Nurse/Patient ratio - what's too much

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I have an interview for what may be my first nursing job. I only have an ADN and no job experience. The job is at a nursing home and I would be assigned 30 patients. Is that too much?

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Yessssss it is so unsafe!!!! Incredible stress!!!! I would run away, not walk.

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Depends on your role - are you supervising or working a run? In my LTC, RN's are typically supervising the LVN's, so their pt. load is between 30 - 90 depending on shift. LVN's usually get assigned a specific run of 30 pts. each, and CNA's get 10-20 pts. per depending on how many are available to work. Ratios vary depending on shift, with NOC getting the most pts. per, and days getting the least.

Sounds like you may be getting essentially an LVN role to start, with a single run to work. 30 pts. for a single run is fairly typical for LTC. Some run higher, some lower. Best of luck to you! :nurse:

----- Dave

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Specializes in retired LTC.

Sounds like a typical number but it all depends on what's included during care - meds, treatments, charting, phone calls, etc.?

I'm guessing your position would be a staff/floor nurse.

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Tough much is the number at which you say you've had more than you can take. Worst case for me maybe was 50, night shift- did all treatments, all MDS, stocked everything, made rounds on every person every two hours with the aides (we had an assembly line system, worked like a clock), passed meds all night. etc. Another worst option was 3-11, 22 beds. Could get up to 5 admits a day (F I V E), 15 diabetics, deaths and falls and discharges and emergencies every few minutes, staff came and left (many walked out all the time) almost daily. Hell, in a word.

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Thank you all, turns out they want a Nurse Manager and they gave me the job. The DON says she has faith in me (because I have a military background and supervisory experience) and that she will not set me up for failure. Please pray for me :)

I don't think it's normal for a new graduate nurse to land a Nurse Manager position...I would love to hear someone else started off as a Nurse Manager and is doing well.

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Specializes in Critical Care, Education.

Accepting a 'supervisory' position as a new grad is risky. Will the DON be immediately available for assistance when you need it? If not, this is not an acceptable position for a new grad, no matter how comfortable you are with non-clinical supervision.

As the RN, you will be legally and professionally responsible for all the clinical care delivered by your subordinates. You will be ultimately responsible for any errors in judgement or failures/delays in treatment due to lack of recognition or awareness of a patient problem, including emergency response & resuscitation. That's a very scary place to be if you are not ready for it.

Many state BONs (including mine) do not approve of new grads in roles that do not provide adequate structure & clinical supervision. You probably need to investigate this before you accept that job. As an licensed professional, you will always be faced with a dichotomy - your employer's expectations versus your professional obligations/ accountability. This is one of those situations. Jobs come and go, but risking your license can have much more serious consequences.

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Thank you HouTx, I am really scared, I don't want to loose my license. I will speak up and see how long I can extend my training...it's a weekend job so I will also keep applying for acute care in hospitals (to gain much needed experience)...it's been really discouraging though, I've been applying to every entry level position but not a single call back. I feel backed into a corner and I'm praying the DON will not set me up for failure. I will beg to not be left alone too quickly.

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