CNA:RESIDENT ratios in ALF

[nurturer]

I am in school to become an RN. I have been working as a CNA in an ALF for 3 months now. Am I just not experienced enough or is it true that it is impossible to be responsible for 12-13 residents in an 8 hour shift and give them adequate, quality care? Some of these residents require showers, almost all wear incontinence products, and I'd say 25% don't even know what I mean when I say it's time to brush their teeth!!! When I have 12 to 13 people to care for my job becomes nothing more than an "ass-wiping marathon"! I didn't sign up for this! The extraordinary principles and values of the facility....plastered all over their sales literature, are a total farce.

Is this common? I'm afraid to hear the answer..... On the days I have 8 residents everying is okay. Just by adding that additional 4 or 5 residents lowers the quality of care significantly.

[fuzzywuzzy, CNA]

12-13 is pretty common, but you're right, it's not comfortable. You can barely cover the basics- forget about actually paying attention to residents. Especially because you don't have the whole 8 hours to get everything done- usually starting right after supper there's a 1.5-2 hour window where everyone wants to get their HS care done.

I'm under the impression that ALF ratios are worse than nursing homes because it's assumed that residents are more independent but in reality they need just as much care? Plus, alert people take more of your time than total cares/extensive assists. They like things done a certain way at a certain time.

[amjowens]

I am currently working in a ALF. I'm a new grad LPN, and in a regular ADN program. I bought into the bull when I graduated, and was so happy to be a part of the ALF concept rather than a nursing home setting.

In reality, I'm seeing the only difference is the lack of regulation, and if there were regulation, I have a feeling the place wouldn't receive high marks. The management speaks of nursing homes as horrible places, and love to present the ALF philosophy as if it's so calm and wonderful. I don't mind working hard and working toward improvement for long-term care, but I DO mind the hypocrisy. This bothers me more than anything-the denial. One nurse for over 55 residents. 4 or 5 (now 5 after aides are quitting and majorly complaining) nurse aides for those. One of the assigments has 19 or 20 residents for the aide. The assignment with 8 is with residents who are total care, and the aides think THAT'S the easiest hall. Since when was total care assisted living? It's insane. I'm going to apply at nursing homes after I take my NCLEX in April. At least if it's bad, there isn't the cover-up, and we can actually face our issues with honesty, get our poor ratings if deserved, and work to improve conditions.