nursing ratios in longterm care

mimimartina · Mar 29, 2007

On my first job as a LPN, I worked LTC (approx. 14 years ago) and I had 63 residents on my station. It took me almost 3 hours to do my AM med pass. Needless to say, I left there burnt out, and am now back in school working towards my RN. I don't think my job choices would have been what they were had I not had such an overwhelming 1st experience. I'm glad the ratios have improved somewhat, but this is still ridiculous....

lovingtheunloved, ASN, RN · Mar 29, 2007

Unfortunately, it's unlikely. That ratio is pretty much the norm. How many aides do you have?

TheCommuter, BSN, RN · Mar 29, 2007

A ratio of 30 patients per LPN in a nursing home is normal. Realize that the typical nursing home patient is elderly, in stable consition, and has a predictable outcome. They don't need the minute-by-minute monitoring offered at acute care hospitals.

txspadequeenRN, BSN, RN · Mar 29, 2007

ive been a geri nurse a long time and my personal opinion is the nursing home residents while yes are somewhat stable have the potential to turn unstable in a rapid fashion . and lets not forget we have all kinds of nursing home residents, alzheimer's patients, hospice patients and pain management patients. these patients require a lot of time to be properly taken care of. geri nurses have been taking care of 30 patients plus for a long time.. i doubt your concern will budge them a bit.. i think ratios should be determined by the type of patient you are taking care of ...and i have yet to see management give a you know what , they just take who ever comes knocking on the door and put them wherever without regard to unit staffing or acuity of the other patients...when you start talking about improving patient care ,it is ok until it involves a little money ..like more staffing, then they pucker up tighter than a drum....

thedude · Mar 29, 2007

I think 30 pts per nurse too much, but that is the norm. It should be more like 20. With the massive amounts of meds these folks are on it takes a very long time to pass meds. That is not to mention any special considerations some pts need after a procedure or operation. Couple that with assisting them with meals, treatments, and paper work and it's overwhelming.

ilostu12 · Mar 29, 2007

30 residents, that's not too bad. Oh wait I forgot...meds, treatments, oh dang this one wet critical gotta call the doc and send them out, oooooops I forgot the two new admissions that came from the hospital at 6pm with out report, well crap everyon needs to go to the bathroom and the aids are busy with other residents, wait did I leave my dinner in the microwave a couple of hours ago?, yeah I know pharmacy is on the phone and has a question about the abt order I faxed but a family member is on the phone and has a question about their parents/spouse frantic call that they didn't get a desert at dinner and I have another family member pacing the halls mad as hell that their loved one is not given top priority for turning their light on.........sorry about that Administrator, I guess staying over 30mins to make sure all my residents are taken care of and are safe isn't nearly as important as you having to spend some money on nursing hours.

Sorry folks I had a pretty rough day today..................but I STILL love my job!!!

fultzymom · Mar 29, 2007

i am a new nurse working in longterm care. The ratio where i work is
one LPN to about 30 residents. How can nursing staff reach administration
in a positive way to provide better nurse to resident ratios to provide
better care for our residents??? Please help, i am getting extremely
frustrated!! (i work on the PM shift mostly) Any suggestions would be
much appreciated!
Thanks.

The LTC facility that I work at has a ratio of 25:1 except on the rehab unit. Then we have 14:1. I think that is pretty much the norm. Night shift has 50:1 on our LT units then the Alzheimer's unit is 24:1 et so is the rehab at night.

butterfly01 · Apr 2, 2007

I think 30 pts per nurse too much, but that is the norm. It should be more like 20.

And how, exactly, do you know this? Did you have a rotation in an LTC? lol. Have you had 30? have you had 20?

Sahara311 · May 13, 2008

Well, let me tell you about the genius that is my LTC...

I work on the "sub acute" / rehab / Medicare unit. These people are younger, yet their conditions, recent surgeries, unstable pain/labs require more critical thinking, not counting the individual time I try to give everyone of them. Oh, don't let me forget about Mrs. Soandso, whose sons don't realize she has no will to heal, eat, drink, take meds, allow me to perform treatments to her aquired wounds from her noncompliance, and the sons are screaming at me because we can't get to her having to pee quick enough (low and behold mom has a fc...) :banghead:

My ratio is approx. 30:1 depending on snowbird season/census.

The long term unit in the SAME building, which most of the patients are extremely stable, don't ask for anything much, have taken the same meds for so many years......

their ratio is about 18-20:1. :bugeyes:

Wow.... seems a little backwards to me, does it you?

And let me point out that Florida Medicare/Medicaid just got cut by something like, oh 70 million or so? (idk the specific number, but it is outrageous.)

So maybe my 30:1 isn't too bad. Months from now, I my be replying about my 40:1 ratio w 15:1 CNA hours...:uhoh21: