How can 1 LPN take on 60 patients in one shift?

Nurses LPN/LVN

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I am a new grad, LPN..And I heard that in a SNF, the ratio is 1 nurse to 60 patients..And in California, RNs get 1 nurse to 5 patients..I was wondering, how can this be and how do you deal with such a big patient load?

At the facility I was at, I had to ask the CNA to help me..The reason why, was that no one was trained on how to use the hoyer lift for patients..That is a lift that lifts patients out of bed and on to a gurney..There needs to be a qualfied person in doing that and the CNA was a qualified person..And the bottom line, my classmates were way too busy in their patient care and the CNAs at the facility were taking coffee breaks!

You mean your instructor didn't know how to use the lift? On our very first day of clinicals we always had an orientation to the floor. With our LTC rotation, on our orientation day, our instructor not only showed us how to use the different kinds of lifts, but she also made each one of us practice on each other. The hoyer lifts are just used way too often for us to not have known how to use them.

My classmates and myself were VERY busy all day long in our clinicals, so we just had to wait until someone was available to help us out. We were learning teamwork: I'll help you do that with your patient and then we can do this with my patient, etc. I think that's how they do it "in the real world".

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You mean your instructor didn't know how to use the lift? On our very first day of clinicals we always had an orientation to the floor. With our LTC rotation, on our orientation day, our instructor not only showed us how to use the different kinds of lifts, but she also made each one of us practice on each other. The hoyer lifts are just used way too often for us to not have known how to use them.

My classmates and myself were VERY busy all day long in our clinicals, so we just had to wait until someone was available to help us out. We were learning teamwork: I'll help you do that with your patient and then we can do this with my patient, etc. I think that's how they do it "in the real world".

You do not understand..The teamwork concept was not with my classmates..They were not team players. It was every man or woman to themselves..Backstabbing, talking behind people's back, ratting people out, that was not a team atmosphere at all and that is the real world also.. And the waiting game, it will not work out..Giving meds to 4 patients and all the other stuff going on, sitting and waiting would not be appropriate..I stand on what I did, and in the real world, I woukld do the same!

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You do not understand..The teamwork concept was not with my classmates..They were not team players. It was every man or woman to themselves..Backstabbing, talking behind people's back, ratting people out, that was not a team atmosphere at all and that is the real world also.. And the waiting game, it will not work out..Giving meds to 4 patients and all the other stuff going on, sitting and waiting would not be appropriate..I stand on what I did, and in the real world, I woukld do the same!

It's too bad your class was like that. Never really realized how fortunate I was to have wonderful classmates.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
The teamwork concept was not with my classmates..They were not team players. It was every man or woman to themselves..Backstabbing, talking behind people's back, ratting people out, that was not a team atmosphere at all and that is the real world also.
My classmates behaved similarly to what you have described. I had the misfortune of having immature classmates who talked behind peoples' backs, spread rumors, speculated, and engaged in sophomoric behaviors. These people still were in the high-school clique mentality.
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:confused: I am wondering why everyone is giving Bala Shark such a bad time. She came for advice and instead, she is getting a verbal lashing. Lets not cast stones here.
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Specializes in long term care.

I thought 1 lpn to 60 residents on night shift was pretty common,esp. in a non skilled facility. I live in Mo. and the only staff ratios set up in LTC are fire safety ratios . Are there guidelines for staff ratios for pt. care in other states? Am i wrong to think 1 lpn to 60 residents is common on night shift? what is the practice in other areas?

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Let's all stay on the subject, ok folks? Thanks!

Suebird :)

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I thought 1 lpn to 60 residents on night shift was pretty common,esp. in a non skilled facility. I live in Mo. and the only staff ratios set up in LTC are fire safety ratios . Are there guidelines for staff ratios for pt. care in other states? Am i wrong to think 1 lpn to 60 residents is common on night shift? what is the practice in other areas?
As Suzanne previously posted, staffing ratios only apply to acute care facilities in the state of California.

One LPN taking care of 60 residents during graveyard shift (10pm to 6am or 11pm to 7am) is fairly common in my geographical location. It is not too bad since most of the residents are sleeping...

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Well if you take on sixty patients on one shift you must be some nurse and the patients all very satisfied that is to say if you're the only one. After all who else would give them the care? I do think that california is a stretch in that like who wants to live in that place. Perhaps if you grew up there you could appreciate it but have you ever visited? Have you seen where you can spend your hard earned bucks? You can go hollywood disneyland worship or drive around suburbs forever looking for million dollar bungalows where you can live and hobnob with the rest of the people doing the same thing. I wouldn't go there except on a travel assignment and i wouldn't go out much. Anyway, how long have you been a nurse? Have you discovered how screwed up it can be? Good luck! Steve

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Hi Mimismom,

As an LPN fir 28 years...Do you believe it is possible to work as an LPN and not sustain musculoskeletal injuries. is there enough help available from fellow staff and mechanical devices so LPNs are not left to move pateints unsafely. OSHA research shows that lifting >35lbs even ergonomically-with good body mechanics is unsafe and does damage even if you don't feel the pain right away. How much is this respected in your experience?

I live in Maryalnd by the way.

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Specializes in LTC, Urgent Care.

At my facility, to have an LPN on nightshift, there has to be 59 or less residents. I'm not positive if that's just facility policy or from the BON.

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Specializes in Med-Surg.
Well only TX and CA have the LVN title..I really dont want any type of confusion because 48 states carry the LPN title so I use that one..I am in CA and I know it is LVN..But in short:

LPN = LVN

There is no difference..Just want to make things clear to the LPN folks out there..

THANKS BALA SHARK FOR MAKING THAT CLEAR. I HONESTLY DIDN'T KNOW THAT LPN'S ARE CALLED LVN'S IN OTHER STATES. SO YOU USING THE LPN TERM TO MAKE IT CLEARLY DOES MAKE A LOT OF SENSE.

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