Safe / practical nurse to patient ratio (SNF)

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To all my friends and fellow nursing family out there! We need to raise awareness to to the often overlooked nurse to patient ratios in Skilled Nursing Facilities! If anything I would ask that you would take the time to read this. If you want any further info or have questions feel free to ask.

Skilled Nursing Facilities (SNF's), also referred to as Long Term Care or Nursing Homes, nurse to patient ratios typically range from 20-59 patients per nurse depending on the shift. The large misconception that only the elderly reside at these types of settings who need little more care than having their medications given to them on time simply is false.

The type of care at these facilities range from patients with gastronomy / tracheotomy tubes, have large or multiple wounds, post-op patients, psyche as well as brain injured or mentally handicapped patients vary from 18 years of age and up.

The average nurse/patient ratio at a Hosp. is 1:6. The current ratios at SNF's is simply too high to attain the highest practicable physical, mental or psychosocial well-being these patients deserve.

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I wouldn't hold my breath. The for-profit nursing home industry has a powerful lobbying presence in DC.

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Specializes in Family practice, emergency.

I would feel more strongly about a petition that addresses staffing across the board. Also, I'd be cautious about reaching for hospital ratios, as these are patients who are acutely ill, sometimes 1:6 is too much, too! I do agree that 20-59 patients is too much for a SNF and unsafe... just bringing up another part of the equation.

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Specializes in Pediatrics, Emergency, Trauma.
I would feel more strongly about a petition that addresses staffing across the board. Also, I'd be cautious about reaching for hospital ratios, as these are patients who are acutely ill, sometimes 1:6 is too much, too! I do agree that 20-59 patients is too much for a SNF and unsafe... just bringing up another part of the equation.

There is a safe staffing bill in the House as well as the Senate; it address staffing in hospitals; it MAY (don't quote me) have ratios for "skilled floors" as well.

A fellow poster posted a link in another thread; check it out in the Nursing Activism forum and contact your Senator :yes:

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Thank you for your feedback! There is currently a floating around in Senate that does address staffing across the board at hospitals just not SNF's.

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I agree that I would be going against a seemingly uphill battle because lets break it down, $$$ rules. But I figured its worth a shot. I can say at least I tried.

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I would love to see acuity based staffing in LTC. I might be able to handle 20-25 long term care residents, but at a skilled level....no.

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Specializes in Pediatrics, Emergency, Trauma.

This thread has the safe staffing acts proposed ratios; SNF is on the list as well:

https://allnurses.com/general-nursing-discussion/safe-nurse-staffing-908167.html#post7769859

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I totally agree! I have 19 residents. 5 bariatric, 8 that cannot feed themselves, 2 that are highly combative, 6 high-maintenance ringers, and only 1 that is self care. Most of the time I ony have 1 cna per shift for the whole floor. It's way too much for 1 cna and 1 nurse. None of the residents get "top if the line" care. We do the best we can, and mgmt comes to us and complains that our medcart is turned the wrong way! It's crazy, mgmt needs to get their priorities in line.

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I don't feel comfortable at all at my skilled facility which happens to be a 5-star. The patient's do not get the care they need. We don't have time for breaks (noc shift) and nurses usually have to stay an hour or more past shift with administration complaining that we have a "time management issues". Plus part- timers do not have a regular floor so we float to 3 different areas, being new and knowing that I will be in charge of 36 complete strangers with respiratory issues and mental issues along with being discharged so quickly from the hospital is scary. I am so scared of getting sued due to not being able to document everything that I did and having the facility throw me to the wolves. When it comes to reporting to the on-coming nurse I even have a hard time remembering who exactly the patient is (I equate it to having 36 babies show up at your house that you are suddenly in charge of overnight- they don't sleep and try remembering their names and what they look like by the morning)I spent 4 years on this degree and feel completely lost and unsupported. I put out hundreds of applications so I know that if I quit it will be really difficult to find a new job. It keeps me awake and my stress level is through the roof. I have actually considered just babysitting because the money after taxes would not be much of a difference.

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I know when I first started, fresh out of school, my other nurses really helped me out. I work night shift, so things move a little slower. I'm sure I bugged everyone, but who cares. I busted my butt to get my license and refuse to lose it over something dumb. Talk to your DON, or your ADON...they might be able to help. Hang in there it does get easier. I made a checklist in the beginning to help me stay on track and get it all done.

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In LTC it depends on the patient specifically. I could have maybe a max of 20 if they were walky-talky, non-fall risks, etc. If they're needy or have machines or are a fall risk, have to be toileted by staff, max of 10. When I worked LTC though they stuck us with 50 and all were almost fulls. It was hell.

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