Nurse/patient ratio

[madghost31]

Does anyone know if there is a law that prohibits an lpn from being responsible for too many patients?

I won't say the name of the facility, but it's a psychiatric facility where sometimes a night nurse is frequentmy forced to monitor 100 patients. This sounds ridiculous right? Frequent call-offs and not enough permanent staff to cover the floors is a huge burden on the nurse, but not so much the facility not having to pay for that missing nurse. You would think they would at least receive compensation for doing the job of 2 nurses, but not so. If this issue is brought to the attention of the DON and problem still persists, then what?

I've heard nurse/patient ratio being as low as 1:40 or as high as 1:60 in similar facilities, but never 100.

Most of these said patients are more independent on adls, but are psych patients. The nurse is required to give heparin shots, inhalers, pills, many accuchecks. Several are priority in taking showers in the morning for poor self hygeine and incontinence. Sometimes there are only 2 cnas to cover the whole floor because of call offs. This facility has been unable to keep staff because of this issue.

What's your take on this issue? How many patients do you oversee on the night shift?

[Esme12, ASN, BSN, RN]

thread moved for best response

[HouTx, BSN, MSN, EdD]

I'm not a psych nurse, but that really seems excessive. What does your RN supervisor think about it? Are there any psych techs available for back-up?

One of the most awful codes I have ever responded to (as an ICU nurse) was on a 36 bed in-hospital locked unit for adolescents... I distinctly remember the horror of discovering that they only had one nurse on that unit, and he had absolutely no preparation for medical emergency response other than just 'call a code'. Code ended badly. All of us (code team) were deposed for legal follow up.

[classicdame, MSN, EdD]

look at your nurse practice act to see what the rules are, if any, regarding staffing. I would be tempted to ask my supervisor, or THE top person, what the standards are for staffing in your area of practice. I do not see how it could be safe for the patient or the staff. Maybe an accreditation body needs to be consulted.

[madghost31]

Several months back,we received a readmit from a hospital. When i made my initial rounds she was non-responsive, cpr given and ambulance responded quickly. Luckily they were already in the building for something else.

Now since there's nearly 100 patients, working alone it feels like an hour to do rounds. Incidents happen, such as falls, etc. Which when it does occur takes a lot of time and paperwork. How can 1person possibly provide the proper care to 99 other patients.

[TheCommuter, BSN, RN]

Only California has legally-mandated nurse/patient ratios for LVNs working in psychiatric facilities. In CA, LVNs working in psych can care for no more than six patients.

[madghost31]

I wonder if that mandate includes nursing homes

[TheCommuter, BSN, RN]

I wonder if that mandate includes nursing homes

No. It only applies to acute care facilities (a.k.a. hospitals) in California. In CA, med/surg, ICU and other specialties have lower legally mandated ratios than psych.

[herring_RN, ASN, BSN]

I wonder if that mandate includes nursing homes

I wish it did.

[imintrouble, BSN, RN]

How awful. How is it possible that decent human beings can warehouse the old and impaired in such a way?

[~PedsRN~, BSN, RN]

1:60?!?!?!?!?! 1:100??!?!?!

I wouldn't work in ANY type of facility with those numbers.

[madghost31]

It's ridiculous and there is no money compensation either. That's why the turnover rate is extremely high. Sadly health care is big business and only the wealthy benefit here.