In my state, staffing ratios haven't changed since the 1970s, when many nursing-home residents were still ambulatory and cognitively intact for the most part.
If it were up to me, I'd mandate staffing ratios of 1:5 for CNAs and 1:15 for nurses. Guess that's why I'll never strike it rich in this field!
Jan 24, '08
Eye-opening reading ... thanks.
Feb 25, '08
OMG!!!! PA doesn't seem to require much. I do agency in a LTC that has 2 units, one has 39 residents(1 RN and 1 LPN on days and eves, 1 RN night) and 5 CNAs days and 4 CNAs eves and 2 CNA on nights and the other unit has 47 residents and is staffed with 2 LPNs on days and eves and 1 LPN on nights. and 3 CNAs on days, 2 CNAs on eves and nights
I go to another LTC and they are only 37 beds and they have 1 RN and 1 LPN on days and eves and 1 LPN on nights..... not sure about the CNAs --- they haven't been without empty beds when I am there so they have some working part shifts, coming and going... makes me crazy because I never know how many staff I have....
Either way..... these are bare bones numbers, and if anyone calls off..... it is not a good shift.
Feb 25, '08
I live in Florida. The staffing ratios are preety good, but when our staffing is low, they can and do use activities, restorative and management hours to bring up the numbers.
Feb 27, '08
I live in Oregon as a CNA and we do have the max on days - I have 10 residents a day and I think its ridiculous. Starting I believe in April they are lowering our ratios to 8 and then next year it will be 7 - the state that is. It is hard enough to do the basic care with 10 nevertheless the extras such as nails, but we try....
Apr 6, '08
ok, Do you think that taking care of that many pts is safe nursing? You can`t tell me that you don`t short cut on nursing? I just get amazed that this is allowed to continue. This is shameful. That medicare comes up with such numbers. The pt.s are shorted everytime. This is not nursing this is cattle farm care!But lets speng billions of dollars on other countries who in the end could care less about us!
Apr 6, '08
Just a few years ago many of these people would be in the hospital.
IV medications and such with only ONE licensed nurse required for up to 59 patients!
unsafe and inhumane!
Apr 9, '08
Well the ratio has changed but it is based on census so some days I may have 10 some days 8 or it can changed periodically as residents go out to the hospital or what not, I think that it's a hard enough job for nursing staff in general and the shortages. I have been off of work for 4 days for an abcess and they still call me (besides my doctors note) to come in even though I can't lift anything. We are in this field because we love it but it is hard to be motivated about it when you work 8 days straight and doubles because everyone else is overworked or we're understaffed.
Apr 10, '08
I`m sorry kids ,but the reembursement just dosn`t cover from Medicare and such.BUT they have no prob. sending BILLIONS over to other countries. WHEN will the silent majority wake up and stop this and start taking care of those who have been paying that. It is a disgrace that I have to run my butt off to pass meds to 24 very acute pts. and I have a LPN who is doing all the treatments and two aids who you can`t find half the time. Then management can`t` understand why we have falls. Then comes up with this brillant idea that to have a contest to help reduce falls.HELLO, maybe more eyes and hands on the floor would help. I had asked for getting people to work as walkers, with their sole duty is that of just getting pts up and help them walk safely.I have come to discover that in nursing there is alot of higher educated (queen bee`s) talking about evidence based practice. Its simple girls! There needs to be more worker bee`s to make the hive safer. One of the mistakes that is taking place is this push to have higher degree nurses and thus there will be better care. DA-A-A, give me just simple help, to care for these pts. We need to get back to basics.
Oct 11, '08
These staffing ratios seem irrational to me. I tried to recently work in LTC , I was only there for 2 orientation shifts. I saw 1 nurse whether it was an LPN or RN for each hallway of 20 residents. The medications alone on 20 patients should have been the only responsibility of a nurse, let along throw in the treatments and documentation. It's not like the days when patients had few medications, or few treatments in any setting for that matter.
Wasn't for me. I felt my license would be jeopardized if I tried to stay. Not having the time to take a patient's every MAR to them while giving their meds is a JACHO issue in the hospitals. This appear to be an acceptable practice in LTC. I saw not one MAR taking to the patient. I could not work like that, yet I do not judge what the nurses were doing to survive their shifts.
It just was not for me. I will stay in the hospital setting.
Oct 22, '08
The average ratio in New York State is 10:1 cna day 13:1 cna eve and
20:1 night Lpn 20:1 day 40:1 eve/night RN charge 40:1 supervision 240:2 as an LPN 40:1 sucks meds treatments and documentation!!!!!!
Jan 31, '10
I have been working in an assisted living faciity since August. It is my first nursing job. We have about 22 now, varying degrees of care. I have had to work alone with 14 and up. We are expected to do dining chem sticks med pass toileting (if we are alone, the toileting can get rough) And we carry pagers. Is this ok? I rearely have more than 1 caregiver if I have 1.