.
    I hope this doesn't scare you...the care aides also have some down time to relax, evenings are quiet at nine, nights can be hectic, but there is more down time there than on days and eves.
    The care aides are amazing team workers!
  5. by   momrn50
    On a 60 bed floor, 8 cna's on dayturn, 7 on afternoon plus a 4-10 float, 4 on midnight shift. Some nurses will do rounds, some don't, mostly because we just don't have the time...our place is pretty good on teamwork, so it works out pretty well
  6. by   km rn
    Our staffing is as follows:

    Days: 2 nurses and 6 CNAs for 48 residents
    PMs: 2 nurses and 6 CNAs for 48 residents
    Nights: 1 nurse and 2 CNAs for 48 residents.
  7. by   night owl
    On our 60 bed unit, we have:

    3-4 RN's, +1-LPN, +4-5 CNA's on days
    2 RN's, +1-2 LPN's, +3-4 CNA's on evenings
    1 RN, (2 RN's one night a week), +1 LPN, +3-4 CNA's on midnights (one CNA is for 1:1 for fall precautions on each shift)

    I'd say 3/4 are total care, 1/4 self care
    I work midnights so after report myself and the RN make rounds on our residents. The CNA's also check their assigned res. to see if they are soiled. They are supposed to make rounds q30 minutes (to check if they're breathing) q2hrs to check for soiling and turning. Your back is of utmost importance! ALWAYS get help when turning if you cannot do it alone. If you cannot get the help, a sure way to turn a pt by yourself is pretty simple. Take the arm that is closest to you and drape it over the pt's chest. Then take the leg closest to you and bend it up so that the sole of the foot is on the mattress. Then simply push the pt over on his side by pushing the shoulder and the bent leg. It really doesn't take much effort and you could turn a +300 lb. pt alone. I've been doing it for 25 years and I still have my back...(watch tonight...I'll mess it up... **sigh**
    CNA's are expected to do their work which is pt. care. For our shift (12-8) that entails a.m. care for approx. 20 residents which really begins at around 0430, washing and changing them, some have to be dressed and out of bed, others stay in bed. There are vital signs to be taken and charted in the computer, weights that have to be taken by the 10th of each month and charted in the computer, and then there are the breakfast trays...some need to be fed, others just need assistance. If anyone is on restraints, the CNA's have to fill out the restraint log sheets q 2hrs and hand them in at the end of the shift with their SIGNED assignment sheets. Our CNA's also change the tube feeding bags and do the tube feedings. Out of 20 res. maybe 1-2 are tube feedings, 10-12 are total care and are incontinent, 3-4 need to be turned, 3-4 need to be fed, and 3-5 need to be dressed and placed in w/c, or geri chairs. Breakfast arrives on the unit at about 7am., some go to the dining room by themselves. Oh, and the incoming CNA checks the roster with the CNA that's going off duty.
    Hope this gives you some sort of an idea of what you're in for. Good luck to you!
  8. by   RNIAM
    Oh my gosh, sorry but I had no idea the ratio was so low? Call me crazy but I cannot see doing this at all. It seems dangerous at best. Why is the staffing so poor? I am a night shift person as I have children at home. I can't imagine some of the ratios being discussed here. A ratio of 1:10 is reasonable for total care patients. I could maybe do 5 more independants as they only require help prn. I can't imagine turn/positoning patient q2hrs? exaxtly how much time does that give you with each resident,not to mention those patients who decide to go bad on you?
    sorry but I was trained to do back care ,provide oral care/liquids/toilet/change/comb hair even (although the last one was done only if it was evedently necessary.)Then put on top vitals/bathing/dressing for am etc...oh boy!
    How can good care be given...I guess I got my education just in the nick of time.
    thank you everyone
    thank you everyone for the information
  9. by   RNIAM
    oops maybe that was the ratio is so high??hmm not sure
  10. by   CoachCathy
    Rhona - you also have to remember that on night shift, most of the residents are asleep and may not need to be changed q2h. If the resident is dry, then only turning and repositioning is needed. Back care, oral care, combing hair, etc. is done on one round (usually the first or the last). The other two rounds, the residents are usually asleep and don't require them. When residents go bad, the nurses are there to step in. It's a busy time, no matter what shift you work. Organization is the key. take care
  11. by   RNIAM
    CoachCathy
    Although you are right that some resident may not need to be changed q2hr, the certainly may need to be turned and positioned q2hr(for skin breakdown). I know there is that thought that noone does anything on nightshift but trust me that is far from the truth. I work as a PCt at a local hospital. I can tell you I work plenty hard.There is less staff and that equals more work. oral care at my place of work is done twice,first and last rounds, back care on immobile patients are also done twice. As far as the nurses being there to step in for a patient going bad, well I have also had to be right there to help with whatever was needed. When you have a skeleton staff,you quickly become a jack of all trades.
  12. by   ltc
    Our units are anywhere from 37-39 residents per unit.
    SNF has Full time Nurse Manager, Part-time Asst. Nurse Manager
    Minimum 2 staff nurses, 5 CNA's, Full time unit secretary, Res. Service Tech, 4 hrs a day Mon-Fri (makes beds, water pitchers, straighten closets, transport, pass trays) for Day Shift.
    Eve- 2 nurses and 4 cna's Nights- 1 nurse and 2 cna's.
  13. by   mtgirl63
    What I wouldn't do to have 7 CNA's on the floor for afternoon shift where I work!!!!
    We are a 60 bed facility and the staffing is supposed to be:
    days: 2 nurses and 7 CNA's
    afternoons: 2 nurses and 4 CNA's plus 1 or 2 1/2 shift aides.
    nocs: 1 nurse and 2 CNA's

    What we often get:
    days: 2 nurses and 3, 4 or 5 CNA's
    afternoons: 2 nurses and 2 or 3 aides, and occassionally 1 o 2 1/2 shift aides
    nocs: 1 nurse and 2 aides

    There's been times when noc's have had only one aide and believe it or not --- the administrator will go in and work 3 or 4 hours doing as much as he can. He's been known to make beds, change wet beds, pass gowns, and has helped res. to the bathroom a time or two as well.
    At times on afternoons we have had only 2 aides and once again the administrator has come in (week-ends and holidays included) and helped get res. to and from the dining room, served out the coffee and water for dinner, and passed trays for dinner.
    Funny thing is --- our D.O.N. has never done that!!

    It's a shame that our CNA's have to work with inadequate staffing so often. Right now staffing is a little better and I told them to enjoy and make the best of it while it lasts. The maddening part is that I really believe staffing is only adequate because they're anticipating state to come in any day now. GRRRRRRRR.
  14. by   GreytNurse
    OMG..........

    Some of you 'have it made'......
    .......some have 8 CNA's for 60 pts.......
    .......some have 6 CNA's for 48 pts...... WOWIEEEEE!!

    Where I 'used' to work...in a skilled MC facility, we would have, at most, 4 CNA's for 60 on days. Remember, this is a skilled fac. w/ post surgery pts, MAJOR wound care pts.....etc...... Most of the time we would have 3 CNA's......1 for each hall of 30 pts. and one of the CNA's would be 'split', taking half of each hall. These girls had to get most of these pts. up (if indicated) showered, dressed and ready for breakfast (in the diningroom) in 1hr 45 min. You talk about superwomen!!!!!!!
    I now work in a brand new facility, ICF and so far, we only have 3 pts......I LOVE IT!! We are adding slow and staffing as we go. We have 1 nurse and 2 cna's on days and evenings and 1 nurse 1cna on nights. I am the night charge and the main problem right now is boredom.....we are checking on these pts. all the time (they are getting spoiled ) washing everything in site, waxing floors, organizing charts, you name it......I'm taking advantage of this as I know it won't last forever.
    We need national reform to set limits on ratios!! I know some legislature is in front of Pres. Bush right now.....let's all hope and pray it passes. But, the one big problem I see right now, connected to the staffing shortage is $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
    Our CNA's work their butts off and are paid embarrassing wages.......I admire all of them and if it were up to me, they would all be making $20 hour!!:kiss

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