CNA/Patient Ratio Laws

merricat · Sep 7, 2004

Is there a CNA/Pt ratio law in your state? there is a website -- owned by the coalition for reform in nursing homes-- under "govt laws" tab, lists laws and/or regs or guidelines for each and every state. how awesome is that?oops-- no, wait. is national citizens coalition for reform in nursing homes-- and obviously it probably does not also cover hospital care, just LTC

dizzydana · Mar 1, 2005

Is there a CNA/Pt ratio law in your state? To my knowledge, there is not one here in NC. I'm currently in nursing school, and have opted not to get my CNA certification back due to poor work conditions. I got burned out! I was working in a nursing home, where we would end up with two aides on the night shift, with almost 50 patients, most of whom were alzheimer's or total care. We would start out with three, but management would send home someone (fire them) without telling us we were now short staffed. It wasn't fair to us and employees, and definitly was not fair to the patients! We physically weren't able to care for them all, turn, change, etc. I quit before something happened to a patient that was somehow related to poor care. I feel horrible for the way things went there, and I am ashamed to say I even worked there and put up with the crap for as long as I did. We were written up for not taking supper breaks (we didn't have time between the two of us), so we'd clock out and go back on the floor, then clock back in after 30 minutes. This is one of my reasons for even choosing nursing school, was to somehow try and help change the poor conditions I have seen. Back to the original question, is the a law where you live? How do you feel about it?

Since you feel so strongly about what happened at that particular nursing home... did you report it to the state board of health? With anonymous reports, they investigate matters... I have had the pleasure to insure that the facility I worked at receive an Immediate Jeopardy citation... These things should be reported and investigated... it could be your mom/dad in that nursing home!!!

pumpkin92356 · Mar 20, 2005

Is there a CNA/Pt ratio law in your state? To my knowledge, there is not one here in NC. I'm currently in nursing school, and have opted not to get my CNA certification back due to poor work conditions. I got burned out! I was working in a nursing home, where we would end up with two aides on the night shift, with almost 50 patients, most of whom were alzheimer's or total care. We would start out with three, but management would send home someone (fire them) without telling us we were now short staffed. It wasn't fair to us and employees, and definitly was not fair to the patients! We physically weren't able to care for them all, turn, change, etc. I quit before something happened to a patient that was somehow related to poor care. I feel horrible for the way things went there, and I am ashamed to say I even worked there and put up with the crap for as long as I did. We were written up for not taking supper breaks (we didn't have time between the two of us), so we'd clock out and go back on the floor, then clock back in after 30 minutes. This is one of my reasons for even choosing nursing school, was to somehow try and help change the poor conditions I have seen. Back to the original question, is the a law where you live? How do you feel about it?

I work swing shift at an acute/snf facility and we often work with only 2 aides and 50 patients! I am so tired sometimes that I wonder why am I doing this kind of work? My partner another CNA and I do not get lunch breaks , nor do we get to sit down for several hours at the beginning of our shift. I have complained to the DON and no results . I am wondering should I go to the labor board with this? I hate seeing the patients having to tolerate this kind of staffing. They always make sure that day shifts are fully staffed. Looks good to the public, know what I mean. I have worked graveyard shift there and many times I was it the only person to turn, change bedding and answer lights for over 50 total care patients. What , do you think? pumpkin92356 I live in California

blue chips · Mar 20, 2005

I work swing shift at an acute/snf facility and we often work with only 2 aides and 50 patients! I am so tired sometimes that I wonder why am I doing this kind of work? My partner another CNA and I do not get lunch breaks , nor do we get to sit down for several hours at the beginning of our shift. I have complained to the DON and no results . I am wondering should I go to the labor board with this? I hate seeing the patients having to tolerate this kind of staffing. They always make sure that day shifts are fully staffed. Looks good to the public, know what I mean. I have worked graveyard shift there and many times I was it the only person to turn, change bedding and answer lights for over 50 total care patients. What , do you think? pumpkin92356 I live in California

After first quater of nursing school i became a NA, and the hospital i work at had 15 to 22 pt. to one NA. It was out of control!!!!!!!!!!!!!! :uhoh3: :angryfire :uhoh3:

happthearts · Mar 20, 2005

I work in a nursing home in Utah and I feel that the CNA to resident ratio is horrible. There are 2 aides on the floor I work and currently 28 residents. We usually try to share the work, but the CNA I'm usually teamed up with spends most of his time on the phone, out smoking or finding other ways to avoid actually working. So I end up doing most of the work for all 28 residents. Very exhausting and frustrating! We have a good majority of these residents that can't stand without assistance, can't do anything to help care for themselves and are incontintent. This makes the job even harder, though I don't mind doing these things, I just need more help in order to get everything done that needs to be done. We usually have about 6 showers to do during the morning shift and about an hour to complete them in. We get written up if we don't take our lunch break and get in trouble if we don't complete our showers. I always feel as though I'm letting the residents down when it comes to caring for them properly. There's always things that get missed because we just don't have the time to do it all. I try to always keep my residents in clean briefs and safe, those are the two most important things we can do, but there are so many others.
I greatly feel that there needs to be a requirment for the CNA/resident ratio. I dream of the day I only have 10 residents to care for.

I would complain to your charge and then your DON you don't have to put up with this.I had someone who did this to me and I told them what she was doing .They fired her. I actually doumented all the times she left the floor .in a little book after 3 days went to my charge the charge did nothing then made an appointment with the DON.What would kill me is she the aide would sluff all shift ,till the end and she would still have Pt's to put to bed and would ask for help .I said gee you had all that time to smoke and eat and I didn't get a break so I am taking one now You'll have to ask some one else .Have to take lunch .

I work in Utah the ratio is 10 to 1 on the non medicare side

with 3 max beinging bedridden or total care .On the medcare side it is a 5 to one ratio durring the day 7 on 3-11 and nights 2 for 20 Pts Many times I would have to do upwards of 30 on a 3-11 on the non medicare side.That's why I quit doing nursing homes ..(call your Odbudsman in the state.) I think they even have a web site.

I went in and set up care just recently for my home health agency because a women Pt was not being attended to at night. The assited living had 150 Pt's for 2 aides (one of these aides was also passing meds as well ) is what I was told. I told the assited living nurse charge, durring the day that this was really not good because of the liability issue. Then she told me the normally just have 3 on . couldn't belive it for 150 PT

Hey if you live in Provo SLC or Odgen area's every want a part time job let me know you sound like your a great aide.Plus the ratio at most would be 1 to 2 if you had a husband and wife ,family to care for But mostally you would do one PT's in the home .

GLORIAmunchkin72 · Apr 7, 2005

This is why I would have to think very hard before leaving our facility to another one. We have our problems but there are so many nursing homes out there that sound HORRIBLE! I just wouldn't want to take a chance of ending up there.

Is there a CNA/Pt ratio law in your state? To my knowledge, there is not one here in NC. I'm currently in nursing school, and have opted not to get my CNA certification back due to poor work conditions. I got burned out! I was working in a nursing home, where we would end up with two aides on the night shift, with almost 50 patients, most of whom were alzheimer's or total care. We would start out with three, but management would send home someone (fire them) without telling us we were now short staffed. It wasn't fair to us and employees, and definitly was not fair to the patients! We physically weren't able to care for them all, turn, change, etc. I quit before something happened to a patient that was somehow related to poor care. I feel horrible for the way things went there, and I am ashamed to say I even worked there and put up with the crap for as long as I did. We were written up for not taking supper breaks (we didn't have time between the two of us), so we'd clock out and go back on the floor, then clock back in after 30 minutes. This is one of my reasons for even choosing nursing school, was to somehow try and help change the poor conditions I have seen. Back to the original question, is the a law where you live? How do you feel about it?

TheCommuter, BSN, RN · Apr 9, 2005

As a student, our very first clinical site was a convalescent facility. We noticed the care was poor, with patients sitting in their dry feces for hours! Many of the staff members acted cold-hearted and would rather go outside to smoke than care for the patients. Even our clinical instructor said the care was bad. And clinical instructors usually refrain from speaking badly about any colleagues.

cnavoicewebmaster · Apr 20, 2005

Well, Spacenurse. I agree. I got so fed up with being expected to do the impossible...I put up a website to inform the public about our staffing (and other) issues. It's a regional site for C.N.A.s here in North East Tennessee, but I'm pretty sure the info is accurate pretty much anywhere you find a nursing home. Oh, I also wish people would inform the right people to get some laws changed. I'd be happy to get some traffic from any public official who wants the info! It's also very new...and unknown. :crying2:

Plagueis · Apr 20, 2005

In my state, the governor did sign a bill earlier this year requiring hospitals to publicly post how many RNs, LPNs, and CNAs were working each shift, along with the ratio of those workers to patients. However, I don't think applies to nursing homes, since I have seen homes that list the number of nurses and aides, but not the ratios of nurses/aides to residents. The bill, however, doesn't legally specify what ratio of CNAs to residents/patients is required, so the bill hasn't changed the ratios at all. I guess they don't want the public to know that most aides regularly have 15-20 residents to take care of for around $8 per hour. Then they wonder why nurse aide jobs have a high turnover rate!

LPN1974, LPN · Apr 20, 2005

In my state, the governor did sign a bill earlier this year requiring hospitals to publicly post how many RNs, LPNs, and CNAs were working each shift, along with the ratio of those workers to patients. However, I don't think applies to nursing homes, since I have seen homes that list the number of nurses and aides, but not the ratios of nurses/aides to residents. The bill, however, doesn't legally specify what ratio of CNAs to residents/patients is required, so the bill hasn't changed the ratios at all. I guess they don't want the public to know that most aides regularly have 15-20 residents to take care of for around $8 per hour. Then they wonder why nurse aide jobs have a high turnover rate!

The NH I worked in for 2 years/part time had a sign in sheet you were to sign at the beginning of the shift, so anyone could look at it and tell how many nurses or CNAs were working that particular day or shift, but you couldn't tell what the ratio was of nurse or aide to patient was. This is in Arkansas.

That home was bad, too, for not having adequate staffing.

When I started there someone warned me to not agree to work the nightshift by myself, and I never had to, because I made it clear in the beginning I would NOT do it.

But there were several nurses who would do it.

not now, RN · Apr 23, 2005

On a good day (i.e. everyone shows up) we have:

16 CNA's on AM with two extra CNA's that do no ADL's but do take care of feedings, ambulation, daily weights and help PT

8 CNA's on the PM shift with two extra that feed and help PT

5 on PM's no extras

On my shift I usually end up with the same 15 people, three of them take care of themselves I just have to bring them dinner and answer the occational call light. The other 12 are total care and aren't congnitive enough to hit the call light, instead they like to slam their bed rails into the wall. I also have two G-tube patients who don't do anything and are a pain to turn. Thankfully the DON overstaffs us by at least one and their job is to take vitals, help transfer/turn, pass water, feed and any of the 'little' things we can't get to. I honestly don't mind the staffing. It's rare that I don't get everything done on time.

This is a 98 bed facility.

It is not all sunshine and roses. I have had to change a patient that wasn't on my list because no one else wanted to do it "I'll get to it later." I have had to page people when I needed help. I have had to call someone from the other side of the building because my side is nowhere to be found. I have caught CNA's on the phone in an empty room while I was running my butt off. I am one of the only CNA's that actually does two rounds between 1900 and 2300. I recently asked the DON to not staff me on the same side as a particular CNA because I can't stand her or her lack of work ethic.

More than likely I will work at this facility after I graduate and while I bridge over to my RN. I know it has it's problems but I love my residents, most of the PM CNA's are excellent and I know all the tricks that the bad CNA's pull.

dkayb · Jan 5, 2006

please tell me how many residents should a cna have is there a limit how can you give good care with 15,16 or more residents on a shift