nurse/patient ratio?


Im a new grad. I just got licensed and started my 1st job in long term care. The nurse/ patient ratio is between 35-47 patients per LPN. I feel completely overwhelmed and believe the ratio is crazy high. Is this because I am a new grad or is it really a high ratio? any advise?


344 Posts

That ratio is not unheard of in LTC facilities. However, it is IMO crazy high, unless you are talking NOC shift, then it seems about right. I worked LTC in subacute area, had 20-25 patients to myself (no med tech) on PM's.

There is no ratio numbers in my states nurse practice act, it says something like facility must provide "adequate staffing" Who defines adequate, I have no idea. Sad really, someday soon I hope states declare an actual number, until then, I will feel that "quality care" in facilities really isn't much of a priority...


1,194 Posts

Specializes in Cardiac Care.

what shift is that for? Hope you have a treatment nurse or a med tech or something. I have 28 and its pretty bad somedays.


3 Posts

It's 2nd shift. I am med nurse and treatment nurse, no med tech. There is an RN supervisor, however they supervise 3 different floors. They are called in case of emergencys or change in condition. Sometimes if I have a nice RN with extra time, they will help out on charting. Thanks for the reply!


1,194 Posts

Specializes in Cardiac Care.

I work 2nd and with that many people with a dinner in the middle and all the meds and treatments... you will be lucky to get out of there by midnight every night... Godforbid someone fall or get some other incident report needing paperwork... who handles phone calls, labs, doctors orders and such? Not to mention charting... I would really reconsider that position but I know money is money and we all need it. But yeah that is crazy high. I think 30 is the max I would do on that shift. Good luck!

My last facility had me responsible for about 44 residents on a 12 hour day shift. Three med passes, three meals, all tx and any extra prn meds/vitals as well as charting. Also expected to help feed at 2 meals(lunch&supper). Includes any new skin tear drsg and charting of risk mngmt, falls with HIR, etc. Unbelievable. They fired me "without malice" as I just wasn't fitting in or fast enough but they said "I tried". d'ya think? I was going to quit soon anyhow I think due to the stress. Impossible to complete the work under compliance.


9 Posts

Specializes in Oncology,Orthopeadics,LTC. Has 20 years experience.

We have about 30 residents/1nurse-LTC has really changed over the years those ratios may have been acceptable 10years ago but the acuity of residents in LTC has really increased over the years. Usually acceptable nurse/resident ratios are set by the state you practice in and it is actually based on nursing hours per resident. They really need to rethink this, esp, since most LTC owners will not staff over this "acceptable" ratio. And not just the acuity of residents has increased the amount of required documentation is just insane and is only getting worse.


1,756 Posts

Specializes in LTC, Memory loss, PDN. Has 23 years experience.

If you don't feel overwhelmed as a new grad, you're not doing your job. As far as the ratio is concerned, acuity is the factor, numbers mean nothing. E.G. I've comfortably handled 60+ patients on one floor while getting my hiney kicked on a 28 patient skilled floor.

I wonder if, with the information collected by the MDS-RAI, that they will be able to assess the acuity and staff appropriately ?


3 Posts

I handle it all. I had only 2 weeks of training then I was thrown to the wolves. Ya, I am definately still looking. Thanks!

TheCommuter, BSN, RN

226 Articles; 27,608 Posts

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 17 years experience.
I handle it all. I had only 2 weeks of training then I was thrown to the wolves. Ya, I am definately still looking. Thanks!

Two weeks?

I had only 8 hours of training as a new grad LVN/LPN in a LTC facility in 2006 before I was cut loose to work on my own due to short staffing. Most facilities in my area will give a new grad 3 days of training and orientation before cutting them loose. However, I do agree that a new nurse's orientation should be lengthier since there's such a learning curve to tackle.


17 Posts

Wow that is a lot! I do home health and we have one on one care. It can be much easier depending on who you work with and how the family is. I would recommend this if you are planning on attending school. Good luck!