Mixing Rehab and LTC

Nursing Students CNA/MA

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Specializes in LTC.

At my LTC we have a rehab floor and we also have rehab patients scattered around on our long term floors. It seems like a bad idea. There's usually a huge difference between the patients on the rehab floor, where they're more willing to push themselves, and those that are with the LTC. The ones mixed with LTC treat the place more like it's a hotel.

Does anyone else's workplace do this?

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Specializes in CV Surgical, ICU.

If we have an empty bed on a long term unit, no prospects and there's a questionable rehab patient, they'll move them up to the empty bed. That way, if they (or the family) ultimately decide to go with long term care, they've got the bed. They do this only if they can't find any guaranteed long term candidates to fill the gap.

Actually I always found it a nice break because they can usually do a lot more for themselves than our typical residents. :)

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At my ltc we have a mix of rehab, elderly, and psych. And I'm talking about just one floor with the whole mix. Makes for a very interesting day I must say. Most of the residents are men as well, which is not very common in ltc. I agree with the above poster. I usually have 8 residents on shift and about half of them are self care, so it makes things a bit easier. And when I update my resume I can say that I worked with rehab and psych residents, which makes it look better. :heartbeat

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Specializes in IMCU.

Why would it be a bad idea? Are you saying the rehab pts that are on the ltc floor treat the place like a hotel and are unwilling to push themselves places?

Is it possible that the rehab pts that go to the LTC floor require more assistance and are therefore put on your floor because you lot have the requisite experience in dealing with people with greater need? Just wondering. If that is not the case then maybe your nurse needs to explain the concept of rehab to them.

I suspect it might be a good idea for the ltc residents to get some fresh faces in the place. Perhaps that is one of the rationales.

Still I don't see a downside to it.

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if a patient is admitted to rehab and becomes ltc, they can not, by medicare regs, be forced to move to a ltc floor.....therefore the institution has a lic for rehab patients up to a certain number, the recompence is greater for those rehab patients so they will be admitted into ltc beds.....not really fair to staff and prob not patient either.

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Specializes in IMCU.
if a patient is admitted to rehab and becomes ltc, they can not, by medicare regs, be forced to move to a ltc floor.....therefore the institution has a lic for rehab patients up to a certain number, the recompence is greater for those rehab patients so they will be admitted into ltc beds.....not really fair to staff and prob not patient either.

Sorry I am so ignorant but I don't understand the problem. Why is it not fair?

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Sorry I am so ignorant but I don't understand the problem. Why is it not fair?

a ltc nurse is not going to have the same exact skill set as rehab nurse, and the staffing is much better (usually) on a rehab floor....ltc may be 30:1 and rehab maybe half that or even less.....would you want to be that rehab patient with the nurse that has 29 other patients some of which are demented and/or psych? instead of being on a floor with like patients, with similar concerns to your own?

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Specializes in CV Surgical, ICU.
a ltc nurse is not going to have the same exact skill set as rehab nurse

My mother is an LPN who has worked on a long term floor for 15 years. She has gotten, rehabbed and sent home many rehab patients. She has worked with the other nurses to heal a stage 4 ulcer that was only getting worse down on the rehab floor and had 'no hope of healing.' She has also (along with the cna's) rehabbed long term patients from barely walking to walking independently without use of a wheelchair sometimes allowing their families to take them home. When they send a rehab patient up to her floor of 40 residents, they get the same good care as those on the rehab floor downstairs, and actually sometimes it would seem they get more attention than they would on a subacute floor.

I'm not saying this to say she's Florence Nightingale or anything, just to say that just because a nurse doesn't work on a rehab floor that doesn't mean she doesn't possess the skills nessecary.

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My mother is an LPN who has worked on a long term floor for 15 years. She has gotten, rehabbed and sent home many rehab patients. She has worked with the other nurses to heal a stage 4 ulcer that was only getting worse down on the rehab floor and had 'no hope of healing.' She has also (along with the cna's) rehabbed long term patients from barely walking to walking independently without use of a wheelchair sometimes allowing their families to take them home. When they send a rehab patient up to her floor of 40 residents, they get the same good care as those on the rehab floor downstairs, and actually sometimes it would seem they get more attention than they would on a subacute floor.

I'm not saying this to say she's Florence Nightingale or anything, just to say that just because a nurse doesn't work on a rehab floor that doesn't mean she doesn't possess the skills nessecary.

i stand by my original thought, healing a stage 4 is not exculsive to either....and may well be more apt on ltc than rehab....and if your mothers istitution is providing the same degree of attention on both floors, one is over staffed or one is understaffed.....

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Specializes in IMCU.

Thanks for explaining!

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Specializes in LTC.
Why would it be a bad idea? Are you saying the rehab pts that are on the ltc floor treat the place like a hotel and are unwilling to push themselves places?

Is it possible that the rehab pts that go to the LTC floor require more assistance and are therefore put on your floor because you lot have the requisite experience in dealing with people with greater need? Just wondering. If that is not the case then maybe your nurse needs to explain the concept of rehab to them.

Yes, I am saying that the rehabbers on the LTC floor don't want to push themselves. And what floor they end up on has nothing to do with acuity-- it just depends on available beds and how much money they have.

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Specializes in CV Surgical, ICU.
i stand by my original thought, healing a stage 4 is not exculsive to either....and may well be more apt on ltc than rehab....and if your mothers istitution is providing the same degree of attention on both floors, one is over staffed or one is understaffed.....

Again.

My point was, that just because a nurse works on a long term floor does not mean they 'lack the skills' needed to take care of a rehab patient. :rolleyes:

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