please help: is 1 nurse: 50 patients

[lhsouthern]

I interviewed at a dementia care facility. There are medtechs who pass oral meds but I would do the injections ( insulin) and dressing changes etc. But I would care for 50 patients! That seems that is too much or am i just over reacting?

Please help.

linda

[skittlebear]

i interviewed at a dementia care facility. there are medtechs who pass oral meds but i would do the injections ( insulin) and dressing changes etc. but i would care for 50 patients! that seems that is too much or am i just over reacting?

please help.

linda

i don't think you are over reacting one bit. that is a high pt load! even though you have med techs, you are ultimately responsible for each resident. i personally wouldn't feel comfortable in that situation. i would want to administer medications myself based on the findings of each resident. for example: if i was to administer a medication for b/p, i would want to take that b/p myself before doing so...even if i had a tech take it before hand.

they should have at least 3 nurses for 50 residents, in my opinion...passing the medications as well. i hate that nursing homes and even assisted living facilities have such short staffing! (anything to cut costs though, i guess

[TheCommuter, BSN, RN]

The medication aide or medication tech is taking the vast majority of the workload off the licensed nurse's hands by administering all the oral pills, patches, eye drops, etc.

Therefore, I feel that 50 patients to one nurse in a nursing home is an okay ratio with the help of a medication aide. The nurse will be doing a few dressing changes, obtaining some finger stick blood sugars, giving insulin injections, administering occasional breathing treatments, and completing routine paperwork and charting.

It might seem like a whole lot, but the physical tasks that the nurse must accomplish don't add up to very much. In addition, nursing home residents do not need daily head-to-toe assessments that consume a lot of the nurse's time since they live at the facility and tend to have stable disease processes.

I work at a facility that heavily utilizes medication aides, and I find that I have more time to complete my assessments, paperwork, charting, and other tasks. I also have more time for breaks.

[DaniLPN2RN]

I work in a facility that does not use medication aides and I have to pass meds as well as finger stick blood sugars, giving insulin injections, administering breathing treatments, wound care and preventative treatments, and completing routine paperwork and charting. All that is hoping that nothing goes wrong, no falls or injuries or change in pt condition. I care for 20-30 pts per shift and still manage to get it all done (never thought I would when I started as a new grad though ).

If I had a med tech to assist in passing meds, I feel the pt care I could give would improve because it would allow me to spend more time with them instead of running in throwing some pills at them, quickly splattering some wound care dressings, taking their blood, or throwing their insulin like a dart at them ... would be nice to slow down and enjoy being a nurse!!!

[NursePeace]

It all depends on what your comfortable with. Sounds like a manageable amount to me, as your med pass takes up alot of your time. This should be a nice amount of time you will now have free. Def with dementia PTs, who at times, you'll have to spend alot time with to get them to take the meds. I say if your confident, jump in head first, you may surprise yourself

[Simba&NalasMom, LPN]

I've worked agency shifts at a dementia facility that had over 100 residents and med techs; it's set up into different "cottages" where each has two caregivers and one of them passes the meds. Most of these shifts were WAY easier than some shifts I've done in nursing homes with "only" 30-40 residents to care for. Acuity is typically low and if there are any extreme changes in condition (i.e. sudden high fever, or a fall resulting in injury) you send them out 911.

I think it should be more than manageable for you, esp. if they give you enough orientation as a new grad to make you comfortable. Again, the big thing is physical acuity; a lot of these facilities do not accept patients with multiple medical issues. For a new grad, a place like this is often a better place to start than a busy SNF/nursing home setting.

[Simba&NalasMom, LPN]

P.S. here in OR, some places also use visiting nurses if the residents have complicated wound care. I would be sure to ask that as well. :)

[LPN&momof3]

What shift would this be on? I have had that many on 3rd shift without a med tech.

[meadowsong, ASN, RN]

Like others have mentioned, it depends on the level of care the clients will need. With med aids, that will take a huge burden off of our shoulders. I'm sure you will be busy, but it will more than likely be very manageable after some time.

[caliotter3]

I was the only licensed nurse in the building for 52 residents, 21 of which were subacute on night shift. I had from one to three nursing assistants, depending upon who showed up for work on any given night. No med techs in my state. I had my hands full on some nights when several people went south on my shift or decided to fall or die all at the same time. One night it got so bad I called the ADON for help with something and she didn't answer her phone. Lots of help that was. At another facility I was responsible for 80 residents. You just do what you can do and hope for the best.

[BlondieNH]

No way! This is ridiculous! Your license is on the line. I don't care what shift it is! I'd be out of there! You don't say where you are from. I don't like the idea of a med tech. How much training have they had? If this were assisted living, then maybe....

[Simba&NalasMom, LPN]

No way! This is ridiculous! Your license is on the line. I don't care what shift it is! I'd be out of there! You don't say where you are from. I don't like the idea of a med tech. How much training have they had? If this were assisted living, then maybe....

I think acuity needs to be taken into account; you can't just look at the numbers. I've worked in both memory care facilities (which is the one the OP is inquiring about) with over 100 residents and skilled nursing facilities where I have only 20. Guess what? It is almost ALWAYS more stressful having 20 skilled patients. Most of these memory care facilities have very low acuity and when anything major happens, they get sent to the hospital or a skilled unit. I'm guessing the med techs work under the DON's license; here in OR lots of places use med techs and my experience with them has been 99% positive.