Eek, Is 48 patients by myself too many for a nightime LTC center shift?

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Specializes in Dementia.

Hello, I am a new nurse. I passed my NCLEX a couple weeks ago and will be starting a job in the next few days. I was told that I will get 2 weeks training before I will be on a night shift with 48 patients! I have no idea what to expect. Is that even reaonable? The LTC where I had clinicals had 16-20 patients each nurse and it seemed so hectic to me. But that was also during the day when it is busier and there are more procedures to be done.

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Specializes in Medical Oncology, Alzheimer/dementia.

I think that's a lot for a new nurse, but that's how it is. I was an experienced nurse and I had 51 patients on nights. However, one of my units was an Alzheimers/dementia non-locked unit with several 1:1 and wanderers. My other unit had residents who were total cares so the CNAs needed my help often with turning and boosting. The residents were also very needy. So I suppose it depends on what type of residents you have on your unit. Don't get fooled into believing the residents will be sleeping and it won't be so busy.

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I know it seems like alot but that's the reality of things in LTC. It also depends on whether there is a night supervisor. Who would that be? It would be my expectation that the supervisor is around to help you or, if there's another more experienced nurse in the building on another unit, that person should be available for help and questions as needed. Night shift has its own set of responsibilities and hopefully you are well staffed with at least 3 CNAs. They are your eyes and ears on the floor and should be able to help make it a good transition for you. Good luck and let us know how things turn out!

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Specializes in LTC, Education, Management, QAPI.

Our nighttime nurses have 60 patients each, 10-15 skilled.

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On 11-7? In a word, no.

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In the " good old days" I was the only night nurse(LPN) in a 99 bed nursing home.

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No that's common. I, however, would not feel comfortable being the only nurse on staff. My facility is one of the best in our state (not , exaggerating we are listed as such), so our ratios are better than other places in our area. We have a 75 bed capacity, although we usually never have over 70. Noc shift has 2 nurses and 5 CNA's. Dayshift nurses are on a ratio of 17-20 residents to 1 nurse. Most in the area have 24-27.

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Specializes in Dementia.

Blackcat99, holy crap. It's been a crazy couple of first weeks as a nurse. I actually got moved to day shift before I even had to work one night shift on my own! Dodged that bullet! I probably would have told the DON that I couldn't to it though. I just worked my first day shift on my own with 24 residents and felt SO overwhelmed. There were three other nurses but on different halls. So I had someone there to ask questions. I am sure I could do it in a few months or so, but right now I am just too new.

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Specializes in LTC/Sub Acute Rehab.
Our nighttime nurses have 60 patients each, 10-15 skilled.
Our night nurse has 62!:eek: I did it for 30 days and quickly got on the 7P-7A baylor shift on the same unit where we work with 2 nurses on the weekend. IMO, ITS TOO MUCH; so much so, I absolutely refuse to work extra if the nurse calls off. You just never know what could happen plus, with only two other nurses in the building, the facility won't hesitate to throw you under the bus. It's just not worth it to me and I value my license too much. I can get another job, I CAN'T GET ANOTHER LICENSE!:no:
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Specializes in LTC, Education, Management, QAPI.

Of course it's too much! 30 during the day is too much, too- however with funding only being cut, there's not much other way to stay in business. It's really sad. I'd like to see at LEAST 45/nurse at night and 20/nurse days.. It will eventually happen, but the SNFs need to find out how to make money some other way first. I COMPLETELY agree with you; but- it is doable. Our night nurses (also baylor on the weekend) have 30/nurse until 11 then 60 overnight. They do very well, both have been doing it 15+ years and the supervisor is extremely helpful.

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Good for you! Many times it's easier to start off on a busier shift (days or evenings vs. nights) so that you can get a good grasp of your time management and prioritizing skills, plus get to know your residents' norms much better prior to having them at night (even though it is unclear from your posts if you are even going to be moved to nights eventually?) 24 residents is a "reasonable" amount for a day shift with other nurses on the floor, given the acuity of residents and the amount of hands (CNAs) you have helping you out. At my facility, a day shift has 3 nurses (3 halls) and 8 CNAs spread amongst approx. 64 residents, so I think that I "got lucky" at my facility...

Good luck, and hang in there!

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DEPENDING on what floor i'm on, I can have 60 patients 30 skilled and the locked unit (dementia unit), or 60 on a separate skilled unit I pray that when I work no one falls, my Cna's don't " forget " to tell me about any skin tears, falls, or changes in patient conditions, and that I don't overlook any new orders not noted on MAR. OH! and I forgot LOL My relief comes on time HEE HEE

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