Total Patient Care Nursing

[Sydryth, ASN, RN]

The facility I am currently at is proposing going to total patient care for nurses. They are talking about cutting out the CNAs and replacing them with LPNs to split the case load. That entail would make it roughly 1 to 5 on my end. Granted the RNs are still responsible for all the assessments, so the LPNs would have to have heavier loads on certain aspects, such as med passes.

I was wandering if any other facilities out there has tried this approach, and does it work? If it works does the advantages outweigh the disadvantages? I'm not above wiping butts and helping people on the pot. I worked in ICUs for a long time and we didn't staff a CNA. We did bed baths, cleaned patients, and etc. However, that was a 1:2 nurse patio ratio, so we had plenty of help and not 1:5.

[TheCommuter, BSN, RN]

I would not want to perform total care in the rehab nursing setting with a nurse/patient ratio of 1:5. 1:3 or even 1:4 seems okay for total care, but 1:5 is pushing it when you've got multiple CVA patients who are dead weight Hoyer lift transfers.

[Sydryth, ASN, RN]

I opposed it myself, but administration actually implemented it on our acute care side. After nurses started turning in their resignations and others threatening, they quickly brought back the CNA's. So I don't think I have to work about it anymore.