LTC Nursing/Skilled Rehab RN Ratios (Ohio)

[SNgirl21, BSN]

Hi Nurses,

Just wondering, is 1: 20-25 typical for a RN: patient ratio in LTC (I'm in Ohio). I'm a new grad and I honestly don't know. I'm just worried. Should I be worried? Would you work somewhere with these ratios? I'm worried my time management and organization as a new grad might not be good enough to handle this. I also struggle with ADHD and it's been a real struggle. I was let go from my last job after 8 weeks (med surg 1:6 ratio) for not progressing through orientation fast enough. Also, any tips would be much appreciated <3. I just want my patients to be safe and get the best care because I do care and I wouldn't be doing this if I didn't.

[kbrn2002, ADN, RN]

Yes, that ratio is typical in LTC and no, it's not easy. Just the med pass for that many residents is brutal, then add in the rest of nursing care you are responsible for and it becomes even worse. Oh...and don't forget the massive amounts of frequently redundant and seemingly useless documentation to add the cherry on top.

Should you be worried? Probably.  It's hard work that requires an ability to multi-task while still being able to finish all tasks. You need to able to  juggle a lot of balls and somehow keeping them all in the air.

LTC is also notoriously short staffed so you might be looking at just working short frequently which means you are not only covering your RN job you'll be helping the CNA's with their job even more than the RN should be expected to.  There does come that point in a shift when it becomes just about impossible to get your work done because you are spending so much time on tasks that could be delegated to the CNA's.  Also if the facility relies on mandated OT to cover shifts expect to be stuck working unwanted doubles way more than you want to. 

I don't want to make it all sound negative though.  I worked LTC for 25 years and still miss many of my residents and a lot of the staff I worked with. I don't however miss the more negative aspects of the job and eventually those negatives outweighed the positive enough for me to leave.  There are good SNF's out there, it just seems like they are the exception rather than the rule.