nursing duties and nurse/pt. ratio

[Katele]

Hi!

I would like to know from any of you what is your nurse/pt. ratio and the nursing duties

that are involved. I work as a 1 nurse to average 41 pt ratio with one half long term stable residents and the other half for rehab., drug treatments, and so forth which involve a stay between 30 to 90 days. My duties include not only medications, but at times I would have 5-6 IV's going, 1-2 G-tubes, poss. trach. and wound care and drsg. changes, and then have to paper work, charting and supervising the floor, doing complicance rounds, checking in medications from the pharmacy and answering phones which do not include the possiblity of res.. change in status when my focus has to be on assessing the pt. Am I having too much of a workload for one nurse or is

it just me? I am stressed and usually having to average 5-10 hrs. of overtime per week because eight hours is not enough time to finish the work. I would appreciate your advice because I feel that having to have this workload with one nurse does not give me enough time with each individual pt. which puts me at risk for missing signs and symptoms if something goes wrong with my pts.

[Nancy1]

Hi Katele,

I am not sure where you are from, or what shift you are talking about, because that makes a difference but I think my nurses would be walking.

I am one of two ADONs for a facility in Milwaukee, WI. We each have a unit to run. My unit has 44 capacity, but we usually have 38-40. These residents are pretty much intermediate care and stable. Days and PMs the schedule is for 2 nurses and 3-4 CNAs. The Noc schedule is for 1 nurse and 2 CNAs.

My partner's unit is the rehab unit she has 2 separate floors wiith 25 beds on each floor, and her census is usally 45-50. Each floor has a nurse and 3 CNAs for days and pms and nocs has i nurse each floor and 1.5-2 CNAs per floor. If the census is at capacity we try to give the nurse a med passer, whether a specially trained CNA who has taken the Medication Assistant course or a nurse who wants extra hours.

Now that is how we try to keep it scheduled. I will not lie and say it is that perfect because it is not.

Sometimes call-ins cannot be replaced and we work at a minimum, but that is where the teamwork has to really kick-in.

As management, I know all about the bottom line, but good managers do not want to burn out the staff.

I have a friend who was in a situation similar to yours and they wanted to add doing parts of the MDS on top of all that she did. When I asked her if she asked others about what it was like where they may have worked in the past, and they all said the same thing. I would suggest finding out from others in your area, network in your local chapter of ANA.

It sounds like you are showing signs of burn out and that is why the profession loses good nurses.

I wish you luck.

Please feel free to send a private message to me, when you feel you need to talk, that is the best I have to offer. NA

[allevi]

I am a new LPN and currently took my first nursing job in a LTC facility. I am feeling very overwhelmed. I to have 40+ patients to pass meds to. There are a total of 80+ residents, and 3 nurses. The charge nurse mainly takes care of paperwork and very little patient care. I am terrified of screwing up. To get all the meds passed on time, and to even have any time to just talk to the residents is about impossible. I am seriously thinking about quitting, because I don't feel that the residents are getting the care that they deserve. I worked as a CNA in a facility that had 62 residents, no IV's or highly skilled residents like the facility I am at now, and they had 3 nurses to the 62, and all three nurses provided patient care. I know I wouldn't put my loved one in the place that I am working now. Will I feel better about this place once I get used to the routine or will I continue to feel overwhelmed? HELP!!

[Nancy1]

I don't blame you for the way you feel, your load seems high to me, but if you read my previous posting you will see that not all facilities staff like that.

Talk to classmates and see where they are working, and what kind of load they have. Check out other facilities. I have a cousin who felt like you did, I am thankful she did not leave nursing, but is working in a clinic instead.

I am not sure what your financial status is, but I recommend using a day off to check out other facilities. They are not all like that. Good Luck, NA