How many residents do you care for Per Shift?

Specialties Geriatric

Published

I work 1400-2230 as an LPN (soon to be RN as soon as I take boards). I work in a LTC facility that has 68 beds that are always full. So, each night, on second shift there is always myself and 1 other nurse. We are constantly promised that we will "soon" get an OMT to help with med pass, but this never occurs. I am curious what other LTC 2nd shift (evening) nurses have to deal with?

My duties: I have 34 residents a night... all get pills at 1700, about 50% of these get pills again at 2000, and about 25% get pills at 2200. I have approximately 10 diabetics that need blood sugars/insulin at least once per shift, 3 wound dressings that take atleast 10 minutes each, I have 2 residents with G-tubes. Almost all my residents get atleast 5-10 different meds during our 1700 med pass. I have 10 residents with eye drops, 4 with weekly procrit injections, 1 with a colostomy that gets completely changed q3 days. This is in addition to the fact that our secretary leaves at 1500, so we answer phones, respond to faxes, get doctor orders, sign out meds from pharmacy, call family with labs/med change/condition changes, ect.

And then comes charting.... on average, of my 34 residents, at least 6-10 are skilled, so they require mandatory in-depth charting, usually 4-10 residents are "flagged" (i.e. monitor for mood changes d/t decreased antidepressant), and then any charting that comes from lab results, med changes, ect.

I'm just very interested in what other nurses responsibilities are, such as how many residents they are responsible for, ect. Even our first shift nurses (0600-1430) often get stuck with just 2 nurses and 1 OMT for all 68 residents. I'm very interested in what everyone else has to deal with!

Specializes in Med/Surg, Geriatric, Hospice.
Isnt that out of your scope?! oh my GOD

well i think the nurse to patient ration is 1:80, and that is just sad:yawn:

Holy god, where do you live? In Florida, our scope is 40, and THAT can be pretty bad as well.. I usually have no more than 25-30.

Specializes in long-term care.

i am a lpn on evening shift as well, and i have 45 residents, with at least 8-10 skilled, plus hot rack and q shift charting which on any given night can put you to charting on up to 20 charts or more! in whats suppose to be an "8" hour shift! my med pass is just as horrible,10 fsbs at 4, and 8, with s/c and scheduled insulin, 4 pegs, and a million narcotics to give scheduled, and prn, plus at least 4 up-drafts to do, meds are due at 4, so i start at 3, and i move quick and i still dont get thru with the first pass until around a quarter till 5, then like you said theres answering the phone, signing in medication, and the cnas cant touch the feeding tubes, so im ripping and running placing feedings on hold, or turning off when the cnas need to do something with the resident, plus summaries, treatments, and body audits! its absolutely ridiculous and unsafe! and that doesnt include if something out of the ordinary happens, i&a, someone gets sick, someone comes back from the hospital, new orders, etc, and god forbid a peg tube is stopped up!.............so know that you are not alone, lol, and i kno you cant wait to get your rn, good luck

Specializes in Medicine, Geriatrics, Pedi,ICU, Oncology.
:bugeyes: good question ! Why is the patient ration not controlled or regulated ????? and to think I am changing gear to go to this specialty ?????tha is why I am here and listening to you ladies . So far it sounds like that the LTC is controlled by a small business people , and staffing is done so low for profit??? should we not bring this up for regulatory review so staffing may be also by ratio? It's just not the employees, but also the safety of the residents!!!

There is a federal regulation for what the temperature can be in a home but the regulation for sufficient staffing it is basically defined as ability to meet basic needs. It is really hard to get cited for insufficient staffing because if the feds/ state cite you then they ACKNOWLEDGE that they must pay to reimburse the care they say you must provide. The feds/ state are not willing to do that often enough to make it an issue that requires probing. It is a vicious cycle. I have seen some horrendous examples of staffing reviewed during a complaint survey that were not cited. I am talking 2 nurse aides for 120 residents. It astounds me.

Management has their head stuck up their butts. Thats why they can't see or hear these complaints or problems. We have been telling them, but they don't listen and we still keep working and trying to get it all done. I really think when you get it all done and complain, your pleas fall on ears that don't believe your problem. I can never get it all done, so don't look to me for perfection. But at the beginning of my shift I have such high hopes.

I work the 11-7 shift generally. I care for 52 elders with the help of 3 CNA's. Med pass is lite when coming on shift but by 5am I'm like a steam roller trying to get morning med pass, fsb/insulin and last minute charting finished prior to 7a shift reporting. Just when you think you've got a system....someone CTB's or falls at 6:30a and I still have meds to finish, a colostomy to change unexpectedly becuz it wasnt intact, or a bottle to hang...Im sure you know what I mean. Oh did I mention that the facility for which I work is run by the county...currently we are on an OT restriction which means any OT must be okayed by administration. This correlates to get everything done and be punched out no later then 7:15a. Ridiculous.

But for as much as I like to complain about the work load and the serious walking (wear a pedometer 1x) I do....I wouldnt not be there. I give as much to the people I care for as they give back to me. I never received this kind of fulfillment in any other occupation. Sure there are times when a resident might swat, spit, kick you when trying to do a dressing tx or give a med but more times there are those that generally appreciate that you are there to help them or hold their hand when they are passing.

Fellow nurses, I feel like I have come home. Thank you for sharing.

I'm on 3-11 shift. 27 residents, 12 skilled requiring qshift notes, 7 diabetics w/4p/hs fsbs, 2 foleys, 1 picc, 1 nephrostomy, 1 gtube w/3 feedings on my shift, 1 requesting a straight-cath at least twice on my shift, 3-4 dsg changes. Nurses do all our own tx. I have 2 cnas with me. No secretary. We do all the admissions, paperwork, etc. Although this doesn't sound this bad reading some of the others.

This is my first job out of school. I NEVER WANTED to work LTC. There was nothing else available around me, and believe me I looked. I am still looking. I am doing everything I can to get out of there. Mgt is unbelievably demeaning, the latest is we have all been "verbally warned" that our call lights are not being answered quickly enough; if it continues then everyone on my floor will be written up. My unit mgr actually snuck down to a room, hit the call light, and timed how long it took someone to answer the other day.

Everything we hear is negative, nothing positive about all the work we do. I am beginning to have panic attacks before I go into work. I cannot sleep when I come home from a shift because I worry about what I missed (case in point, tonight - I've been up since 3 because I suddenly questioned whether I wrote a note or not).

The pay is decent; I love some of my residents and some are very grateful; I have made a very good friend there. I used to be in computers. There are more and more days when I wish I still was. I am rapidly questioning why I ever decided to become a nurse.

Specializes in Dementia Care, Long-Term Care, Sub-Acute.

When I worked in the alzheimer's LTC unit on average I took care of about 30 residents, with me and 2-3 CNAs.

Now I take care of about 22 LTC residents and it varies, my section has 30 available beds. It doesn't seem like much but nowadays my residents are more medically complex. I have a mixed population of residents which vary in age from 30-90 year olds. I also have bariatric residents, I have residents that are there for short-term rehab and need a lot of attention. As everyone here knows that we bust ourselves trying to get done.

I don't think the number of residents you care for matter. I can take care of about 40-50 as long as they are medically stable. I know that in hospitals nurses have about 4-5 but stays busy all day long!

It's the amount of care that each of them need and the amount of people you have for support to help you care for their needs that matter. Thank goodness for the CNAs I have with me and the treatment nurse who does the dressing changes.

Specializes in psychiatric, UR analyst, fraud, DME,MedB.

Well look who is here !!!! My favorite niece !!!!!!! By the way folks this lady have awards of good work done from where she works. I feel very proud of her for what she has done for herself. She said that I was the one who influenced her to go into nursing ! Gosh.....(blush , blush .....) If I did, then I must have kudos up there since she turned out to be such an excellent and hard working nurse and really cares for her residents!!!!

:redbeatheI love you girl, always!

Go for that studies---- I know that you will be do it w/ flying colors !. You pick a career that does not stop learning......always moving ahead and improving processes......... :yeah:

Specializes in Geriatrics, MR/DD, Clinic.

I have worked in 2 other facilities where there are approximately 60 residents and 2 nurses on. It was always very busy, g-tubes, established trachs, numerous diabetics, wound care, colostomy care, you name it. I understand how difficult it can be. On a *good* night (no falls, no transfers, no admits) it's not so bad. But when things get hairy it can be difficult to manage.

Now, I just took this job so you may take it with a grain of salt.......but I am currently working in a 37 bed facility (not all filled up though, so about 33 right now) and there is just one nurse and one TMA (plus CNA's for patient care). I don't think it's too difficult, as long as there are no falls, no admits, or no transfers. Just the same haha. I am really enjoying the smaller facility but since it is smaller, there is no other nurse working with you to help out if you fall behind on nursing duties. I stay busy and on my feet for the full shift and have a hard time taking my 2 15 minute breaks, but I enjoy it.

Specializes in psychiatric, UR analyst, fraud, DME,MedB.

It does sound reasonable . But what are TMA's ? How many CNA's do you get for help? Of course it also makes sense as to what are your patietns diagnosis. You see I am listening to this , since this is my alternative and direction to go if I change directions of my career. As of now I have worked in medical review or UR in private insurance , Medicare and now DME A jurisdiction. I find reviewing med nec as a 2nd nature by this time , and only do research on those that i have not heard or more complex. We have what they call LCD's ( policy guideline) and this is helpful in guiding for a proper determination.

Somehow I am attracted to the geriatric population...I know ther are lots of room of improvement in the services of the elderly , not to mention the meager reimbursement from the government , and this is possibly the number one cause of the understaffing in these type of facilities. We have a long way to go , and as nurses we can really help if we actively get on board for the health reform.

Two important things we need to be proactive ladies and gentlemen, and that is to be pro active and even an activist for health reform and financial regulation reform. A nurse association should be as powerful and effective as the AMA! The AMA are taking care of themselves, why can't we nurses do the same ? There are plenty of us and are smart people.......so what is keeping us?

Any suggestions how we can move this forward ? ;)

47 residents...7-3 shift.I'm usually the only LPN on the unit and someone is sent to do the treatments...4/5 CNAs...NOT easy at all....But I LOVE my residents!!! Well most of them.lol

Specializes in Dementia Care, Long-Term Care, Sub-Acute.
Well look who is here !!!! My favorite niece !!!!!!! By the way folks this lady have awards of good work done from where she works. I feel very proud of her for what she has done for herself. She said that I was the one who influenced her to go into nursing ! Gosh.....(blush , blush .....) If I did, then I must have kudos up there since she turned out to be such an excellent and hard working nurse and really cares for her residents!!!!

:redbeatheI love you girl, always!

Go for that studies---- I know that you will be do it w/ flying colors !. You pick a career that does not stop learning......always moving ahead and improving processes......... :yeah:

My Auntie is the greatest! When I was in my teens she always told me I had great potential to do whatever I wanted to do in life. I chose nursing because of her. My Auntie is tough, intelligent, caring and beautiful! Her positive influence will always stay with me. Thank you Auntie and I love you too, Very much!:redpinkhe

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