LTC Staffing Levels

[norlns24]

RE: The "Going to be fired" thread aside, LTC staffing levels, generally speaking, are inadequate. Even all of my nursing instructors admitted this fact numerous times. They stated unequivocally that most LTC facilities in my state (IL) are not adequately or safely staffed. No surprise many are for-profit enterprises.

I get that nurses need to be organized, efficient, have good time management skills, be critical thinkers, etc. but at some point the fault (in some instances) lies not 100 percent with an individual nurse's skills in these areas. Some blame for med errors, bed sore development, falls, etc. lies with inadequate staffing. Truth.

[JennaRae]

LTC is the worst. Unsafe and a bad career move unless you are a new grad looking for experience to bridge to a hospital. I just got out of LTC and started orientation at a magnet hospital. What a difference! LTC is good for basic but the longer you stay the less desirable you are to future employers. It is like repeating remedial HS classes when others are moving onto college, bigger and better things. LTC doesn't require a lot of critical thinking at all actually. It is all tedious task after task, never ending med passes. So glad to be where I am now!!!!

[rpsychnurse]

LTC is the worst. Unsafe and a bad career move unless you are a new grad looking for experience to bridge to a hospital. I just got out of LTC and started orientation at a magnet hospital. What a difference! LTC is good for basic but the longer you stay the less desirable you are to future employers. It is like repeating remedial HS classes when others are moving onto college, bigger and better things. LTC doesn't require a lot of critical thinking at all actually. It is all tedious task after task, never ending med passes. So glad to be where I am now!!!!

You're completely entitled to your opinion about LTC- but I found it a bit offensive that you said LTC doesn't require critical thinking. I'm not sure where you worked but as a charge nurse in LTC I'm critically thinking all day everyday and - my job is definitely not tedious! LTC patients have numerous diagnoses and countless medications to keep track of. Trying to assess a dementia patient who can't answer your questions is incredibly challenging. Trying to manage emergencies with little to no support (no in-house doctors, RTs, code teams, etc.) takes a lot of skill, in my opinion.

Just wanting to point out that LTC can actually be incredibly challenging and isn't just "basic", "tedious", or a "bad career move". The geriatric population needs quality care just like anyone in the hospital.

And to address the actual thread- yup, staffing sucks in LTC. That I wholeheartedly agree with. We are expected to provide high levels of care with minimal nurses and aides and staffing seems to keep getting cut while patient acuity rises. I adore my job but it breaks my heart to see the stresses my co-staff deal with due to poor staffing levels. And I think our facility has it pretty good compared to a lot of places. It's a system wide problem and I definitely don't have an answer.

[HeySis, BSN, RN]

When I started LTC we had 44 residences with 2 nurses and 6 CNA's for days, 1 nurse and 4 CNA's for evenings, and 1 nurse 2 CNA's for NOC.

It was super tight and busy, but working together as a team we were able to give great care, no restraints, decreased falls, no bedsores.

We couldn't have done this as individuals... but as team we worked smart and hard.

Staffing levels were not so good in other facilities and I have been watching them decrease over the last 17 years. It makes it really hard to do everything well. But most of our client were Medicaid.. and the daily reimbursement didn't even cover the cost, we had to make sure to keep rehab numbers up (payment is better) to spread out the money and relied heavily on donations. They keep cutting reimbursements while the cost of supplies and living goes up. There is only so much "quality savings" a facility can do.

Those that stay in LTC, do so because they love the people they care for... certainly not for the staffing or money.

And with MD's only required to see their patients once every other month... the nurses must have critical thinking skills and be able to do more with less, and assess constantly during their routine tasks.

The facilities that can keep nurses with these skills, have better patient care. If the nurse doesn't advocate, doesn't know when or how to advocate, no-one will.