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shift report, CNA/pt ratio

In your nursing homes I'd like to hear how the change of shift routine goes. Specifically:

  • who sits in on report--all oncoming nurses and CNAs hearing the same report from offgoing staff? OR nurses give report to nurses while CNAs report to CNA?
  • If your CNAs give report to each other (without nurses) does anyone have a formal list of items they report?

Also, I'd like to know:

  • what are your ratios of CNA to patients?

Thank you

Most CNAs and nurses don't give report at my facility-which is dangerous, in my opinion, because many of the residents are so medically/mentally fragile. When I leave at the end of my shift, I do give report.

I usually have 18 residents to care for during my 12 hour shift, by myself. I just started my first CNA job on April 20, so I am a bit overwhelmed, especially with no update on my patients! I had 3 shifts of orientation.

tyvin, BSN, RN

Specializes in Hospice / Psych / RNAC.

The last LTC facility I worked at everyone (charge, RNs, LPNs, CNAs) sat in on report that the previous shift recorded. After we would go out and do something similar to walking rounds with the remaining people since it would be like 10 more minutes until the off going shift had to leave. It was the nurses who would record report.

It could get chaotic since some people want to sit on there ________ since they believe there work is done and don't have to participate with the report. The place I worked at had a real bad morale problem and the CNAs who numbered in the large digits were at war with each other and the nurses.

Patient ratio was supposed to be kept at 8 residents per CNA during the day shift, 10 in the evening and they would split the house between 4 of them at night. The rooms and floor assignments were designed so the acuity was all mixed up and the probability of getting a whole load of extremely hard residents was minimal (but it would happen). Now remember this was suppose to be but most of the time call ins for sick changed it almost everyday.

Now the licensed staff who passed meds; well the place had 94 residents and only 3 carts for med pass. Always had 3 nurses on to pass and many times the charge would have to take a cart due to call ins and the inability to fill the spots so it got crazy. The charge had to have the ability to go on any cart since the nurses wouldn't trade the carts once assigned. OH the terror stories I could tell (but won't) also remember the nurse had to do the wound care as well. 3 nurses to pass day and 3 for evenings and 2 for the night shift.

Do I miss LTC, no; I'll have to say it just wasn't my niche'

I have worked at many nursing homes/skilled nursing facilities/rehabs. I have found that normally nurses give to nurses and CNAs give to CNAs. As far as CNAs go though, I have never seen it really enforced. Besides charting, I have never seen any type of formal list of items. Just all in the head and on the charts. The nicest places I have worked at had an all staff report go on. Ratio is anywhere between 6-10.

Neuro Guy NP, DNP, PhD, APRN

Specializes in Vascular Neurology and Neurocritical Care.

At my facility, nurse report to nurses, PCTs (which are like CNAs) report to PCTs.

In their report, the PCTs talk about pt ADL needs/abilities, blood sugars (whether or not q6h, AC/HS, or whatever the case may be), foley care (including whether or not they need to D/C or insert foley per RN delegation); yes they can do that if they have documentation stating they have training, particularly if they are nursing students. They also discuss Vital Signs routines, if there are different from normal floor routine, meals, bathing, and other such things within aide's job descriptions.

Double-Helix, BSN, RN

Specializes in PICU, Sedation/Radiology, PACU.

In my old facility, the nurses gave report to each other in the report room. The CNA's did bedside report to each other. It was the charge nurse's job to make sure that the CNA's had been informed of anything resident-specific they needed to know (urine sample, falls, etc.) There was no formal report system for the CNA's- it was basically a by-exception report and if there was a new admission the report would include assistance needed, continence, orientation, and assistive devices.


days- approx. 1:8

evenings - 1:12

nights- 1:17

Mandychelle79, ASN, RN

Specializes in Psych.

It depends on which floor you work on in the hospital I work at

I work on Geri Psych

The aides give their own report. We have code status, vitals, how the person ambulates, what assistance they need with are, any safety devices ( bed checks/chair checks), what type of incontinence product they use, and a brief overview of how they were that shift ( combative with care, isolation, take two people into room, etc)

Our ratio depends on how many nurses are working a lot of the time. If there are 12 patients we get four staff. Some do it 2 and 2, others do it 3 nurses and 1 aide. Not usually too bad unless you have a lot of assists of 2 and the nurses cant help. at 18 we typically get 2.5-3 aides on days, 2 on eves, and 2 on nights


Specializes in LTC, Memory loss, PDN.

ratios depend on so many factors...

what shift, what day of the week, are there hospice aids or private aids, are there activities, certainly acuity, and of course call offs, as a general rule it's 1:8 on 7-3, 1:12 on 3-11 and 1:18 on 11-7 (skilled floor)

when 7-3 comes on duty, everybody sits in on report (DON's choice)

for 3-11, nurses report to nurses and aids to aids (I give report to my aids after I take report from off going nurse) The aids do have a report sheet for giving report.

Forever Sunshine, ASN, RN

Specializes in LTC.

We(nurses) receive report from the off-going shift and then repeat the report to the CNAs. Its face-face report. I wouldn't like getting report or giving report to a tape recorder.

In a perfect world.. and sometimes this is timed right.. the CNAs listen to the report from off-going shift with us and we don't have to repeat it. Just things that are important for our shift and assignments.


Specializes in LTC/Skilled Care/Rehab.

I have very rarely seen CNAs give each other report at the LTC facility I work at. I didn't generally give the CNAs report unless there was a new resident or there was something new or a specimen I needed. For a while we were doing group report so that the nurses could cover for each other during breaktime. Breaks? I had to LOL at that one. I even said to the manager that I hadn't taken a lunch break for weeks....what a joke!



At my facility there is no CNA report, however the nurses do report to each other. We also have started using Accunurse whitch I feel is a wounderful technology. It is basicly like a fastfood drive through headset that resident ADL are recorded into a computer system that the nurses can look at real time. The nurses have not started using them yet but will hopefully start in 6 - 9 months. the ratio varries on 6a-2p is 7-8 residents per cna on 2p-10p it is 10 - 12 residents per cna and on 10p-6am it is 15 - 20 residents per cna. day shift has 2 floor nurses and 2 unit managers with the DON & ADON and 2 MDS nurses Mon - Fri. On SAT and SUN we have a weekend rn for 8 hrs and a treatment nurse for 8 hrs besides the charge nurses. on the weekends no unit managers are there.

Edited by carlton.jeffery
left out patient ration for cna's


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