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Geriatric   (1,864 Views 12 Comments)
by sister--* sister--* (New Member) New Member

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Wanting to change from Acute Care med/surg to LTC/Rehab, I recently took a job in a LTC/Rehab facility as an RN, 12 hr. night shifts.

Ratio on my wing is 25-30 pts. from alert and oriented to alzheimers/dementia. Fairly safe and independent residents to total care. I've found that Med-passes and treatments are all mine on this unit for the full 12 hrs. I'm there. Have been promised a Medication Aide but rarely have one.

Staffing on my wing (25-30 residents) consists of Myself, one and rarely two aides to assist people to bed from 6 p.m. until either 8 p.m. or 10 p.m. One aide after that until 6 a.m.

In addition, Trachs, G-tubes, IVs are my total responsibility facility wide....about 100 residents. Also, this facility is computerized and I've been promised, but, have had no training on that. Very frustrating and time-consuming not knowing what I'm doing with that computer.

I was given three days of orientation and requested and received two additional days. I asked for more, but, didn't receive it.

Is this usual staffing for LTC/ Rehab facilities? I'm feeling overwhelmed and that this situation is quite unsafe.

Please reply.

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57,428 Visitors; 10,263 Posts

Everywhere I've been on evenings had two nurses and three to four aides. Nights, one nurse and two aides.

It's very unsafe, and impossible, at that level, to deliver decent care.

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the princess specializes in Med-Surg, ED, Home.

1,001 Visitors; 17 Posts

i'd say you had a better life when you were at the Acute Care Med-Surg, at least you only have 6 pt.s, 7 at the most...plus you have aides at the acute care...though it's computerized, you have time to tinker the computer coz you don't have that so many patients...and it's safer...protect your license....

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TheCommuter has 10 years experience as a BSN, RN and specializes in Case mgmt., rehab, (CRRN), LTC & psych.

1 Follower; 228 Articles; 316,236 Visitors; 27,607 Posts

Ratio on my wing is 25-30 pts. from alert and oriented to alzheimers/dementia. Fairly safe and independent residents to total care. I've found that Med-passes and treatments are all mine on this unit for the full 12 hrs. I'm there.
You say you work night shift? If so, you've got it better than most night shift LTC nurses. I know of night LTC nurses who are legally responsible for 60 to 85 patients during those hours, all by themselves. These nurses are often the only licensed nurse in the entire building.

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marjoriemac has 5 years experience and specializes in nursing home care.

3,481 Visitors; 231 Posts

The least number I have worked on night duty is 1 nurse, 1 carer for 15 30 residents and it was tough!

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nightmare specializes in Nursing Home ,Dementia Care,Neurology..

2 Articles; 14,210 Visitors; 1,297 Posts

At the moment we have 1RN and two carers for 30.We should have 3 carers,that's the usual staffing level for up to 35 residents at night.

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Hospice Nurse LPN has 15 years experience as a BSN, RN and specializes in LTC, Psych, Hospice.

16,513 Visitors; 1,472 Posts

I'd love to have only 30 pts at night! I work 7p to 7a and we have 2 LPN's and 5 to 6 CNA's with a census of 108!

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3,945 Visitors; 192 Posts

You say you work night shift? If so, you've got it better than most night shift LTC nurses. I know of night LTC nurses who are legally responsible for 60 to 85 patients during those hours, all by themselves. These nurses are often the only licensed nurse in the entire building.

Hmmmm, legally responsible for 97 residents here. 1 RN, 1 LPN, 3 aides at night provided all show-up. Sat. is was me and two aides.

Too many issues. Run, Sister, run!

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busy-bee has 6 years experience and specializes in Long Term Facilitly.

3,043 Visitors; 101 Posts

Evening shift usually 2 nurses 2 CNA's- 3 CNA's if you are lucky...not to mention you have an addition 20 residents on the Altz unit with only a CNA, which equal 60 residents total..... on nights one nurse responsible for 60 residents....one cna on the altz unit.....one cna if you're lucky two cna's....responsible for 40. Complete nightmare....one emergency...you are SUNK!

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3,945 Visitors; 192 Posts

Worked with a picc line and discovered there is no policy and procedure book for the facility. This frightens me.

I was wondering why there was no I.V. sight/line care listed on the mar. Now I know.

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PACNWNURSING specializes in Emergency Room.

10,125 Visitors; 365 Posts

And I wonder why there is a long list of open positions for LTC's in my area... This is a total nightmare...

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dream'n has 25 years experience as a BSN, RN.

14,550 Visitors; 1,026 Posts

When I worked nights in LTC, we had 2 LPNs and 3 CNAs for 90 patients. We had IVs, TPN, G-Tubes, and trachs too. Mixture of assistive-only patients and total care, with most being at the total care end of the spectrum. So I'd say your ratio is slightly better than what we had, which seemed to be norm elsewhere also. LTC is a tough job.

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