Quote from CapeCodMermaid
We're going through this now in my building. I say one nurse to 34 patients on a 3-11 shift is more than adequate. We need to look at acuity as opposed to just numbers of people in the beds. On my long term floor there are 4 residents. There are 2 nurses the first half and one the second half. My dementia unit is the same. All the nurses are up in arms. I've been a nurse for 25 years and when I worked on a true sub acute unit, I had 30 patients for meds, treatments, and MDSs. I had 5 IV's all with q4 antibiotics, 3 Gtubes, fresh traches, and a few people at the end of their lives from AIDS. I got it all done (well and on time I might add). Now my nurses complain about 34 old people who aren't subacute in the least.
I suppose, like you say, it depends on acuity. On swing shift with 34 it COULD go either way...in my experience, every nursing home with that kind of census had 6-10 diabetics (so that meant finger sticks and sliding scale at 1630 and 2000); plus we had 1700 and 2000 meds, with the average resident taking 4-6 pills at each pass plus BP meds which more often than not had a BID BP check along with giving the med. Then there were typically 2-6 tube feeders, and a PICC line or two thrown in with vanco or similar being hung QID. I would typically have around 15 on alert charting and some of those on Medicare/skilled charting as well. Then there are all the unexpected things; falls, fevers, unexplained injuries, etc.
What I have noticed is that there are a few nurses, such as yourself, who are capable of handling such a workload, and doing it well. God bless them and you for doing it, because in my experience (and I include myself) there are those for whom it is just way too much.