Nurse to patient ratio for LTC.

ltcnurse4u, CNA, LPN · Jun 13, 2016

It seems to be a problem everywhere. I am currently working to overnight positions. At one place, I am the only nurse (lpn) from 10p-6a with 3 CNA's and at 4am a TMA comes in to help with med pass. I currently have 84 residents...we are full at 90. At my other place, we have 60 beds and we are currently full. Its just me and one can from 10pm-6a.

Nursynursenurse, ADN, RN · Jun 14, 2016

Where I work, it is one nurse in the LTC wing for 70-75 residents with 2 CNAs. Luckily the residents have been pretty stable recently so it isnt too bad. Just a HUGE med pass. The rehab side has 50+ and is a nightmare to work always. A million tube feedings, uncontrolled pain, falls, psych issues, etc. I never get a break.

TheCommuter, BSN, RN · Jun 15, 2016

When I worked overnights (10pm to 6am) in LTC, I was the licensed nurse for 68 residents. The 68 residents were split between three CNAs, if they all showed up.

Alisonisayoshi, LVN · Jun 15, 2016

The highest I've done is 40, with 3 CNA's, 6 total for the facility, plus an RNA on shift through dinner and activities assistants on shift through the hour post dinner that can double as sitters. That facility is 80 beds 1/2 rehab, 1/2 LTC. Usually on PM we had 3 nurses, 2 doing rehab halls and 1 covering all the LTC beds, 40 was always due to call outs.

The facility I worked right before was much higher ratios, mostly LTC, very few rehabs, and I quit there before I completed orientation because it was something like 60 residents and next to no CNAS and I was a brand new grad and it scared me to death to do alone.

I have a friend who's regularly doing 50/1. He's fairly miserable.

Quo Vadis · Jun 16, 2016

My facility has several floors that each cater to different needs and need a different nursing skill level. Depending on the floor there are more nurses than CNA's or the other way around. The nurses typically rotate floors while the CNA's do not (both due to nursing staff shortage and the facility's regulations).

Floor one is typical nursing home where people are semi-dependent so there usually is just one nurse with three CNA's for 31 patients. Floor two is an extension of the geriatrics unit of our local hospital, so we usually have around 2-3 nurses working there with 5 CNA's for 27 patients. We also have a wing solely for Huntington's disease and only the nurses who are certified in HD care can take care of them, so that's usually 1-2 nurses for 10 patients. Then there are two closed floors for patients with dementia but who can mobilize themselves. Uusally there's 1 nurse for 70 patients with 4 CNA's. There's also a seperate buidling for people who come in for short care (max 3 months) and service flats and that's usually just 1 nurse and 1 CNA. Those two people are just on call though, as these patients are expected to be able to fend for themselves and only call when something's wrong.

For night shifts it's just 1 nurse and 1 CNA for all of these patients though.

rpsychnurse · Jun 18, 2016

We have 50 beds and are staffed quite well, in my opinion.

Days: Two LPNs (they split meds/treatments for all residents, one goes home at 12), one charge RN, and 7 HCAs (6 take assignments and one does the baths).

Evenings: One LPN and one RN (they split the patients), 6 HCAs(2 only work 6 hours)

Nights: One RN and one HCA(this is poorly staffed in my opinion- I'd love to see two HCAs on nights).

kbrn2002, ADN, RN · Jun 18, 2016

Holy smokes! Reading some of these responses amazes me. Are some of you even meeting minimum nursing hours for your state? Gosh, I thought we had it bad. We have 75 residents now, max is 84 since we banked some beds. A mix of LTC and short term rehab, about 70% are LTC. On days we have 3 nurses and 7 or 8 CNA's, PM's has 3 nurses and 7 CNA's, NOCS has 2 nurses and 3 CNA's. This is the absolute minimum staff we run. We usually have enough coverage by mandating staff to stay over but it's not at all unusual for one of the unit managers to work the floor. Only a couple of times has a nurse worked as a CNA.

There are big enough bonuses for picking up shifts that most staff don't mind the OT, but it is getting old.

suzw · Jun 25, 2016

This thread is super depressing and making me hope I never have to put a family member in LTC, though it is a real possibility in the near future.

My place has a max capacity of 68. The LTC floor typically has one RN or LPN for 34 patients, and 3-4 CNAs. A few people are fairly independent but most need help with ADLs, several need feeders, and probably 15 or more are Hoyer lifts. One tube feed, and several with varying degrees of dementia. A few daily dressing changes. It's a lot.

The other floor is mostly rehab with a few LTC. Max capacity 34 but usually is 22-32. One nurse and usually 3 CNAs but we have a split shift nurse who helps out with morning med pass and then does treatments and other stuff like entering orders. Sooooo many diabetics and PRNs on this floor. Usually 1-3 IVs and a tube feed or two. It gets really hard, and yet reading the previous comments, it seems we are no worse off than anyone else; which is depressing to me.

LTC_LNHA · Dec 18, 2017

My experiences,

Approx. 50 residents

6a/2p 2 nurses w/ 5.5 CNAs et rehab nurse

2p/10p 1 nurse w/ 5 CNAs

10p/6a 1 nurse w/ 2 CNAs

Approx. 60 residents

6a/2p 1 nurse w/ 4 CNAs, 1 rehab aide, et 2 medication aides (M-F "floor nurse" 7a/5p)

2p/10p 1 nurse w/ 4 CNAs et 2 medication aides

10p/6a 1 nurse w/ 3 CNAs

Approx. 140 residents

6a/2p 5 nurses w/ 3 medication aides, 3 rehab aides, et 14 CNAs

2p/10p 4 nurses w/ 2 medication aides, et 12 CNAs

10p/6a 3 nurse w/ 7 CNAs

Approx. 200 residents

6a/2p 1 nurse practitioner, 8 nurses w/ about 18 CNAs et 2-3 rehab aides

2p/10p 8 nurses, about 15 CNAs

10p/6a 4 nurses, 7 CNAs