Safe nurse to resident ratios in LTC? - page 2

by erinp88

5,727 Views | 15 Comments

I was wondering what everyone thought about staffing ratios in LTC? I work on various units and am feeling like the acuity is really starting to soar with no increase in staff. I've done everything from 1:15 (that's great)!... Read More


  1. 0
    It really wouldn't surprise me if the DON did get a bonus for not using agency nurses... I've seen this happen more than once. The facility where I worked maintained the philosophy that "we have never nor will we ever use agency nurses, because we believe it is in the best interest of the residents/patients to have someone committed to the facility where they work, and take "ownership" in the patients they care for". <Laughter> sounds good on paper as if the Board of Directors actually cared for the welfare of the residents, what they care about is the extra money forked out to "agency" nurses. What they don't get is "what about the overtime that's paid to your regular employees in addition to the stress and exhaustion they face?"

    Most regular employees will come in on their days off, work over, whatever it takes to assure these people are cared for. What you WILL NOT see is the DON or ADON picking up a shift. It's been said before, but worth repeating...."if administration or owners cared about the patients/residents and the employees, follow an LPN for a day, on an off shift." It would be interesting to see how many of them would remain on a job with the conditions they face, for the pay they receive.

    It's also interesting to note, that once new graduates are hired, and trained by the senior staff, it's not long thereafter that for "some reason" the senior nurses are either terminated, laid off, or pressured until they leave. The new graduates work for less money. Personally, I wouldn't want my family member's welfare entrusted to anyone with less than a year of nursing experience under their belts, and NO ONE physically there with more experience. (Happens all the time on the off shifts).
  2. 0
    I currently work in an ALF and the ratio is 1:40 and one aid. After morning cares (which we do together and I pass medications, insuling, accuchecks) the aid is away completing whirlpools, and I run the floor. I am busy, but unless something out of the ordinary happens, it is a comfertable busy. We also work as a team, and if we get too busy on the floor, the activity director and receptionist will help out when they can.
  3. 1
    I love being an LPN and no offense to my fellow LPN/LVNs but we are employed mostly in LTC where nurse to patient ratios are very high! this is why I'm going for my RN so I can work in a hospital in critical care with 2 patients (not easy but more focused care) giving out meds to 40+ residents killingme, everyday I leave work with a headache, backache and footache, its ridiculous and the LTC I work in is just increasing the workload year by year!
    eldragon likes this.
  4. 1
    Quote from frustratedlpn
    it really wouldn't surprise me if the don did get a bonus for not using agency nurses... i've seen this happen more than once. the facility where i worked maintained the philosophy that "we have never nor will we ever use agency nurses, because we believe it is in the best interest of the residents/patients to have someone committed to the facility where they work, and take "ownership" in the patients they care for". <laughter> sounds good on paper as if the board of directors actually cared for the welfare of the residents, what they care about is the extra money forked out to "agency" nurses. what they don't get is "what about the overtime that's paid to your regular employees in addition to the stress and exhaustion they face?"

    most regular employees will come in on their days off, work over, whatever it takes to assure these people are cared for. what you will not see is the don or adon picking up a shift. it's been said before, but worth repeating...."if administration or owners cared about the patients/residents and the employees, follow an lpn for a day, on an off shift." it would be interesting to see how many of them would remain on a job with the conditions they face, for the pay they receive.

    it's also interesting to note, that once new graduates are hired, and trained by the senior staff, it's not long thereafter that for "some reason" the senior nurses are either terminated, laid off, or pressured until they leave. the new graduates work for less money. personally, i wouldn't want my family member's welfare entrusted to anyone with less than a year of nursing experience under their belts, and no one physically there with more experience. (happens all the time on the off shifts).

    you've taken the words right out of my mouth, i couldnt have said it better!
    FrustratedLPN likes this.
  5. 0
    "As far as "ratio" when talking about nurse/patients, the "powers that be" have figured out how to get around that one long ago. The law is based on "nursing hours" to patients, not actual nurses per shift to patients. Thus, all those "management" nurses that "work" day shift have their hours counted. This includes the ADON, DON, Nurse managers, MDS nurses, Restorative Nurses, TX Nurses, Skilled Care Coordinator, etc. The hours they work, PLUS the nurses that are actually working the floor are added together. This amount is then averaged among the shifts and patients. Looks good on paper! No one seems to notice that most of these "nursing hours" include nurses that never touch or see a patient."
    This is how it is in Indiana too. I researched the issue after finishing training and being so frustrated I didn't want to return. I figured there had to be regulation somewhere saying what the max. was. But all I could find was nurse hours to resident and yes, they include everyone with a license whether they do direct care or not. The only exception in Indiana is they don't include the DON.
  6. 0
    I've been a nurse in LTC for 6 months now and am already burned out. I've had up to 33 pts max and usually run 25 per shift. I didn't know until I read this thread that the nursing ratio included nurses who are employed but not doing direct care. Wow! I took another job recently in a "rehab" center thinking I would have less pts and more time to spend educating. Yea, right. Instead, even with higher acuity, I am in the same boat as I was before when I was in a nursing home. I wonder if I am cut out for this profession but if anything is positive, I definitely have more of a drive to get my BSN and get out of frontline nursing once and for all.


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