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What should the nurse-patient ratio be in long-term care facilities?

Geriatric   (6,768 Views | 12 Replies)
by Jaimie.RN Jaimie.RN (Member)

4,079 Profile Views; 82 Posts

Honestly, I think ten should be the limit. I work with over 40 as of now and I have barely any time for any of my patients, especially with all the other nonsense work they require of me.

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3 Posts; 654 Profile Views

I have around 35 and can go as high as 45 if we are short nurses. I too feel as if I don't have enough time for my patients.

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82 Posts; 4,079 Profile Views

What do you think would be a safe number of patients to take? I spend 4 hours at my first med pass when I come on to my shift. Inevitably some people get their meds late cause it's physically impossible to get these people their meds crushed, injected, and deal with the combative ones, let alone pulling the 20 meds for each person, checking their bps, sugars, then dealing with dumb requests like fluff my pillow, it's like I DO NOT HAVE TIME. Makes me feel like the worst nurse ever.

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feelsafewithanurse has 6 years experience and specializes in LTC, Geriatrics, MDS.

10 Posts; 1,249 Profile Views

i usually have 56 as charge split it for med/tx nurse. Have you noticed anything in the meds that they may not need. Like B/P stable but your checking it every shift? or On colace and senna, request to switch to senna s. Send them to the MD to review and ask if can be changed or decreased or better yet d/c. I know it sounds time consuming to do but trust me in the long run it really really helps. Get rid of old things no longer needed. Make a list or like a shift book maybe specifing specific task, who gets blood sugars, who's skin do i need to look at. Just look at what you do in a day and go home and just think "what can i do to make this easier?" Then when you have some ideas talk to ur DON or whoever is appropriate and say "hey i have some ideas to help out with time on the floor". Trust me most of them like that and it shows good management qualities.

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noc4senuf specializes in Geriatrics, WCC.

683 Posts; 8,534 Profile Views

In my facility on long-term care floor, it is max of 32 with a TMA to pass meds. On the TCU, 16.

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82 Posts; 4,079 Profile Views

Wow, only 32 and you have a TMA? I have 45 with no TMA and my aides don't do sugars or foley care or anything.

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Nascar nurse has 25 years experience as a ASN, RN and specializes in LTC & Hospice.

2,216 Posts; 32,320 Profile Views

And to add to feelsafewithanurse posts...get rid of the QID blood sugar checks on the residents that have been there for years and have had stable blood sugars for years too. Some can go to BID if needed - others to just weekly.

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82 Posts; 4,079 Profile Views

Yeah, there's people I poke 3 times in one shift for no reason. One lady has never had to get sliding scale insulin except once, why am I poking her every 4 hours?

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3 Posts; 666 Profile Views

What do you think would be a safe number of patients to take? I spend 4 hours at my first med pass when I come on to my shift. Inevitably some people get their meds late cause it's physically impossible to get these people their meds crushed, injected, and deal with the combative ones, let alone pulling the 20 meds for each person, checking their bps, sugars, then dealing with dumb requests like fluff my pillow, it's like I DO NOT HAVE TIME. Makes me feel like the worst nurse ever.

I know this is an older post. However, you took the words right out of my mouth! I've been on all nurses to get some more info on this exact subject. I've been feeling very overwealmed and ready to just QUIT my LTC job lately. We have 47-52 patients and I work the 7am-3:30pm shift. We do have a treatment nurse and there is a supervisor that receives the faxes, most calls, admissions, transfers (thank God because I would NEVER be able to do it all and get my meds out!) But I still feel like the quality of care is severely lacking. I got into nursing to do a rewarding career of helping peoples quality of life but I feel as though I'm a glorified slave who shoves meds all day. I feel myself panicking when I get that patient who wants to take 1 med at a time, and it just shouldn't be like that! By the end of my shift I feel physically and mentally exhausted! I want out of LTC so badly. Luckily, I'm only on-call because I don't know how I could cope full time. I plan to try to get a job in home care and quit my current facility.

Right now at my current "skill" level, I think I would be much more comfortable handling 20 patients, 30 patients maximum. That would be with med-pass only. If it were treatments too, 20 would be ideal.

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Animal House R.N. has 23 years experience as a ADN, CNA, LVN and specializes in Geriatircs/Rural Hospitals.

57 Posts; 1,167 Profile Views

Right now I work 12 hour night shift with 39 patients. Om Mon and tues nights there are orders left over from where the nphas been in the facility. I think that 30 would be much better. I also have a med pass that last from 6 to 9 pm.

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strawberryluv is a BSN, RN and specializes in LTC, Med-surg.

745 Posts; 11,920 Profile Views

I work 3-11 shift and I have been receiving 30 patients. It seems that management thinks 1:30 is okay but it takes me 3 hours for both of my med passes. I then have to squeeze in treatment at 11:00-12 midnight and I feel awful about it but there isn't any way I can see myself going about this in the easiest way. I sometimes try to combine my early evening meds and late evening meds together if I can that way I can knock some time off but I still finish my med pass at 10:30 p.m.. Its a damn shame.

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Adele_Michal7 has 5 years experience as a ASN, RN and specializes in Pediatric.

893 Posts; 8,420 Profile Views

I know this is an older post. However, you took the words right out of my mouth! I've been on all nurses to get some more info on this exact subject. I've been feeling very overwealmed and ready to just QUIT my LTC job lately. We have 47-52 patients and I work the 7am-3:30pm shift. We do have a treatment nurse and there is a supervisor that receives the faxes, most calls, admissions, transfers (thank God because I would NEVER be able to do it all and get my meds out!) But I still feel like the quality of care is severely lacking. I got into nursing to do a rewarding career of helping peoples quality of life but I feel as though I'm a glorified slave who shoves meds all day. I feel myself panicking when I get that patient who wants to take 1 med at a time, and it just shouldn't be like that! By the end of my shift I feel physically and mentally exhausted! I want out of LTC so badly. Luckily, I'm only on-call because I don't know how I could cope full time. I plan to try to get a job in home care and quit my current facility.

Right now at my current "skill" level, I think I would be much more comfortable handling 20 patients, 30 patients maximum. That would be with med-pass only. If it were treatments too, 20 would be ideal.

47-52 on day shift is insanely unsafe.

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