# of residents in LTC

eldragon · Nov 7, 2008

I have 35 patients because the census is down. I do all the meds on dayshift, and split charting with another nurse. She does treatments and charge. It's easy.
(I moved from a skilled unit that was a nighmare.............)

This was my post several months ago and I'd like to revive this thread if possible.

I now have 43 (needy) patients. And the DON says more are coming, to capacity - which could mean 5 more.

I just happen to work on two very long halls and in the 8 plus months I've worked at this facility, rooms were always empty. Now those rooms are being filled.

I have 43 patients to pass meds to, and 3 hours to do it in. Every patient takes meds, many have prn and scheduled narcs. Many eye drops, inhalers, etc. 3 peg tubes.

I never take a break, except for lunch because they take it out of my check anyway. This is becoming insane and it's downright impossible to do this med pass correctly and not cut major corners.

The patients, and the management who caused this, are sucking me dry. Unfortunately, my husband was cut back on hours from his job (18 years) and we can't really afford for me to quit.

Any advice? I'm exhausted and about to walk.

eldragon · Nov 7, 2008

Oh, and I have to chart all my prn meds, plus do MDS charting on up to 8 residents every single day.

pielęgniarka, RN · Nov 8, 2008

Oh, and I have to chart all my prn meds, plus do MDS charting on up to 8 residents every single day.

Sounds like they're trying to balance the budget at the expense of the nurses and residents. I know it all too well. Tell your DON you feel unsafe working at those ratios and see what they can do. Write up a time log so DON can see you're not "wasting" time.

eldragon · Nov 8, 2008

Sounds like they're trying to balance the budget at the expense of the nurses and residents. I know it all too well. Tell your DON you feel unsafe working at those ratios and see what they can do. Write up a time log so DON can see you're not "wasting" time.

She is on the floor enough to see that I am working my tail off - nonstop - all day long.

I feel like I'm being taken advantage of.

There are other things too, like newer nurses being promoted to charge, etc., while I am on the med cart forever. I have talked to the DON about it and she gives me a snow-job, saying they "have had a meeting and know I am dependable and reliable and have something in mind for me I"m really going to like." She said that 10 days ago and so far the only thing that happened was was 5 additional patients.

I have a timetable set in my mind and if something doesn't change big-time - I"m outta there.

4x4country · Nov 8, 2008

i work in a subacute rehab unit- at this point of time i have 33 (needy) res. i have to do everything. medpass, tx, charting, prns chart in 3 places, fax, new admits, orders,------basically everything, I have picc line, atb hanging, trachs (7), gtube, wounds, i see it all everyday.

now my new Exe. Director is implementing a new rule that we wont get a second nurse untill 44 res!!???? I honeslty can't believe it. Everyone is saying there is no nurse-to-res ratio law. What should I do?

NurseKatie08, MSN · Nov 10, 2008

i work in a subacute rehab unit- at this point of time i have 33 (needy) res. i have to do everything. medpass, tx, charting, prns chart in 3 places, fax, new admits, orders,------basically everything, I have picc line, atb hanging, trachs (7), gtube, wounds, i see it all everyday.
now my new Exe. Director is implementing a new rule that we wont get a second nurse untill 44 res!!???? I honeslty can't believe it. Everyone is saying there is no nurse-to-res ratio law. What should I do?

Holy gucamole...I work sub-acute/rehab....My team is full at EIGHT patients, nine for the other two teams. As you mention, I do pretty much the same things as you--med passes, tx, charting, new admits, orders, etc & my floor sees PICCs, wound vacs, g tubes, etc. I am a new grad (starting my 4th week off of orientation)--I work 3-11p & I'm lucky if I'm done before midnight---same goes for other nurses I work alongside with who have way more experience. How on God's green earth can you possibly safely care for 33 patients?? RUN far & fast away from that place!

mondkmondk · Nov 10, 2008

The last facility I worked in we barely had 20 residents with varying levels of care. We usually had 2 aides, a med tech, and me.

This new place I'm working is a 154 bed LTC with Residential Care Apartments too. At my station, we have like 37 residents and I have me, a med tech, and 4 aides. If the other stations need help, I sometimes send 1 or 2 of my aides when not busy over to help them. I pass all the narcs, do all the nebulizer tx's, the insulins and accu checks, assess the Med A people, do tx's, feed and pass trays in the massively huge dining room, chart everything under the sun...and try to be a good team leader. I have yet to take a tour of the apt's but I'm sure they are really nice. This is a really nice nursing home now. I did LPN clinicals in this nursing home back when the nurses there wore all white and caps. Of course, now you can wear cute little smocks and scrubs, haha.

Blessings, Michelle

southernbeegirl, BSN, RN · Nov 10, 2008

our days and evenings have about 25 pts each, with 3-4 CNAs for 50 pts...all skilled.

nights is the same on the skilled wing and then one nurse for 50 pts on the LTC side but now it is also half skilled and the work load a lot bigger.

we have a lot of new nurses and when they complain about the load i just smile and remember when I had 48 pts on evening shift with 2 aides or when i was 11-7 super that at least 3-4 days a week i had 2 floors, 60 pts each floor for a total of 120 pts, half skilled and still had to be house supervisor, do staffing, tape report after getting it from all the nurses and get chart checks done on all 120.

lexibear99, LPN · Nov 12, 2008

I have approx 48 residents on 3-11 shift. I have 4 cna's and me and I do all treatments, med passes, dr orders etc. This is to many to give any kind of care to let alone quality care! :nono:

catlvr · Nov 15, 2008

I have 29 pts (2 tube feedings, 3 foleys, 15 dementia) on the 3-11 shift, with 2 aides. I do the meds, treatments, and charting. I used to float in this facility, but now have a permanant assignment on what everyone agrees is the hardest long term floor of our facility. (The previous RN and LPN were terminated, so I have a lot of qualms about taking the assignment!). For those of you who have more patients, my hat is off to you. I am stretched to my limit as it is, and cannot imagine having one more patient to think about.

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Gizmo44 · Nov 20, 2008

I am a new grad (May 08)/licensed (Aug 08) LPN. I just started PRN in LTC facility with 90 beds. Finished training in October - 1 day in each of 3 halls. Depending on the shift I can have on days/evenings - 20 residents (alzheimers hall) or 38 or 32 residents in the other 2 halls - There is one nurse + 3 CNAs in each hall and the supervisor who mans the desk. We do all meds, I&O, accuchecks, insulin, treatments, assessments, charting, & dinning room supr during meals - I probably forgot something. Evenings there is 1 QMA to help everyone but mostly focuses on the hall with the most meds. At Night there is 2 nurses - one in each of the main halls and they share the Alzheimer's unit meaning up to an additional 10 residents = 48 or 42 total each & I don't know how many CNAs. We have 2 hrs for each med pass. Each resident has 5-8 meds min. and some have more than 10. for each pass. This facility is total paper charting and there is lots of duplication. I hate punching pills through those cards - it is so time consuming for me.

Now keep in mind that I finished training over a month ago and my first shift on my own is this weekend (6A-6:30P Sat. & Sun.). Don't think I am not nervous. I have been trying to keep preoccupied studying for Microbiology but it doesn't work always. Yes, I am continuing for my RN because I dont' see me working in LTC my whole career.

chioma_LPN · Nov 30, 2008

I pass meds to about 23 patients...