1 LPN to 75 Residents

Nurses General Nursing

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I just started my first lpn job working nights, and normally there are 2 Lpns for the entire building over night. Census of 75. I just passed the nclex on the 3rd of January, so I'm fairly new to lpn game. Last night where I work they had me from 6p-6a and another nurse 6p-4am scheduled. I called the DON and told her I was uncomfortable being the only nurse in the building for 2 hours. At first she told told me that there used to be only 1 nurse that worked over nights and I should be able to handle it for 2 hours. Then the DON did come in at 5am to help me. I'm just wondering if that is something that is normal or if that is a no no to having only 1 nurse for 75 residents. Granted there were 3 CNAs too. What do you guys think?

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Specializes in Psych (25 years), Medical (15 years).

Welcome to AN.com, Sarbear!

In comparison, I worked the MN shift at two different LTC facilities being the only nurse. One was back in 1984, and I don't remember the number of residents, but I was the only LPN. The second one, in 1995, had 90 residents and I was the only RN. Well, sometimes an LPN also was also on duty. I believe there were usually about 4 or 5 CNAs.

Aside from passing a few meds, doing a few accuchecks, and maybe one tube feeding, the majority of the work was custodial.

Being a relatively new nurse, I can understand your concern. Sometimes we are bathed in the waters of reality and have to fly by the set of our pants to make due. The DON as good enough to come in early and help out, so all is well that ends well.

Hopefully, this will not be the norm, but under staffing is something we all have to deal with from time to time.

It is good that you voiced your concern so your stance is known.

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Specializes in Hematology-oncology.

I agree with everything Davey Do said. My only added piece of advice is to quickly check your state regulations. My only experience with LPN nursing (before finishing my RN) was at an LTC in South Carolina. That particular state has ratio laws for extended care facilities which limits the number of patients a licensed nurse can have to 44. At the time, I thought that number was crazy high....but I guess now I see why it was in place. Hang in there!

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Specializes in Pediatrics Retired.

And...it's always a good shift when no one dies.

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Specializes in Psych (25 years), Medical (15 years).
And...it's always a good shift when no one dies.

Never mind.

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Just updating everyone but in Kansas, as I called state since I couldn't find the information on the internet. There is no nurse patient ratio. They told me If I don't feel comfortable being the only nurse the only thing to do is to not accept the assignment, but as soon as I accept it, I have to finish the shift.

Hopefully this isn't an everyday thing but at least I have the peace of mind of knowing my state regulations (:

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Specializes in Geriatrics w/rehab, LTC, hospice patient.

75? That's way, way too many. All it takes is one thing to go wrong and you're screwed.

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Specializes in retired LTC.

1:75 is way too much for a newbie. RN or LPN, it doesn't matter!

Today's facilities are no longer mostly 'custodial' care. Too many 'sick puppies' out there.

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There is no way I would work a 1:75 ratio of an assignment. What if something happens? You have to protect your license. Especially as a new grad.

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That is a lot for one nurse to handle. I like the way you handle the situation. At the LTC facility that I work at we have I believe approx. 184 beds/residents. The powers that be (management/head office) decided to layoff 2 day RNs and add one extra on evenings and nights. Meaning there will be only 1 RN in the entire building during days for 184 people. The RN left on the day shift has already expressed her concerns with this but management haven't really done anything yet to help alleviate her concerns. My suggestion would be to continue to express your concerns to DON and contact your union (if you belong to one) to see if they can help you or offer any advice. Another suggestion would be if you can find another job/position that does not require you to risk your career/license.

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