Is this understaffing (or is it me?) - page 3
I recently interviewed at a 120-bed, LTC facility. 118 beds are currently occupied; 16 are a locked Alzheimer's unit and the rest are two wings consisting of fifty + residents. I would be working... Read More
Aug 8, '04Joined: Jan '02; Posts: 5,673; Likes: 159Wow, I don't know how LTC nurses do it. 50 plus patients to oversee....I imagine all you do all shift is put out fires and do paperwork. I can see why these homes go to medaides...the nurse doesn't have time to get the routine meds passed.
I imagine having good CNA's is what can make or break a nurse in LTC...you rely on them so much by necessity.
My hat's definitely off to those of you whose love for the elderly keeps you in such tough conditions.
Aug 12, '04Occupation: lpn charge in nursing home Joined: Jun '04; Posts: 32Our facility has about 110 beds, and we are practically full right now. Our staffing is this:
7-3 shift: 4 lpns, 1 tx lpn, 12 cna's, 2 rehab cna's, rn(mds) lpn (mcare coord) don, adon, rn supervisor
3-11 shift: 4 lpns, (sometimes only 2 or 3) 6-8 cna's
11-7 shift: 2 lpns, 6 cna's
Even with all this staffing, dayshift runs ragged...what with all the family, doctors, etc. calling/visiting + visitors, too. Then add in the "call-ins" on all shifts, it's rough. we have 2 main nursing stations, and on the night shift, sometimes 2 nurses will split the 11-7 shift for one station....1 stays until 3 am and 1 comes in at 5 am. Not much fun for the other nurse left in that lone supervisory position for that small time period. I always wonder what will happen when the are catastrophes at opposite ends of the building!
Aug 14, '04Occupation: RN Joined: May '99; Posts: 3,488; Likes: 118My experience is that most places are well staffed only in the best case scenario...in other words, IF everyone shows up, IF your staff all do their jobs well without constant supervision, IF there isn't a full moon, IF there are no residents going bad, IF there are no new admissions, IF there are no visitors coming and complaining about their relative's care, IF you aren't interrupted with a phone call every 15 minutes. Those IF days almost never occur. Most days you run yourself ragged and you consider it a good day if actually acheive decent nursing care.
Aug 18, '04Occupation: Independent Nurse Practitioner Joined: Aug '03; Posts: 191; Likes: 17Quote from aimeeeIF ONLY! Have experienced many years of nursing (35+) and still waiting to hit the real no-IF day.My experience is that most places are well staffed only in the best case scenario...in other words, IF everyone shows up, IF your staff all do their jobs well without constant supervision, IF there isn't a full moon, IF there are no residents going bad, IF there are no new admissions, IF there are no visitors coming and complaining about their relative's care, IF you aren't interrupted with a phone call every 15 minutes. Those IF days almost never occur. Most days you run yourself ragged and you consider it a good day if actually acheive decent nursing care.
Best time, and probably the only time to experience no-IF days, is when you are away on leave somewhere on a beach into your second glass of bubbly.
Aug 18, '04Occupation: Pedi RN Joined: Sep '00; Posts: 2,728; Likes: 109I think the criteria for determining staffing should be based on patient safety (including patient acuity) and whether or not the staff gets work done consistently on time. If there are med errors, falls, tx being missed, etc. then there is not enough staff. I have never worked in LTC but that sounds like too many patients for one nurse.
Aug 18, '04Joined: Aug '04; Posts: 566; Likes: 8In our assisted-living home we have 45 residents, 15 of whom are in a secured Alzheimer's unit (dementia wing).
We have 1 or 2 med techs and 2 other CNA's on the 7-3 and 3-11 shifts. Typically, if there's one med tech, they are assigned to pass all meds and be the CNA for the assisted-living halls. If there's two med techs, one of them passes meds for the residents in the dementia wing. On 11-7 we have 1 med tech and 1 CNA (who works on the dementia wing).
In the morning 11-7 is to have all residents on the Alzheimer unit dressed and ready for breakfast. In assisted living 4 residents need to be dressed, and several others need us to wake them up. All of this must be done by 7 AM, because breakfast starts at 7:15 in the Alzheimer unit and 7:30 in assisted living--crack o' dawn, folks!
Does anyone know the requirements for staffing in assisted-living homes in Georgia? We're staffed pretty well right now because census is up, but in the past we've had problems with short-staffing.
Aug 29, '04Joined: Jul '04; Posts: 260; Likes: 19on 11-7 shift we have 1 LPN no RN and 4CNA's for 60 patients.
Jul 7, '07Joined: Jan '70; Posts: 279; Likes: 26Quote from PRILLY515hello all, i am new to allnurses. I currently have 4 more classes left for my BS in health science but i plan to attend nursing school in the spring. I've been reading the posts for several days now and it has helped me answer some questions that i had. But as for the 50 patients per 1 nurse, that is crazy! I work in a hospital here in Miami and it is usually 1 nurse and 1 cna per 5-6 patients. I couldn't imagine anything more.
The 50+ patients, 1 nurse, 2 CNA's ratios that people are talking about is for nursing homes, not hospitals.
Jul 15, '07Occupation: staff nurse Specialty: 16 year(s) of experience in LTC ; Joined: Apr '07; Posts: 50; Likes: 5i work in LTC also - i am responsible for 40 patients on 2 long hallways -we have med techs that pass meds to all of these patients, but that is on 2 units, some days she is required to work also as a GNA in addition to being a med tech on one floor- on those days i do med pass to 25 patients, along with 12 fingersticks and insulins in the morning, and pass all of my AC meds or otherwise they would not be given as scheduled - i also do on the average 150 lab results a month to all of the docs, and do documentation on such - PLUS the 24 hours report - PLUS admissions and discharges -PLUS IV therapy -PLUS listen to my supervisor tell me that i am not doing my job properly because i missed doing a skin assessment - which got me a interdisciplinary action taken right as i was leaving for vacation that day - if you are lucky enough to have 3 GNA on a unit, thats a day to celebrate that 25 people will actually get fed their meals before it gets cold -
Jul 15, '07Occupation: staff nurse Specialty: 16 year(s) of experience in LTC ; Joined: Apr '07; Posts: 50; Likes: 5i just re- read your post - and i agree with you there - i know for a fact that my med error rate has at least doubled - (for little things, but my NM feels the need to write up everything ) and my documentation could be much better - but now we are on the "dont use the clock" plan which means no overtime, even if you are not finished with your assigned duties - which my charge nurse likes to tell me " just let the next shift do it" and as for patient safety - we now have an abuse issue because their was only one GNA on the unit during midnite shift ( the nurse was on the other wing she has to cover with an emergency situation) and there were 3 people trying to all get out of bed at the same time - and one resident was put in a wheelchair with a gait belt to keep her in place while the GNA tried to tend to the other 2 - with no assistance because the staffing is so low on 11-7 in my facility - now not only are the GNA and the RN on that shift being investigated, but the state nursing board is examing other issues there - thank goodness that we have an Ombudsman that is on the ball and trying to get staffing issues covered - but i doubt that the corporate offices will see her point of view either
Jul 15, '07Occupation: Psych nursing Specialty: 9 year(s) of experience in LTC, MDS Cordnator, Mental Health ; From: MN, US ; Joined: Jul '06; Posts: 525; Likes: 354the LTC that i work at we have 1 LPN and 2 CNA 's for 58 residents 6 units are Assisted living, There is only and early morning Med pass that consists of Tylenol Supps Some Neb Tx and eye drops. and an assortment of PRN's Lots of Charting. the CNA 's do Rounds and the LPN Asssists when necessary. I loved the night shift. when i was an LPN