question-- new to LTC

TeresaB930, BSN, RN · Nov 25, 2007

This is truly a great ratio! I also work in a non profit SNF, and we've recently added a new cart, now dividing 85 resident amongst 5 med carts. Its absolutely wonderful! However, this isn't a cakewalk either.......The patients that come in are much more acute.

Count your blessings.......not a lot of facilities have "seen the light!!"

caliotter3 · Nov 25, 2007

At one facility our subacute unit had 21 beds and they were always full. You are very fortunate. I have been responsible for 80 residents and for 52 residents (including 20+ subactute) when I was the only licensed nurse in the facility. Enjoy this ratio while you can.

actioncat · Nov 29, 2007

Just want to give an update... so far, so good. I think I'm going to like it.

Rexie68 · Dec 1, 2007

Holy Cow.....that's WONDERFUL staffing!! We staff 2 nurses and 6 CNA's for 48 patients on day shift. When I worked 11-7 there were nights that I had 75 pts and 3 CNA's to help. Those were nights I got a work-out....rushing to keep the IV's runnings, tube feedings flushed, etc, etc. And I was able to do it!! Not the best of conditions, but do-able...unless someone coded, fall with injury, etc. Somehow, with time and experience, we figure out what's essential and what's going to have to wait. LTC has so many darned regulations...when what we really need is just more staff. That alone would solve many of the problems such as incontinence, pressure sores, combativeness, depression, etc.

pirituba · Dec 1, 2007

I'm working in MASS and we only have 6 skilled residents! I have no Idea how i'm going to remember how I'm going to handle this situation. Wed I was doing an admission with my preceptor and I took forever and forever to complete paper work! In the back of my mind I was thinking how I am going to gives meds, and do tx and do the admission at the same time, since admission took 3 1/2 hours to complete paper work!

actioncat · Dec 22, 2007

More update:

Well, I truly like this job, but like all nursing jobs it can be stressful.

Pros: I love my patients and I have the same assignment every time I work. This is so wonderful. I really know my patients and develop a good relationship with families too.

I am running constantly and trying to provide the little "extras" which make patients happy. I tried to do this in the hospital, but you cannot help but be a little resentful when they don't understand that titrating a heparin drip or suctioning a patient with a mucus plug has to come first. Nobody is really unstable, so this is not such an issue here.

I love seeing the old married couples who really take the "for better or worse" part of their vows seriously. I see this on my rehab wing and the LTC wing too. It restores my faith in humanity.

At the hospital when I was working regular staff I got called nearly every day to see if I wanted to come in. No. I did not. I don't need the money. I don't get these phone calls now.

The aides. For the most part, they do a wonderful job and are grateful for any help you give them. I was just used to helping with ADLs such as toileting, ambulation, clearing trays, etc. when I worked in the hospital and aides rarely thanked me for it there.

I wish CNAs would get more respect. They have such hard work and they put up with a lot from some residents.

Cons: Management. I don't really want to get into it now, but I am not in love with my unit manager, to say the least.

Discharge planning-- I feel like I am out of the loop when it comes to this and am made to feel that it is not my place to ask questions.

Pay-- not as good as hospital and no weekend shift dif. We had awesome shift difs at my old job.

Paper charting.