Is this understaffing (or is it me?)

  1. I recently interviewed at a 120-bed, LTC facility. 118 beds are currently occupied; 16 are a locked Alzheimer's unit and the rest are two wings consisting of fifty + residents.
    I would be working weekend option on nights.
    I asked about the staffing and was told that on my wing (50 + residents), there would be a nurse (me), and 2 nurse aides.
    That's it.

    I feel that is ridiculous.

    They should have a med tech. How in the world do they expect ONE NURSE to pass meds, PROPERLY assess, document, do Medicare charting, handle INCIDENTS (what about treatments??), and all the myriad things that pop up DURING TWELVE HOURS?

    Giving meds to fifty + residents and everything else? Not to mention PRNs...

    I dunno, but it seems to me they need at least a med tech........what do you all think?
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  2. 36 Comments

  3. by   CoffeeRTC
    If this is 11-7 shift it might be okay.... We have 48 residents one nurse and 2 cnas for 11-7. This is doable but then again only 48 residents....how much over 50 do you have? For 3-11 we have 2 nurses (one RN, one LPN) and 4 cnas/ sometimes 3.
  4. by   Town & Country
    Quote from michelle126
    If this is 11-7 shift it might be okay.... We have 48 residents one nurse and 2 cnas for 11-7. This is doable but then again only 48 residents....how much over 50 do you have? For 3-11 we have 2 nurses (one RN, one LPN) and 4 cnas/ sometimes 3.
    It's a twelve hour shift. 7p to 7a. 51 or 52 residents....
  5. by   michelle95
    Well, I would think that 50 patients would be ok with one nurse for 11-7 (I've done it myself) but 7p-7a? You have to do 9pm med pass for 50 folks with one nurse? Nope. Not me.
  6. by   CapeCodMermaid
    We have one nurse and 3 aides on 11-7 for a 60 bed unit. 3-11 there are 2 nurses and 5 or 6 aides. It's a long term floor, hardly ever any medicare patients.
  7. by   donmomofnine
    We have ninety beds with a census that runs around 84. We have a sup and four nurses along with 10 aides for 3-ll. We have a sup, two nurses and five aides for 11-7. On days we have two unit managers, four nurses, a treatment nurse, two unit clerks and twelve aides and two restorative aides and one and a half unit assistants.
  8. by   Destinystar
    in terms of california the staffing ratio is for a 24 hour period. meaning that the the hours that each nurse work are added up then divided by the number of nurses in a 24 hour period to come up with a staffing ratio. the facility can do whatever they want to with that number meaning they could staff heavier on days, lighter on pm's and even less on nocs. it is very important that you know the staffing period on a particular shift before you accept an assignment. every nurse in ltc is different some cant even handle a private duty case and some can handle 60. it also depends on the acuity level. i worked in a psych place where the pts. were ambulatory and continent with no iv's or gt's. mostly routine charting and finger sticks on nights. i have also worked on units with iv's, gt's, ventilators, etc. ltc is not for everyone that is why the turn over rate is so high. it is a challenge to your organizational skills. for me personally i dont feel comfortable with more than 35 residents to pass meds for no matter what shift.
    Quote from sunstreak
    i recently interviewed at a 120-bed, ltc facility. 118 beds are currently occupied; 16 are a locked alzheimer's unit and the rest are two wings consisting of fifty + residents.
    i would be working weekend option on nights.
    i asked about the staffing and was told that on my wing (50 + residents), there would be a nurse (me), and 2 nurse aides.
    that's it.

    i feel that is ridiculous.

    they should have a med tech. how in the world do they expect one nurse to pass meds, properly assess, document, do medicare charting, handle incidents (what about treatments??), and all the myriad things that pop up during twelve hours?

    giving meds to fifty + residents and everything else? not to mention prns...

    i dunno, but it seems to me they need at least a med tech........what do you all think?
  9. by   Town & Country
    I don't feel comfortable with it, either. Probably because I know it can't be done.


    The real kicker was I just had a job like this, in LTC, about the same staffing/patient levels...the first night I was there I started my med pass and the DON called the nurse's station wanting to know WHY IT TOOK ME SO LONG TO ANSWER THE TELEPHONE........(duh....probably because I was giving medicine to the residents, Einstein.)

    THEN she ranted and raved because the meds were given "too late".......sigh.........I hope and pray I never end up in one of these so-called "nursing" homes.
    They are so pretty from the outside but inside the lights are on but NO NURSES ARE HOME........OR CNAS FOR THAT MATTER....GOD HELP THE RESIDENTS!
  10. by   Dixiedi
    Quote from michelle95
    Well, I would think that 50 patients would be ok with one nurse for 11-7 (I've done it myself) but 7p-7a? You have to do 9pm med pass for 50 folks with one nurse? Nope. Not me.
    I have to agree with you on this one. They ALL get em at 2100. Gives you 1 hr to pass meds to 50+ folk. Just about 1 minutes each, No way I could do it.

    Did you ask if there's a med tech on til 2330? They may have techs that work 8 hr shifts and you would have one for 2100.
  11. by   jkaee
    I agree with the others.....the only time I would be worried about is the 7p-11p part of your shift. On nights, the 1 nurse and 2 CNA's seem pretty standard.
    I would at least try it.....or at least spend one or two shifts shadowing the nurse and see what it's really like. Maybe the med pass isn't that bad at HS, or maybe there aren't that many skilled patients that need charting. Is there a supervisor that's on at night that can be called to help you out in a pinch? At least try it for a couple of days to get a feel for it, and if it's not for you, explain why to the DON. Maybe all the nurses there have put up and shut up for so long that they might need a reality check!

    BTW, in the skilled nursing unit where I work, for 62 beds the night shift has one nurse and 3-4 CNA's. But, the ADON works 7p-3a, so she is there for part of the shift to help out as needed. And, they do not schedule tx or meds for nights unless absolutely necessary. Their am med pass takes maybe 1/2 hr to do, it that.

    Good luck!
  12. by   donmomofnine
    It could be set up like my facility, where the bid's are given at nine and five, not nine pm. Our nine pm med load is very light.
  13. by   LPN4Life
    I work nights and in charge of 48 res, I have 4 aides, I give my own pills but only have about 20 residents to pass pills to and do accuchecks.
    I don't see how 2 aides can get everyone up in the morning unless you have someone coming in at 5am?
  14. by   CapeCodMermaid
    Your 11-7 CNA's are expected to get EVERYONE up for breakfast? On our 60 bed unit there are 3 on 11-7 and they get about 8 people up and dressed....the Alzheimer's floor has 41 residents with 2 CNA's and they get 4 or 5 people up, and the subacute floor has 41 residents with 2 CNA's and they usually get no one up

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