Nurse to patient ratio on night shift LTC (no state regulations)

[traumaqueen36467]

I was wondering what my fellow night shifters have as far as patient load in a SNF. Some nights I have as many as 63 while the other wards average 40 residents. This ward has a variety of TNC, up ad lib, comfort measures only, bolus tube feedings, continuous feedings, treatments and 4 CNA's. I have done it off an on for a few years now but the case load has changed and there are more acute residents. I have considered refusing to accept the case load especially with increasing demands and inability to supervise my UAP. I have been nursing for 3 years now but this is still just about too much for me. We have talked with the administration with very little efforts to improve patient safety. What are your opinions? Too much or suck it up?

[mirandaaa]

63?! Holy crap!!

[Sixtyseven]

Although our nurse to resident ratio is approximately 1:35 in our LTC facility, there is only one CNA and one LPN per floor. There is an RN supervisor for the house, though usually the RN also has a floor. And, like your population, these are skilled care residents, also many dementia. The administration quotes the "state minimum PPD" as their standard, and apparently they can construe our numbers as above minimum. Of course, we all know that "minimum" staffing equals poor care. The attitude towards nurses and CNA's is abysmal. When falls happen, bruises and skin tears appear, residents and families complain, it is all blamed on Nursing, who are deemed lazy and incompetent. The staffing is equally poor on day and evening shifts, with two CNA's and one LPN. It is really sad. There are more administrative people in the facility than actual working nurses, and they seem to spend most of their time trying to find ways to cut staff and make our jobs more difficult. And, the more staff they cut, the more money "saved" by the facility, and up go the salaries and bonuses of the administrators.

[wanderlustnurse88, RN]

I have 62 residents (on two floors) on a night shift. One RN and three PSWs (personal support workers). Some nights it's crazy.

[Animal House R.N., ADN, CNA, LVN]

I have 40 patients most of the time. If they cannot find a nurse for the alu then I will have 17 more residents.

[TheCommuter, BSN, RN]

I've worked at several nursing homes in my area. My highest night shift nurse/patient ratio has been 1:68 (old, antiquated, dumpy LTC facility). My lowest night shift nurse/patient ratio has been 1:18 (upscale, newer LTC facility).

[morte, LPN, LVN]

for this ratio to work at all, there can be NO acute patients at all. a couple of fsbs, and a couple of tube feeds what about max out your capacity.

[kab459]

I work in a 67-bed facility with one other night nurse (usually an RN), have up to 35 residents (mostly LTC, a few subacute) with 2 CNAs if I'm lucky. Sometimes we have 3 CNAs for the whole 67-bed facility, which is difficult. I'm busy every night but I love it. The other night nurse has most of the subacutes, complete w/ nightly Medicare charting & psych issues - a not-so-appealing job!

[4boysmama]

My facility has one short term rehab unit where the overnight ratio is 24:1 (with 2 nurses for the entire unit of 48 beds). One of our LTC units (with higher acutiy) has 2 nurses with 56 beds total (so, 26:1) and then our remaining 2 units are LTC, with 1 nurse on the unit for 48 beds, and the other with 1 nurse for 56 beds. Each unit has 2 CNAs overnight.

[traumaqueen36467]

Thanks for the replies!

[AshortenRN]

I work 6p-6a... We have 67 residents and 2 nurses with 3 CNAs. 14 residents are skilled and we have PICCs,tubefeedings, and all that fun stuff mixed in :) I've come to realize LTC= heavy workload but my passion is geriatrics so I just wear my good running shoes!