How many residents is too many for one nurse? - page 6

How many residents is too many residents for one nurse to safely and adequately take care of? Where I work, the nurse has anywhere from 15-25 or 30 residents, depending on what floor/hall they are... Read More

  1. by   IowaKaren
    Quote from mehitabela
    Oh, I didn't mention. I work nights, 7-7. Our patients are the normal/ ridiculous mixture of inappropriate for this snf/high acuity- should be in a hospital types. I have worked there for a month. The other night, three of my pts managed to be "found on the floor" (they never fell, dontcha know!) and in the midst of all that mess, I had to send a pt out cuz they were...not ok. Four hours and ten reams of paperwork later I finally punched out at ten am. And guess who just got her first write up for clocking unauthorized hours!!
    Sounds familiar, especially the getting written up for not clocking out on time. The last place I worked was notorious for that, never mind what happened during the shift and the 'you should have done this, you should have done that'. Excuse me, you come and work a night in my shoes and tell me you could have done things the way you thought I should have. I'm not a child and I know how to prioritize, you write me up and say I should have found more help. You are the one who sent most of my help home early, where am I suppose to find this so called help. Anyway, that place is water under the bridge for me and now I work somewhere that appreciates what I do for them and if I can get done on time, great. If not, I don't have to go home worrying and loosing sleep that I will be wrote up for things out of my control. Funny how things are in the new place, even management helps if your drowning and doesn't give you the finger wag and treat you like an adolescent when you and they know what they expect out of you is literally impossible. Heck, LTC's anymore are charting much more than a hospital med/surg floor does, mainly because they don't use flow sheets and even with computer, they expect you to chart like you were only taking care of 6 to whatever SNF ressie's and forget the other 40 ICF residents that need constant charting on also.
  2. by   aroyce
    safe practice a "losing battle" w t h? and a DON said that?! w t h? someone in a high place needs to make A LAW for the ratio for safe care by law. It makes me sick, the nurses are dumped on, and the patients don't get what they are due. Unsafe practice and shortcuts are going to continue. as a nurse, i would never recommend any elders i know to stay at any LTC. I can't belive everyone is managing it and lookin the other way, making any LTC a bad enviroment. w t h. "good luck"? what?! i find the situation deeply disturbing.
  3. by   aroyce
    Quote from CapeCodMermaid
    Let's not turn this into a DNS vs. floor nurse. You might not realize all the constraints - time, money, and regulatory - we are under. I've done your job and every other job in the facility. I've had 30 sub acute patients of my own..IVs, TPN, wound vacs, trachs, wasn't easy but I got it all done and none of the residents suffered.
    I will agree that some LTCs need to increase staffing, but where do you propose the $$ will come from to pay for it?
    If the facility can't provide staff to take care of the patients, they need to stop admitting the patients. i think it's greedy for a facility to accept more patients than nurses feel they can safely handle. If you can't afford the staff, what makes them think they can take in the extra patients????!!!! hello?!!!
  4. by   aroyce
    Quote from Aem1215
    LeeLee, you are misinformed. LTC is the most federally regulated industry in the US. We have more regulations than the nuclear power and waste industries, even.
    the federal regulations aren't working
  5. by   morte
    Quote from aroyce
    the federal regulations aren't working
    they are certainly felt!...sometimes misapplied, sometimes twisted, sometimes administered by ejits. sometimes too much! take away money, and expect more services NEVER works.
  6. by   angie1368
    I'm a recent LVN grad and I just got my 1st official job as a nurse. Currently, I am caring for 60 residents. That is sooo insane!!! I've only been on the floor for 3days. I'm going crazy. Seriously, i'm very curious how many residents/patients is too many for a nurse?
  7. by   jeffrey_rn
    Quote from tyvin
    ...make sure you know the code status of all residents.
    There's the rub... when you're responsible for the health and safety of a ridiculous number of human beings (and living in a lawsuit-happy world), you can't know enough fast enough. If it feels wrong, unsafe, overwhelming- stay away! I work in a hospital, so the ratios I hear in this forum freak me out. I know the level of care is different, but I would NEVER EVER EVER assume care of dozens of people. I thank you all for the heads up. Won't be searching the job listings for LTC facilities in this lifetime. If our society cares so much about our elderly, why is it so unwilling to pay for the care providers needed to do the job?
  8. by   nurselabrat
    I worked for the first time last Sunday in LTC. The agency called me about 11:00 the night before and asked if I could take the 7-3 shift. I let them know I had no LTC experience. They assured me if I took the case I would receive orientation and help. that did not happen. I went early for that orientation. I should have left then. But I've never left a job. They did not exactly welcome me there and there was minimal help. Couldn't even find the CNA's. I had 32 patients. about 12 Bloodsugars, Insulin, feeding tubes. 3 very bad patients. One was sent out to the hospital. Worst experience of my life, and I will not go back there. Unfortunately now I am afraid to even try it again in any other facility. This should not have happened. Not only did I feel like my license could be in jeopardy, I was terribly concerned about the care the patients were getting, because this is the norm I was told and as I understand it. Something needs to be changed. There should be laws that restrict the number of patients a nurse is responsible for. There should be something else done. When you have a patient that is about to code, you need help. I don't know where to start with this but I do know something needs to change. In medicine you are suppose to help alleviate human suffering. Not cause it. These people are trapped. They are at our mercy. Our society needs to do more than try to sue the nurses, or the facility. They need to change the way the facility is managed and make sure the residents are taken care of. I am extremely upset about this. My mother was in LTC for a long time years ago. I wasn't a nurse then and did not understand why they couldn't take care of her. I am a nurse now, and I understand, and it haunts me.
    Last edit by nurselabrat on Jul 7, '12
  9. by   JZ_RN
    In LTC I had 50+ residents, some very acute honestly. as it was LTC/SNF and my assignments were spread out over 2 floors. It was miserable. Never working LTC again I hope! The whol LTC system has to change. If a nurse has more than 8 patients, of any kind, ever, period (even ltc) they don't have time to give decent care. Sorry but it's true and we all know it.
  10. by   No Stars In My Eyes
    An LTC was my ruin and I will NEVER EVER work in one again!!!!!
  11. by   CapeCodMermaid
    No Stars....are you working now? Did you give up nursing to work at Starbucks? Did you lose your license? Ruin is a rather strong word.
  12. by   No Stars In My Eyes
    No interviews to any applications. Working as a CNA thru an agency. Have gone thru severe depression and just now stabilizing on new meds. Will make one more stab at applying at a few more places. UGH!
  13. by   seeami
    Every year our facility makes sure every employee completes an abuse mandatory inservice. The administrator is the designated person to go to to inform about an abuse situation. Neglect is a form of abuse. On the eve shift I am responsible for usually 22 to 25 Residents. I have 2 med passes and 9 - 10 diabetics to do finger sticks and sliding scale coverage on. I an suppose to answer any calls from families, labs or any other calls regarding the Residents. I have to do incident reports on fall, wounds or unusal occurances. I am suppose to order meds and check in any meds that are delivered. I supervise CNAs and sometimes only have 1 CNA so I am suppose to help answer lights too. I am suppose to do exceptional charting and any charting on new, skilled , unusal occurances and in any Residents receiving antibiotics. I am suppose to do treatments and body audits scheduled. If it is humanly impossible to do and things get left undone, then neglect to Residents occurs but goes unrecognized because of either blantant denial or
    lack of true understanding. From what I am reading here, this is becoming the norm in LTC. My one break is usually 2 mins to heat my food and 5 min to eat it.
    Last edit by seeami on Oct 31, '17 : Reason: More to add and misspelling