LTC LPN's...how many patients do you have??

cardiacnurse34 · Sep 25, 2010

I was a CNA before becoming an LPN. When it comes to LTC I would rather work as a CNA anyday. I had 12-14 residents as an aide. 25-27 as a nurse. Barely enough time to pass meds and at one LTC had 8 diabetics on that hall. God forbid a resident fell and had to go to ER. Then you have to stop passing meds to do 10 min of quick transfer papers for the ambulance and ER, call the ER, call the resident Dr, oh and don't forget call the family. All that ends up being at least 45 min, now you're behind on your med pass...AND you still have to fill out the incident report...that's takes another 45min to an hour. Not to mention you still have tx to do....oh don't forget your charting......I always had to stay over. The LTC places don't care you're a warm body doing your job. Who cares if it runs you into the ground. The staff that surrounded me at both places was wonderful but the anxiety just got to me. I just wanted to take care of my residents. Not going to happen in LTC your just a pill pusher!! :crying2:

OgopogoLPN, LPN, RN · Sep 26, 2010

21-23 on days/evenings.

42-44 on nights.

knottygirl · Sep 26, 2010

I was a CNA before becoming an LPN. When it comes to LTC I would rather work as a CNA anyday. I had 12-14 residents as an aide. 25-27 as a nurse. Barely enough time to pass meds and at one LTC had 8 diabetics on that hall. God forbid a resident fell and had to go to ER. Then you have to stop passing meds to do 10 min of quick transfer papers for the ambulance and ER, call the ER, call the resident Dr, oh and don't forget call the family. All that ends up being at least 45 min, now you're behind on your med pass...AND you still have to fill out the incident report...that's takes another 45min to an hour. Not to mention you still have tx to do....oh don't forget your charting......I always had to stay over. The LTC places don't care you're a warm body doing your job. Who cares if it runs you into the ground. The staff that surrounded me at both places was wonderful but the anxiety just got to me. I just wanted to take care of my residents. Not going to happen in LTC your just a pill pusher!!

Wow, now that's just crazy. What's even worse if they don't approve OT. Wow, I could definitely see how that's frustrating. I don't know though, I don't know if I'd rather be a CNA, being a CNA is physically hard work, where I guess being a nurse is more mental, it's really really about time management I guess. Being a CNA is how fast you can change the incontinent residents or how quickly you can get everybody into bed. Someone always had something to say if you didn't get everyone to the dining room on time, didn't get everybody into bed on time etc etc. I always hated the fact that a lot of times you need help to transfer residents but no one is around to help because they're too busy, the nurses are too busy. That's stressful too. But I understand what you mean.

JLD930 · Oct 4, 2010

30 Patients. 3-11 shift. 8 diabetic. 16 patients needing crushed meds. Responsible for all treatments. Feed those that need assistance at meal time. Answer call lights. Busy!

Peds_Nurse · Oct 7, 2010

anywhere from 24-35 on the 2-10 shift with med pass and treatments, charting, admissions, etc. And, usually 2-3 CNAs to help with keeping the patients occupied and will do my vitals for me.

Jday · Oct 7, 2010

76 residents(divided into 6 cottages - none are attached) to do rounds I go from building to building, 1900-0700, 5 diabetic, 6 CNA's I am the partner for all transfers, lifts ect. As they are not alowd to leave their cottage for safety of the residents, injectable meds and Prn medications, dressings. And anything admisistrative that was not done by day staff, The CNA all are trained to do medications but only after I have verified that they are all packeged properly from pharmacy.

optimist · Oct 12, 2010

The LTC facility I work has 230 residents and 4-5 nurses during the day. Theres a good mix of low acuity rest home type patients all the way up to comatose trach patients

Sensoria17 · Oct 12, 2010

When we are full, 30 on 3rd shift. I don't know how people handle more.

gymrat33, LPN · Oct 13, 2010

I have anywhere from 35 - 39 residents on a floor where 75% are dementia and sun-downers with 1 - 3 admissions weekly and a med aide only about half the time. Most of the tx are on days but I now have 3 g tubes to take care of and hook up for cont feeding thru night shift. Half of the residents are on 30 to 60 min checks and I usually have 3 techs. 90% of the time I have 2 out of 3 good cnas but there is usually the one that slows things down. It's challenging but I love it

ms.heart · Oct 27, 2010

I just started working at an Assisted Living facility and I am responsible for 32 residents. There are 4 PCA's. I am the only nurse. I only have 4 accuchecks. It takes me about 2.5 hours to get all the evening meds passed. The med containers are color coded. For me, it is a lot stressful than a nursing home (I quit after a few months at one). And I have very little charting to do :yeah: .

matico · Dec 4, 2012

i am a new lpn in a long care facility and rehabilitation center, i am in the am shift 7-3 pm, we have 30 patients, very heavy, a lot of medications to pass, blood sugar, insulins, plus respiratory treatments almost to everyone, wound care, other treatments, nursing notes, doctors orders, emergencies , admissions , treatment books to be signed, and so on and on on etc etc. The worst part is the rules and regulation to nurses , old nurses or more experiences nurses do not teach new nurses, on the contrary the EAT THE NEW NURSES ALIVE,

do not make a mistake , because my god , nobody will help you in any ways. i think it is ABUSE, and nurses should complaint to the nursing board to pass a law , forcing this type of facilities, not to give so many patients to one nurse, this type of jobs put nurses at risk not only to be fired for any little mistake but also putting our licenses at risk, supervisors and administrators do not care about the work load, they care about money and inspections. when there is an inspection, they expect to do everything by the book, which takes time and not possible to assist 30 patients with the speed we need, in 8 hrs. forget about customer care, i really do not have time to spare with any of my patients , which i really care for, i wish i can have the time to at least listen to them for 5 minutes. i am really running the whole day, no time to talk , or listen , or even to have a break, i think it is horrible, i will keep insisting on all nurses to demand a law to limit the amount of patients a nurse can have , perhaps to max 15 residents and some amount of treatments. these facilities always look for the way to abuse nurses. supervisors and nurse managers are on the floor just to demand more and more from nurses without considering the work load, they do not help, and they do not even know how to pass meds to 30 residents. in the facility were i work nurses survive, just in my floor in the pass 5 months 5 nurses have quit, there is always a new nurse. some nurses do not last one day, they just never come back.

please let me know if somebody agrees with me to demand a law to limit amount of patients given to nurses, we must protect first of all our patients as humans not as a medicaid number and also the license we have worked so hard for.

MedChica · Dec 4, 2012

Hey,
I was reading some of the posts, and I remember my days as a CNA and the patient-load I had, yes after a while it did get easier, but I'm wondering how many patients you have at an LTC unit. I was reading another post where the lpn had almost 50 patients in a shift.
I know it takes time but how do you manage so many patients? Do they teach time-management skills in school or is it something you have to learn yourself, kinda like learn-as-you-go type of thing? Probably a dumb question, but what if you don't get everything done? Do you stay, or does it go to the nurse relieving you? How stressful is that? How do you deal with it?
Sorry, lot's of questions, but after reading these posts for a while I've wondered about it.
peacers.

My school never taught time management. You learn that on the floor.

I work psych geri. Dementia/Alzheimers, BP, Schizophrenia, personality disordered, etc...

80% are on anti-psychs. You might have someone on suicide watch and needing 15 minute checks. You might be rounding the corner and see the FD and police marching around it.

***** Who called the ambulance?

The residents, of course. The resident borderline with BP2 might be in the midst of a screaming 'rage attack'. You can't redirect her. They're going to place her elsewhere, I heard. I try to take up time for her but I'm relieved, I won't lie. The CNAs practically flip coins to see whose going to be dealing with her that day. I just think it unfortunate and sad that we couldn't help her.

Yesterday, I had to handle a pt whose voices were telling him to kill another resident. Of course, I have to watch those who are always standing up out of their chairs and trying to amb when they shouldn't. I have to watch the dementia/alzheimers residents to ensure that they're not trying to leave/fighting/falling, etc...

I love my residents. It's a fun place. It's just that, sometimes, it's too much excitement and stimulation.

How many residents are assigned to me? Depends on whatever side I'm working. Between 40 to 47.

It changes what with people leaving and new admits and what not. Never less than 40.

Once, when I first began, I was left on the floor with about 80-87 residents for an hour.

I'd been a nurse for a week. It was just me, 1 med aide and the aides. It was on evening shift, at least.

How do I manage? The Charge does wound care. We have med aides who do scheduled meds. We just handle the PRN meds, accuchecks, insulin, feedings and such. I've done med aide and it took about 3.5 hours to pop pills for 40+ residents, on average.

If I had to pass my own meds, do my own wound care... AND nurse? I 'think' I could do it. I just wouldn't be able to sit down or eat or go the bathroom. That's all.

LOL

On occasion, I've forgotten to eat....

It's not as bad as it sounds, though. 3 day orientation really is adequate for LTC. Honestly, just knowing who the pt's are is half the battle. You have your training. Fine-tuning is required, but no one needs to be holding your hand.

What if you don't get things done? Depends on what it is. Paperwork and charting? You stay and finish. My facility doesn't like to pay OT, but I don't work off the clock. So...if management doesn't like paying overtime, they ought to stop changing paperwork policies and increasing everyone's workload. I've had to leave a UA for the nightshift, though. I did 2 and it was late in the day before I realized that I had to do them. I dislike leaving work behind though.

Worse thing about LTC nursing, imo? The paperwork and the phone. Some family members make social calls every hour and act as though we have all the time in the world to be hunting down their family members. We, the nurses, don't have time. The aides don't have time, hell - they just put the pt down! Now they have to STOP what they're doing in another room...and pick that pt back up?

No, sorry. Call back later or stop by and visit.

I'm serious. A lot of lessons learned brought me to that point.

It used to irritate the hell out of me when they'd call, I'd get up to get their family member, come back to the phone and hear a dial tone in my ear. ****** me off.

Like, "You can't hold? Do you know I tore a// through this facility hustling your mother to this !**%@ phone and you couldn't hold for 1-3 minutes?!"

Yes - I do expect them to hold. They know their family members can't amb as well as them. They know that we have to find them, first. They know that someone has to do the legwork to get the resident to the phone.

...and yes - every minute DOES count. I don't know about these other nurses, but anytime the nurses at my facility are sitting down at the nurse's station? We're charting and doing paperwork.