Skilled Ratios in your facility?

Nurses LPN/LVN

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How does your skilled/LTC facility handle ratios? The facility I work right now has one skilled hall that can fit I think 22 people. I think the whole facility can fit about 90 people it's mostly LTC.

The nurse to patient ratio for the skilled hall is totally dependent on the census of the WHOLE building, acuity is not taken in to account at all. So, when we have 85 residents the skilled hall can have 2 nurses when the census dips they take away the second nurse on that hall. My last facility I worked the skilled hall was dependent on acuity. We would tops have 10 patients but usually it was more like 8. We moved out of state or I would still be there.....

Picture this: Saturday/Sunday we had 2 nurses on skilled. Monday rolls around we had a few in the building D/Ced but the SAME numbers of patients on skilled and now we had 1 nurse (me) to manage it all.

I had 10 skilled and 8 others.(18 its all together) 2 blood draws, did PT/INRs but the machine sucks and it takes more Than one try usually, VS, managed a lady with PNA, another with c-spine precautions, 2 hips, 2 people with scheduled NEBs, changed Fent patches, did wound care, entered orders, passed meds to every one (of coorifice), one lady kept getting naked and standing in her room, wanderers from other halls coming over standing from their wheel chairs who are frequent fallers, feed a gt pt twice, did wound care but of coorifice couldn't find the supplies right away because no one stocks, ordered drugs. Had a problem with a lady's injection that ended up never being ordered, gave a handful of PRNs, talked to the NP numerous times, talked to family members, took phones calls for report, did blood sugars breakfast lunch and dinner on and on and on.

There has to be more Idk I just know by the end of my day I felt horrible. I was not my best and I felt put in the position to not do my best work because of all I had to manage. I am not the only one who complains, its awful. There are nurses who flat out refuse to work that hall. My primary LTC group I have 22 people and my day is a breeze compared to this. Over all its a good facility, the resident/patients are taken care of I've work in some pretty bad place so I know I'm lucky Im not going anywhere but Im about ready to try to just refuse this hall like other do I can not do again.

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