1 nurse to 30 patients!!! 3 attendants

World Canada

Published

Hi fellow nurses!

I just learned about a position where I want to work that keeps 1 RN 30 patients on the unit with 3 attendants! Anyone know a little bit about continuing care/long term care and care to share their experience? Thanks

You are an American. What is good to us is not the same as what is good for you. Our LTC is different from the States from what we have read on other threads.

I had no clue where the poster was from. I don't look at everyone's bio before commenting. Very interesting to learn thay though. Now I'm wondering what the diffetences are. Also though, we have to keep in mind, that LTC facilities here in the US can vary greatly. Some are just pretty much passing meds and making sure everyone is safe. Others have skilled residents with trachs, g-tubes, drains, colostomies, IV's, wound care.... And those are the kind of patients that my load will be 30. (with some dementia mixed in, which can be difficult because of all the safety issues while you're trying to pass meds and do treatments on the skilled residents.

0 Votes
Specializes in critical care.
I had no clue where the poster was from. I don't look at everyone's bio before commenting. Very interesting to learn thay though. Now I'm wondering what the diffetences are. Also though we have to keep in mind, that LTC facilities here in the US can vary greatly. Some are just pretty much passing meds and making sure everyone is safe. Others have skilled residents with trachs, g-tubes, drains, colostomies, IV's, wound care.... And those are the kind of patients that my load will be 30. (with some dementia mixed in, which can be difficult because of all the safety issues while you're trying to pass meds and do treatments on the skilled residents.[/quote']

(This is the nursing in Canada forum.)

0 Votes

(This is the nursing in Canada forum.)

I found it under the general nursing discussion forum. After re reading it though, I can see it can sound like a snotty comment, when in reality I was chuckling when responding. So my apologies.

0 Votes

American or Canadian regardless, these ratios are unsafe. Not directed towards anyone on this board as I understand what is meant by 'good', but I think that we as nurses in general are too skilled at adapting, even to circumstances that should be alarming.

0 Votes
American or Canadian regardless these ratios are unsafe. Not directed towards anyone on this board as I understand what is meant by 'good', but I think that we as nurses in general are too skilled at adapting, even to circumstances that should be alarming.[/quote']

You worded that perfectly. I want so badly to rally and take this to the media. How nursing homes spend money on cosmetics to attract people to their facility, but then provide so little supplies and staff for the residents to care care for them as they should be cared for. Then the owners/higher ups pocket the money and live their Godless rich lives. They are sleeping peacefully in their warm comfy beds at night, while at the exact same time a resident in their facility is lying in their bed waiting hours to have a diaper changed. I almost want to cry picturing that right now.

0 Votes
Specializes in Medical and general practice now LTC.

I find things in LTC here in the province not too bad with good union support and staffing mandated.

0 Votes

When I worked LTC (and I will never, ever go back) we were staffed per the provincial guidelines. x number of staff to x number of patients. What wasn't taken into consideration was the neediness, the family demands for specific care at specific times, the condition of the patient. You could have 7 patients who could ambulate, toilet, and feed themselves, not a wound in sight. Then you could have the patients who were doubly incontinent, medi lifts (2 people to operate per safety guidelines), geri psych issues. All on the same unit. All it takes is for the medi lift patient to become combatant and you wind up with most of the staff in the room with one person to look after the other 29.

Also funding in LTC specifies how many baths a week a patient can have. The staff work load is based on this government funding scheme. It all goes to hell in a handbasket when the family decides that Mum/Dad needs to be tub bathed every day because they enjoy it and that was their routine at home. They don't want to pay extra or hire a private worker to come in and do it. We all know that the doubly incontinent are usually given extra showers because it's easier to clean the skin that way. But it affects staffing levels and workload.

There will never be perfect care given in LTC. There has and always will be demanding families who want it all to ease their guilt for placing their elder. The costs rise with staffing be it public or for profit facilities. The rise of assisted living facilities is only making it worse. People when they become needing of a higher level of care expect and demand immediate placement in a facility providing higher levels of care. Their families abandon them in the emerg and the entire system becomes over loaded. Every winter there are least five elders left in emerg because the family won't or can't care for them. So they wind up in an acute care bed awaiting a transitional care bed so they can move to LTC. It's know that if you are in acute care you have priority for placement. So families at their wits end or going to Mexico just drop them off.

0 Votes
Specializes in Acute Care, Rehab, Palliative.
American or Canadian regardless, these ratios are unsafe. Not directed towards anyone on this board as I understand what is meant by 'good', but I think that we as nurses in general are too skilled at adapting, even to circumstances that should be alarming.

That's true. What we have come to accept as "good" is just what we have adapted to.It could be much better.

0 Votes
Specializes in geriatrics.

None of the ratios are safe anymore, no matter where you work, unless it's one: one or one: two care. Let's be honest. The government continues to make cutbacks everywhere from acute care to LTC. Sometimes acute care can be even worse because you've got 5 or 6 really sick total care patients.

In LTC, you might have 30 or more, but not everyone is acutely ill. Where we often fall short is providing for psychosocial/ teaching needs, which is just as important but there's not enough time. Some facilities are worse than others, too.

0 Votes

I worked evenings in one residence where I had 33 to 35 residents and 2 attendants. We would get a 3rd for a couple of hours during the "heavy" times...when the residents were being put to bed. All the nurses seemed to do was meds. Oodles and oodles of meds...supper meds, bedtime meds, in-between meds and when we were done the meds, we had dressings, procedures and family meetings. We were lucky to get a supper and pee break. All along we were expected to supervise the attendants which was really necessary because they would try to get away with a lot.

Even though I really loved working in gerontology, I lasted less than 6 months. I didn't like the thought of putting my license on the line all the time.

0 Votes
+ Add a Comment