LTC Staffing ratios?

[sjbrk]

Hey all! I am an aide at a 64 bed LTC facility in the midwest. We are severely understaffed -- and have been for quite some time. The majority of the aides have one foot out the door and are looking for work elsewhere. Today I worked what is supposed to be a two-aide floor with 18-residents by myself (on day shift), and this is not unusual. You can imagine what happens to patient care... I am a good aide and do my best but I know for a fact that my residents did not get the time, attention, or care that they deserve. It makes me sick to know that we are taking care of human beings, but our admin cares more about the dollar signs than they do about getting more help (they refuse to hire temps, but they do pay "premiums" for when we work short -- I suppose I should be happy about that extra .50 an hour I was paid today).

So my question is this: Where do I go to find state policies about LTC staffing ratios? I didn't see anything on my BON website. Maybe I'm typing in the wrong google terms, but I didn't find anything there either. Any advice?

[IowaKaren]

Your so fortunate CapeCodMermaid, your staffing levels for manager, nurses, and CNA's are incredible. I could just imagine the amazing things we could do with our ICF and SNF residents if we could have your staffing levels for the 60 residents we could have. It's more like 2 nurses, maybe 5 CNA's on days, 2 nurses 3.5 CNA's on evenings, and 1 nurse 2 CNA's during the noc total in a 24 hr day. Now they've added the assisted living residents to us and we have to assess and handle issues as they arise over there also. All of this is still paper charting, no computers yet and I will be interested in seeing how that will go eventually.

[LTCLPN14]

Most of these ratios sound great to me. We usually have 40 to 45 residents and 1 nurse on each shift and a med aid for a few hours. 3 cnas on days...2 or 3 cnas on evenings and 1 or 2 cnas on nites.

[aspivey80]

I think there are probably very few ltcs that are staffed the way they should be. My facility is a 24 bed for ltc and 16 for assisted living. During the day there are up to 3 RNs ( during the week). All days of the week there are 2 CNAs, a bath aide and restorative aid for 4 aides total. After 5 pm there is one nurse with the 4 aides till 2300. At 2300 we have 1 nurse and 1 aide. That seems like a pretty good ratio but apparently I am charge nurse of a preschool and all any of my aides can do is moan and complain!!! Staffed or not, I don't think any of us as nurses will ever feel completely adequate at our jobs.

[DeBerham]

When I was an LPN I worked at a couple of ltc facilities. One was particularly bad and I left after 6 months. There, there were 70 pts, 3 licensed staff (we were slated for a minimum of 4) but even worse was the lack of aides. It got so bad that I went to my manager and told her that if she staffed my shift with 4 aides I would not clock in until our staffing levels were appropriate (sad that this word is even used in some or these facilities). Sure enough a couple of weeks later they pulled that on a shift that I was working. I told them what I intend to do and I was assured that they had called everyone (bs as I later learned) but no one could come in. "Miraculously" they found someone to come in before I walked out. Some of these facilities are staffed atrociously and shorting on licensed or unlicensed staff puts you and the patients at risk. I have much respect for those in ltc.

[Starkrav]

I cannot accept the poor staffing in LTC; it makes me sick. The facility that I have been working in has two floors. Downstairs has 36 residents, which has 1 nurse and 2-3 aides on days. Upstairs has only 14 residents, with 1 nurse and 1 aide, but there is little to no dietary help. Upstairs used to be manageable until they accepted a resident that should be getting private nursing care. She requires 2-3 hours of one on one care per shift (I'm not exaggerating), and gets that level of care because she has turned the facility in to state before. On nights, there is only 1 nurse in the building and 2 aides.

Lack of staffing results in 2 assists being transferred by one person, residents not being turned, not being changed frequently and sitting in filth, call lights going off for 10 minutes or more. It's disgusting.