nurse to patient ratio

  1. I work 2nd and 3rd shift in a LTC hospital. Am I way out of line for asking for another nurse at night when I have 37 patients and only one is self care? I am so busy at night that I haven't had a lunch break in months. I am never finished on time and stay over everyday. Our residents get to sleep so much during the day they are up all night.
    I also have another question, does anyone else have to deal with combative patients that hit, bite, scratch and throw urine at people? If so does the management do anything or just tell you their hands are tied?
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    About lizzy84763

    Joined: Jun '09; Posts: 5

    15 Comments

  3. by   MurseMikeD
    Wow... just, wow. What state is this in?!
  4. by   lizzy84763
    spectrum health in Michigan.
  5. by   iteachob
    Quote from Elisabeth44
    I work 2nd and 3rd shift in a LTC hospital. Am I way out of line for asking for another nurse at night when I have 37 patients and only one is self care? I am so busy at night that I haven't had a lunch break in months. I am never finished on time and stay over everyday. Our residents get to sleep so much during the day they are up all night.
    I also have another question, does anyone else have to deal with combative patients that hit, bite, scratch and throw urine at people? If so does the management do anything or just tell you their hands are tied?
    Are YOU out of line asking for help? No.
    Is Management out of line thinking that this is a reasonable ratio (37:1)? Without a doubt....yes! How in the world can this be thought of as safe?
  6. by   sunbeach73
    Where I work if someone is acting out: biting, scratching, hitting, throwing urine, feces or other objects we ask for a psych eval, immediately call the doctor for something to calm them down and if that doesn't work we send them to the hospital to be admitted to the psych unit until the behaviors are under control.
  7. by   DAVISJA
    Wow!!! That is very unsafe for the patients and you. If I were you I would find another job. As soon as something bad happens your license is on the line. As far as combative patients, restraints work very well!! Good luck to you!
  8. by   kanzi monkey
    Umm, not to be insensitive, but I'm going to have nightmares after reading your post. (No really. I am.)
    I don't think I could adequately introduce myself to 37 patients in a shift, much less care for them. God forbid their mental status is...compromised.

    I truly admire you for completing one shift. I am in acute care, so maybe I'm making an erroneous association between my facility and yours, but, um, complete care is complete care. It takes a lot of time. I sometimes wonder about LTC, having never working in that environment myself. My toughest, and most critical patients are usually from LTC--when I care from them post-operatively, it's their chronic, progressive illnesses that pop up and bite us all in the rear. The collective sigh of relief when they are discharged back to their respective LTC homes does not bode well for those facilities.

    Just FYI, I don't speak from the wisdom of many years experience. In my 2 years, this is my impression.

    Kudos to you. If you can handle one shift there, you can do a lot of things. I recommend trying something else!
  9. by   Riseupandnurse
    HOW in the world do you stand it?? WHY in the world do you stand for it? I would never accept a job, anywhere, any shift, where I was the only nurse.
  10. by   NursingStudent5548
    I just recently left a LTC facility like this... I worked there for over a year and the Nurse ratio was never better than 46:1 in the entire time I was there. I left we were paid a measley wage as a CNA I was making $6.85/hour!! I was 6 months pregnant when I left and was getting assigned to 16-18 patients myself a night. With combative issues, needless to say the last straw came when my stomach became a beacon to swing at and my back about gave out for having to lift and turn overweight patients by myself. I could have easily left and went to ANY of the surrounding nursing homes during that time and made an immediate $3-4 more an hour. No, I stayed I felt some kind of loyalty to this facility.

    I ran into health problems as well I had high blood pressure, and proteins in my urine. I had severe back pain from my kidneys and the lifting. I was getting bi-weekly massages. Finally I got a doctors note to stay home off my feet unless I could find a job the only required me to lift 25lbs or less and on my feet for less than 2 hours at a time.

    Well finding a job that late in pregnancy and with such a low weight capability was next to impossible. I finally caved and filed for unemployment.

    THIS is a private owned nursing home... the family had been family friends for years (so we all thought).

    A few weeks later they got the notice of my attempt to collect some (VERY MINIMAL) wages. I got a called that day from the main owner and let's just say it was not pleasant...so much for reciporcated loyalty and understanding!!!

    I get disgusted when you do the math... They employ about 30 some employees and all but the 7 RN's and LPN's make 20k a year or less.

    $4k a month from 46 patients= $184K a month spend about maximum $60K (VERY GENEROUS since I made around 500/biweekly and was one of the HIGHER PAID) for employee wages, utilities (Estimate maximum $4K, and groceries (estimate a VERY GENEROUS $10 per meal= about $40K) medical supplies since we don't do IV's rarely do blood draws it is mainly bandages.

    Thats a HUGE PROFIT margin.

    It's disgusting they couldn't pay us more, or higher more employees!!!
  11. by   nurseofalltrades
    I posted something similar to this a few weeks ago. I work 6am to 6pm and I too have anywhere from 35 to 40 residents to myself as do the other LPNs. Do we think it is safe? Absolutely not. Our management doesnt give a damn because the work manages to get done.We have been begging for more staff to no avail. It is very stressful!!!! And by the way, yes my residents kick, swing, bite, spit. It is just part of my day. The management is worried about filling beds. They dont care what type of resident fills it.
  12. by   lizzy84763

    it has become more about the profit than the patient. How can we provide the best care we can to 30-40 patients at a time. Its hard enough to get everything done when its a "slow" night, but can we get some help, no.
    I wish they would walk in our shoes just to see how frustrating it is.
  13. by   nurseofalltrades
    I wonder sometimes why they let us work in these conditons. Do they realize how stressed out we are? I mean say I have my usual 38 pts(is my avg) and one falls and one is vomitting and one is combative..How easy would it be for me to make a mistake that could potentially kill someone?Scary isnt it?
  14. by   lizzy84763
    The problem is they don't care that we are stressed. Maybe it will take someone dying from a mistake for them to realize that's to many patients for one nurse. Kinda makes you want to hit your head into the wall.

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