Work in LTC ? - Does this nurse to patient ratio sound right ?

Specialties Geriatric


Hello everyone.

I wanted your opinion in regards to this nurse to patient ratio. I'm a new graduate Nurse and this would be my first job as an RN. I'm excited, but nervous at the same time. Just recently I was offered a position at a LTC facility. Overnights, 8-hour shifts, 11p-7:30a. There are 72 residents on this particular unit, divided into two wings. There are 2 nurses for 72 patients, each nurse will be responsible for 36 patients.

How will I accomplish anything with such a big workload?

If you work or have worked in LTC, can you please tell me the usual duties and routines of this environment.


Specializes in Peds Medical Floor.

Yes this is typical. When I worked nights as an LPN I was alone on a floor of 43.

Yup. And it isn't that bad. They are generally sleeping and your a.m. med pass will probably be a lot of Synthroid, Fosamax and Prilosec.


Specializes in Vents, Telemetry, Home Care, Home infusion.
Specializes in Oncology.

I had somewhere between 20 and 55 in LTC and it was never easy. It's just plain too much and unsafe. If 2 people have an emergency what do you do when you're the only nurse available? LTC needs serious reform. I quit LTC because of the dangers to my license and the fact that I can't give the good care I want to when I have too many patients like that. Bless those willing to risk it but I am not comfortable like that. Even in daycares caregivers don't have that many kids. If a classroom has over 30 kids, there's an outrage about too many for the teacher to handle. she just has to get them all to behave, we're RESPONSIBLE FOR THE HEALTH AND SAFETY of more than that, with a million meds to pass, treatments to give, deal with families, deal with orders and MDs, phone calls, pharmacy, cleaning, the list goes on. LTC was nothing but a nightmare for me.

For 11-7, this sounds like heaven. I norm had 48-50 on 11-7 at one place and at another around 70.

Specializes in LTC.

We have 2 nurses on NOC for 73 residents and it works out well. We have 4-5 CNA's on, too. How many CNA's would be on? It matters tremendously!

Specializes in Med-Surg, Neuro, Respiratory.

This is typical for most facilities. When I worked NOCs I had anywhere from 35 - 45 residents. It is manageable though! You'll come up with a system that works for you.

I have 49 on 3-11, so your ratio sounds good to me! As someone said, most of your pts will (hopefully) be sleeping. And quality LTC facilities won't schedule meds/treatments in the middle of the night. This violates the residents' rights.

Specializes in Med/Surge, Psych, LTC, Home Health.

I have 54 by myself on 11-7. It **sucks**, especially since every woman in that dang place AND

some of the men, are on Synthroid. Plus I only have two CNA's.

It's silly to wake everyone up at 5 or 6 am to give a stupid synthroid. We've been giving everyone their synthroid along with 8am meds on 1st shift for years. And guess what? Their TSH levels have ALWAYS been 100% therapeutic. I don't give a flip what theta stupid med handbook says, it is FINE to give synthroid close to breakfast.

Specializes in LTC.

I regularly have 51 patients every night but have had as much as 103 all to myself for the greater part of month. Its very manageable when most are sleeping. But when you have dementia patients that are up and are a danger to themselves and/or elopment risks, hospice patients at the very end of their journey, fresh surgeries out of the local hospital that no longer has a post surgical skilled unit of their own... it can be interesting. Don't ever let anyone tell you night shift doesn't work as hard as any other shift.

Besides, in my facility night shift gets all the paperwork that no other shift wants and all the follow up on physician's orders and pharmacy issues, even though no one is awake to respond to our faxes.

Also don't ever believe that LTC nurses don't use just as much "critical thinking" and assessment skills as any other area.

I think it takes a special kind of nurse and a specially developed skill set to truly excel at LTC.

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