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Discussion

Is this common?

I am wondering about nurse to patient ratios in LTAC facilities and what is deemed to be safe. I work on a unit that has 40 residents and sometimes get floated to units that have 58 residents to one nurse. When I floated I ran around for about three hrs just putting Exelon Patches on people that all had to be signed off, (all on count, mind you). Unit manager was nowhere in site, (went out to a doctor's apt, Dunkin Donuts etc.). I had labs up the wazoo! Also, not to mention all the charting that needs to be completed (still paper for everything). Answering the call lights and telephone rings off the hook. Waiting for doctors to call you back because you have many labs to report. Dealing with behaviors, and then, you have to clock out by 3:30pm because they don't want to pay you overtime.

There is enough work for at least three people, that one must try and get done in 8 hrs. Break that gets taken out of your paycheck even though you never eat. Unfortunately, what they (management) wants us to complete cannot be done in the timeframe they want. So, the work gets passed on to the next shift and so on. I feel more like a secretary than a nurse. Definitely, cannot provide the kind of care that is so necessary. God forbid that you have an admission and a fall almost at the same time. Yes, it did happen. I know that I am complaining, but need to know if this is common.

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    • Featured Replies

    • Experts

    Are you sure this is an LTAC...Long Term Acute care?

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    I was thinking the same thing...can't be an LTAC with that many patients per nurse.

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    • Experts

    I don't think so either.....has to be LTC or assisted living

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    • Author

    It's a LTC facility with Rehabilitation. It's a four floor facility. One dedicated to Alzheimer's/Dementia and another dedicated to Psych issues. The other two floors are a mixture of them both with some rehab patients too. Sorry for the confusion.

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    • Experts

    moved to LTC for best response.....I am not familiar with LTC it seems a little high....but I know 30-40 patients is common.

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    At my LTC we are 20-1 roughly. 45 - 65 to 1 is bad!!!

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    You might expect to see that kind of ratio on overnight shift, but not during the day when you are passing meds and completing treatments, charting and noting orders for that many patients. 20-25 patients to 1 nurse on day shift is common, but we also have MDS coordinator, QA nurse, and Rehab nurses who we call on to "pitch in" and help when acuity level is high. The workload can vary a lot in LTC if you have a fall, sick residents,..

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    I work nights and that's about my ratio. One CNA, me, and 40 patients. During the day it's 2 nurses and 2 CNAs.

    It's super tough. The 6am med pass has me in cold sweats, especially when I realize the 7am shift is filing in and I haven't finished, or even recorded report!

    Our Unit Manager is pretty good, but last night she sent a rehab pt with chest pains to ER and everyone had to go help. I was in tears bcs it took so much out of my shift. Same thing if we have a fall. Everyone has to go assist, so you feel like you're losing time and of course you're terrified of what's happening on your own floor.

    It feels like if everything goes perfectly, I have time to provide competent care to my patients. But when does everything go perfectly in nursing? :p

    And yes the paperwork is brutal, the docs specifically ask that you don't call them, and breaks are automatically deducted, even though I've never taken one. I just factor the half hour into some of the time I take to finish up. Even though I'm usually there another half hour after that. :(

    But at the end of the day (or beginning... whatever) I know that I am on my way to becoming a skilled geriatric nurse, and hopefully someday I'll actually feel like a nurse and not a med passing, note writing, perpetually panicking disaster.

    As long as everyone is safe and free from infection, I feel ok when I click out.

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