CNA/Patient Ratio

zeajuju · Jan 27, 2014

I have the exact same problem. I at at 20, its terrible for the residents in long term care, because the quality of the care is decreased drastically and it is terrible for me to be in this situation.

Mr Sacdiff · Jan 27, 2014

We usually max at 15 here but we have 30-1 if someone calls off. Nurses usually step up and help if thats the case.

TheCommuter, BSN, RN · Jan 28, 2014

At my workplace, a freestanding rehab hospital, the CNAs receive anywhere from 8 to 15 patients apiece depending on census.

I've also worked at nursing homes on and off for 6 years, and on night shift, the CNAs would end up with 35+ patients apiece if there were call-offs and replacement workers could not be found before the shift started.

Paws2people · Jan 28, 2014

On my hospital unit, 9 on a good day, 30 on a bad. I wish we did have a set ratio, but it's not so.

studentnursemon86 · Jan 29, 2014

The worst I had was 50-1 and I had one LPN with me on the verge of retirement. That was at a LTC facility.

In med-surg it was 9-1. Low level cardiac unit was 12-1 (funny because that's a higher level of care) and in the er it can range from 6 or 18-1.

Obviously nurses help with boosting patients in bed, and getting some of their own vitals and lab draws when the ratio is higher for their aides and techs.

kenya1005 · Jan 29, 2014

I work in Progressive Care/Tele. On night shift, it's 10 patients per tech on a good night. Sometimes if someone calls in, or if census is high and they float one of us, we go to 20 to 1. On day shift, I normally have 7-10 patients, but I've had all 20 a couple of times.

TurtleCat · Jan 29, 2014

See, I don't even understand how it's even possible to give adequate care with ratios like 1-40, at least not without cutting dangerous corners that endanger the health and safety of the patient. Doing the math... let's saying you're doing your 2 hour rounds on everyone, as you're supposed to. Let's say it takes no more than 5 minutes to resposition and change a resident... not including variables like if a patient is being difficult and uncooperative, if they're exceptionally messy and require a whole bed change, etc... that's 200 minutes for a whole round, which is over 3 hours... That's not even enough time to get to everyone. And that's assuming this is a night shift, which wouldn't even include baths, getting everyone to and from meals, feeding, etc. all things that take up a lot of time in and of them itself. 40-1 on a day or evening shift seems nigh impossible. So basically what I'm asking is... how do you even do it with ratios like that? There's only so much you can do in an 8hr-shift, you're not superhuman. So am I just incompetent or is 40-1 an impossible number.

Tahiti · Jan 30, 2014

I don't think it is possible to see all the patients if it's 40-1.

Paws2people · Jan 30, 2014

See, I don't even understand how it's even possible to give adequate care with ratios like 1-40, at least not without cutting dangerous corners that endanger the health and safety of the patient. Doing the math... let's saying you're doing your 2 hour rounds on everyone, as you're supposed to. Let's say it takes no more than 5 minutes to resposition and change a resident... not including variables like if a patient is being difficult and uncooperative, if they're exceptionally messy and require a whole bed change, etc... that's 200 minutes for a whole round, which is over 3 hours... That's not even enough time to get to everyone. And that's assuming this is a night shift, which wouldn't even include baths, getting everyone to and from meals, feeding, etc. all things that take up a lot of time in and of them itself. 40-1 on a day or evening shift seems nigh impossible. So basically what I'm asking is... how do you even do it with ratios like that? There's only so much you can do in an 8hr-shift, you're not superhuman. So am I just incompetent or is 40-1 an impossible number.

It's not enough time. No way to give adequate, safe care with even over 15 pts. I always feel like I am rushing the pt, and that is not acceptable in my book.

zeajuju · Jan 31, 2014

Its impossible, Mathematically impossible, I feel the same way with 20, I feel the job is lousy and inadequate and should be illegal. If it is not? then why the heck not? Children and care takers have ratios! why not LTC?!

Bbo.W · Feb 9, 2014

I worked at a LTC that had an awful problem w/ call-offs. It was not unusual to have 40 residents each, and it was a dementia unit. Some of the residents were continent but most were not. I found that not every resident was wet at every round, and that helped. But the job took such a toll on me that I quit. On the subject of why our ratios are not regulated, I think it is because the elderly and disabled are devalued in a way that children are not. It breaks my heart. If appropriate ratios were adopted, the facilities would go out of business. It would hurt the bottom line.