Nurse Staffing Ratios in Long Term Nursing

I don’t know how many of you have been paying attention to the nursing news lately. There’s a movement that’s been building over the past few weeks, known as #nursestakeDC. There’s finally honest conversations about nurse-patient ratios and the risk that it puts both on the nurse and on the patient.

Many of the statistics focus on hospital nursing, which has been steadily creeping up over the past few years. When I interviewed with the hospital last year, they told me that they’re being forced to have nurses sometimes have as many as eight patients a shift because of demand.

Imagine their surprise when they found out that I’ve never had a nurse-patient ratio that low.

In long term care, the numbers can become even more terrifying. A few weeks ago, because of low census and low staffing, I ended up having 23 patients for my evening med pass, which included all dressings, skin assessments and Medicare/Medicaid assessments. This number is more than the norm.

In fact, I had a patient’s family member mention to our DON that they knew we were short staffed, and she responded with:

“We are not short staffed. We have better staffing than any other long term facility in the area.”

Scary thing is, she’s right. In long term facilities, we’re dictated by Medicaid, which decides if we’re spending too much time in a patient’s room. If a patient is able to toilet themselves, and if they don’t have wounds, we shouldn’t have to be in there for too long, right?

But the amount of help they need to toilet, or to dress doesn’t dictate how many times they pull their call light. It doesn’t say whether or not they want a hot cup of coffee every ten minutes, or if they want their window opened and closed as they try to get to the right temperature. Some nights, as we’re trying to help people into bed, there will be six or seven lights going off, and when I only have two CNAs plus myself, we can only answer them as best we can.

When you’re spread that thin, even when it’s for patients that are considered ‘low risk’, an emergency can become fatal.

Let’s let our leaders know that setting these standards are not only putting our patients at risk, but also our nurses. Burnout and fatigue are real.