I work nights and that's about my ratio. One CNA, me, and 40 patients. During the day it's 2 nurses and 2 CNAs.
It's super tough. The 6am med pass has me in cold sweats, especially when I realize the 7am shift is filing in and I haven't finished, or even recorded report!
Our Unit Manager is pretty good, but last night she sent a rehab pt with chest pains to ER and everyone had to go help. I was in tears bcs it took so much out of my shift. Same thing if we have a fall. Everyone has to go assist, so you feel like you're losing time and of course you're terrified of what's happening on your own floor.
It feels like if everything goes perfectly, I have time to provide competent care to my patients. But when does everything go perfectly in nursing? :P
And yes the paperwork is brutal, the docs specifically ask that you don't call them, and breaks are automatically deducted, even though I've never taken one. I just factor the half hour into some of the time I take to finish up. Even though I'm usually there another half hour after that.
But at the end of the day (or beginning... whatever) I know that I am on my way to becoming a skilled geriatric nurse, and hopefully someday I'll actually feel like a nurse and not a med passing, note writing, perpetually panicking disaster.
As long as everyone is safe and free from infection, I feel ok when I click out.