LTC nurse:patient ratios - page 2

by ringaring

7,919 Views | 19 Comments

I have not found any state (OR) requirements for nurse:patient ratios in LTC facilities. By 'nurse' I am referring to RNs and LPNs. From what I have read, it seems one nurse for up to 30 patients is generally accepted by the... Read More


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    As alluded to upthread LTCs for the post part still fall under state regulations for when they were mainly nursing homes, and served a vastly different population. Anytime noise is made about staffing or other issues thems that run such places will say reimbursement rates are too low and so forth.
    IowaKaren and herring_RN like this.
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    The only way I see to effectively change these horrendous and scandalous ratios would require 'whistleblower' status on your part, which could effectively end your nursing career (i.e., your getting blacklisted from all facilities in your area, or losing your license over BS charges).

    #1. You could contact local, state, and national media to highlight the unsafe conditions and how our elderly residents are being neglected and mistreated (institutional elder abuse).

    #2 You could contact your state representatives in your state General Assembly in an attempt to get sane nurse: resident ratio laws passed for all nursing facilities in your state. This would in effect call for highter Medicaid reimbursements for institutional long-term care (money that your state is likely not to have), so you would face an uphill battle on this one.

    Thank you for caring.
    IowaKaren, TheCommuter, and herring_RN like this.
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    Quote from VickyRN
    The only way I see to effectively change these horrendous and scandalous ratios would require 'whistleblower' status on your part, which could effectively end your nursing career (i.e., your getting blacklisted from all facilities in your area, or losing your license over BS charges).

    #1. You could contact local, state, and national media to highlight the unsafe conditions and how our elderly residents are being neglected and mistreated (institutional elder abuse).

    #2 You could contact your state representatives in your state General Assembly in an attempt to get sane nurse: resident ratio laws passed for all nursing facilities in your state. This would in effect call for highter Medicaid reimbursements for institutional long-term care (money that your state is likely not to have), so you would face an uphill battle on this one.

    Thank you for caring.
    Number "Two" wraps things up in a nutshell.

    Patients are transferred out of hospitals to LTC/Rehab for many reasons but the primary one is because the latter are less expensive. Well they would be wouldn't they? Instead of 1:7 or whatever RN to patient ratio have 1:15 or more.

    There are only two viable ways to deal with this from a patient care angle; leave them in hospital until they are well enough to discharge home (the old days and very expensive), or increase staffing at LTC/Rehab to reflect patient loads and acuity (also costly).
    IowaKaren, Wise Woman RN, miasmom, and 2 others like this.
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    Quote from TheCommuter
    Money talks and bullcrap walks, and until more money is infused into the Medicaid system to provide for the care of elders, expect to continue caring for plenty of residents.
    Exactly. I've always heard it rumored that often times a state medicaid system will pay more for a convicted criminal care in jail on a daily basis than it does for a LTC resident on a daily basis. I don't have a source to quote for that tho.
    miasmom likes this.
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    WOW! Perfect timing! The thing is the government is broke. Still talking of more cuts! I still remember when we tested urine for diabetes! The stuff that used to be in acute care for years is now outpatient or same day. The stuff we get in a SNF used to be in ICU and now no changes in staffing. we are not getting the sweet little old lady recovering from a hip Fx or some that needs a place to stay help with ADL and meds. I see people 20 years younger than me. That have major issues Held to higher standards. I realize it is a numbers game for bean counters but please this is someone life. A way for someone to support themselves. Something has to change. If something goes wrong it is blame the nurse. Not what is wrong and what can we do to prevent this from happening again. Forget Boss respecting labor law or even the nurse. Tired. Home Health is looking good now. One patient at a time. Sounds good but might miss running or benefits.
    Last edit by miasmom on Jun 7, '13 : Reason: not finished.
    IowaKaren and herring_RN like this.
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    Nascar. I have heard that too. I have also seen years ago that it costs a lot more to have in locked up than give them an education. Maybe I am to much of idealist. I know can not take care of everyone or take care of everything but I am worried about our future as a country and world. I do not see myself as to extreme polictally but there has to be a balance.
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    true. understaffing leads to stress for nurses and the quality of service may be affected as well.
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    I was talking with a co worker about the need for more people and was told the state actually forbids this.

    They're supposed to be concerned about patient safety. They are not even there so they should let the staff decide

    about the ratio.
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    i agree. they should have experienced it first hand..
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    I have found the ratios to be very alarming in the facilities here. I live in Jacksonville Florida. I started as an LPN in a LTC/rehab. I would have at least 24-30 residents. And on the rehab side, I would have a min of 19. It was very challenging. I have gained much respect for the nurses that stay. I felt like there was never enough time in the day. I sometimes get anxiety when I think of some my days there. I am now awaiting to start a position at a hospital. I understand that in a hospital I will have higher acuity patients. But I will be very happy with a better ratio. I've always thought it was ridiculous how staffing is handled in a facility. Not to mention that most staffing coordinators are power struck CNAs. I remember when I was CNA, I had so much respect for the nurses I worked under. I don't feel that is the case now. Very sad is all I can say. At the end the patient is the one who doesn't always get the best care.


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