LTC nurses - I need a reality check

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I have been an RN for 13+ years, med-surg, tele, ER, ICU, PP, IMC, Home Health, Hospice, stress lab, ambulatory care and now nursing home for past 5 mos. I work weekend doubles. I have to say that it is some of the hardest work I have EVER done. I have a whole new respect for LTC nurses, and I wouldn't trade it for anything.

Staffing has been horrible most of the 5 mos. We have 62 residents. Two nurses, 2 med aides, 6 aides, 1 supervisor for 8 hrs. We have worked with 5, 4, and sometimes 3 aides.

THEN:

This weekend, they cut us to 1 med aide for 62 pts. Have you ever heard of this?

Needless to say, I put in my resignation.

Just curious. Are all or most NH like this.

Please advise. Thank-you for your input.

Specializes in Developmentally Disabled, LTC, Clinic, Hospital.

I would love to have that much staff!! We have 110 residents, 3 nurses and 3 aides. (11p-7a shift). That is, providing no one calls in. I love my job and the work is extremely demanding and tiresome, but so worth it when those residents look forward to you working and miss you when you are gone!

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I've never worked nightshift and i wouldn't even know how to compare days to nights. But the acuity is high as far as loads of two pt transfers and getting them up and down for meals, etc. If all I had to do was do my nursing job, I feel that it would be doable for 16 hrs. But all the lifting and cleaning, passing trays, etc and the pts still have to lay in their own waste for long periods of time because we can not get to them makes it impossible to deal with. And the EVERY WEEKEND short staffing

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Yep...short staffing is everywhere in ltc.

I would think they would utilize more CNAs instead of pulling the nurses to do that. Not that any nurse is below those activities. I'm just thinking it would be more cost effective to have one nurse, 2 med aids and more CNAs or the two nurses, one med aid and more CNAs (I like the two nurse idea :)

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Specializes in Homecare Peds, ICU, Trauma, CVICU.

Wow, I feel really blessed. My first job out of nursing school was at this wonderful long term care facility. There were approx 35 residents per unit and each unit was staffed by a charge nurse, 2 med/tx nurses, and 4 sometimes 5 CNA's. Our residents were REALLY well cared for.

Though I am not disillusioned. I have picked up additional LTC work through agency and have had some horrid assignments.........and could not keep up as I was so spoiled being used to lighter assignments and so used to "spoiling" my residents with proper loving care.

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Specializes in Med/Surg, LTC/Geriatric.

I work on a unit with 46 residents. I am responsible for 23 of them-all meds, tx, tube feeds, nebs, etc.

On days and evenings, there are 3 long term care aids (CNAs) for the 23 residents (well, one LTCA is split between my 23 residents and the 23 on the other side). From 1:30pm - 3, there are only 2 LTCA, same from 9pm-11pm. This scheduling normally works fine since most residents are sleeping at those time. It only gets hairy once in a while.

After seeing some of the other staffing ratios, I will count myself very lucky!!!!!

OH, and on weedays, there is a charge RN for the 46 residents, but evening and weekends, there is only one charge RN for my 46, plus another 46 on the other side of the building.

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Specializes in Physical Rehabilitation, med-surg.

sounds like pretty good staffing for a nursing home to me.

It's hard to find good nurses in nursing homes in my area. Usually, the ones that work there can't get work other places or have been fired. Apathy sadly reigns in a lot of LTC settings.

If you have all that other experience, go somewhere else.

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