How many residents is too many for one nurse?

Specialties Geriatric

Published

How many residents is too many residents for one nurse to safely and adequately take care of? Where I work, the nurse has anywhere from 15-25 or 30 residents, depending on what floor/hall they are on. There is two nurses per floor (each floor has the potential to house 55 residents total) on days and afternoons, however on midnights (which is what my regular shift is supposed to be starting tuesday) there is one nurse per floor and 2-3 CNAs. Now, on midnights there isnt as many meds to pass until the 6am med pass, there aren't that many sugars to check, and there aren't a huge number of medicare patients to specifically chart on (the facility's protocol is chart by exception except for medicare patients, patients on antibiotics, patients who have fallen or new admits, and any other condition that requires frequent documentation... which should be all patients in my opinion as there's a reason they are there!). So, I will have, depending on the census, up to 55 patients to myself along with 2-3 CNAs... How on earth can that be safe??? What if one patients begins to decline and I am tied up with them and another one starts to decline... there isn't two of me, and the other nurses in the building wont be able to leave their floor because they are the only ones on their floor too... Granted 911 is a call away and literally 2 minutes up the road, and the hospital is 5 minutes the other direction, but STILL - that's too many patients for one nurse to safely take care of in my opinion. Is it like this is most LTC/SNF facilities? am I being unreasonable?

I worked for the first time last Sunday in LTC. The agency called me about 11:00 the night before and asked if I could take the 7-3 shift. I let them know I had no LTC experience. They assured me if I took the case I would receive orientation and help. that did not happen. I went early for that orientation. I should have left then. But I've never left a job. They did not exactly welcome me there and there was minimal help. Couldn't even find the CNA's. I had 32 patients. about 12 Bloodsugars, Insulin, feeding tubes. 3 very bad patients. One was sent out to the hospital. Worst experience of my life, and I will not go back there. Unfortunately now I am afraid to even try it again in any other facility. This should not have happened. Not only did I feel like my license could be in jeopardy, I was terribly concerned about the care the patients were getting, because this is the norm I was told and as I understand it. Something needs to be changed. There should be laws that restrict the number of patients a nurse is responsible for. There should be something else done. When you have a patient that is about to code, you need help. I don't know where to start with this but I do know something needs to change. In medicine you are suppose to help alleviate human suffering. Not cause it. These people are trapped. They are at our mercy. Our society needs to do more than try to sue the nurses, or the facility. They need to change the way the facility is managed and make sure the residents are taken care of. I am extremely upset about this. My mother was in LTC for a long time years ago. I wasn't a nurse then and did not understand why they couldn't take care of her. I am a nurse now, and I understand, and it haunts me.

Specializes in Oncology.

In LTC I had 50+ residents, some very acute honestly. as it was LTC/SNF and my assignments were spread out over 2 floors. It was miserable. Never working LTC again I hope! The whol LTC system has to change. If a nurse has more than 8 patients, of any kind, ever, period (even ltc) they don't have time to give decent care. Sorry but it's true and we all know it.

Specializes in Med nurse in med-surg., float, HH, and PDN.

An LTC was my ruin and I will NEVER EVER work in one again!!!!!

Specializes in Gerontology, Med surg, Home Health.

No Stars....are you working now? Did you give up nursing to work at Starbucks? Did you lose your license? Ruin is a rather strong word.

Specializes in Med nurse in med-surg., float, HH, and PDN.

No interviews to any applications. Working as a CNA thru an agency. Have gone thru severe depression and just now stabilizing on new meds. Will make one more stab at applying at a few more places. UGH!

Every year our facility makes sure every employee completes an abuse mandatory inservice. The administrator is the designated person to go to to inform about an abuse situation. Neglect is a form of abuse. On the eve shift I am responsible for usually 22 to 25 Residents. I have 2 med passes and 9 - 10 diabetics to do finger sticks and sliding scale coverage on. I an suppose to answer any calls from families, labs or any other calls regarding the Residents. I have to do incident reports on fall, wounds or unusal occurances. I am suppose to order meds and check in any meds that are delivered. I supervise CNAs and sometimes only have 1 CNA so I am suppose to help answer lights too. I am suppose to do exceptional charting and any charting on new, skilled , unusal occurances and in any Residents receiving antibiotics. I am suppose to do treatments and body audits scheduled. If it is humanly impossible to do and things get left undone, then neglect to Residents occurs but goes unrecognized because of either blantant denial or

lack of true understanding. From what I am reading here, this is becoming the norm in LTC. My one break is usually 2 mins to heat my food and 5 min to eat it.

I was very curious. I have been a nurse for 20 years and upon taking a job at the Jail I have been given the med pass duties as well as the blood pressures and diabetics. I have been given these tasks for over 500 that receive meds on a daily basis. It is very hard for me to believe i can be responsible for over 500 people receiving meds and treatments. They give me 12 hours roughly 700 minutes to pull all meds, travel all over the jail over 3 miles a day and give them, chart on them and take all sick calls then come back for treatments. works out to less then a minute and a half per inmate and be responsible for them? Am i wrong or should i be having my head checked to do this?

Specializes in Gerontology, Med surg, Home Health.

YIKES!! I thought 20 patients on a subacute floor was brutal. IMHO there is NO way to safely medicate that many people.

Specializes in Geriatric/Sub Acute, Home Care.

I am burned out. RN charge for over 30 years..have went through the wringer with injuries and now not even being able to function physicaly anymore due to severe short staffing...being habitually hammered on my management and family members. I cut my hours now due to glaucoma and severe vision loss in the left eye....BUT OH NO....don't ask your DON For some type of OTHER work you can do in the facility even though you aren't there as often....they never helped me...but I take care of 30 residents...many don't comprehend or just don't listen to reason. and they are quite capable of doing so. they just don't listen period.....all this patient rights stuff is off the wall too..wheres the nurses rights? when you get hurt and the unit manager says to you..well if you want you can fill out a incident report......

my work place is very very bad.....constant turn over of staff and management for the over 5 years I have been working there.....I do what I can.....I cant do any more than what I have.....I am too seasoned now as a nurse and just want to leave this job and enjoy life a bit.....

I worked at a LTC on the overnight shift in charge of 70 residents.

There were four CNAs.

The residents were low-acuity and not overly needy.

I got out on time nearly every day.

I also worked at a facility where there were 25 residents on my assignment. Medically complex, lots of behaviors, lots of call bell use.

I did NOT get out on time most days.

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