[Jan RN]

Cant figure out why the ratio of nurse to pt on a rehab unit at a LTC facility is 1:17 and when I did a clinical rotation at a hospital on a rehab unit it is no more than 1:5. The pts were no more acute at the hospital.

Do you think 1:17 is unsafe on a fast paced rehab unit? They seem to get their work done (eventually) and everyone is supportive of eachother. I am in orientation and need to decide if I can handle it after being out of nsg for many years. thanks, janet

[nozyrozy40]

hmmmm.....our ratio is 1:20....i am able to get everything done....it's a busy day, but time flies.

[TheCommuter]

17 patients on a nursing home rehab unit is stressful, but manageable.

I worked on a rehab unit at a nursing home for the better part of 2 years, but it was structured much like a free-standing rehabilitation hospital. I usually had 15 of these types of patients during day shift, and about 30 at night. My former workplace liked to separate the rehab wing from the LTC wings, because they did not want the fully alert rehab patients to mix with the demented nursing home residents.

On this particular unit, we dealt with many central lines, IV antibiotics, CPM machines, feeding tubes, suture removal, surgical staple removal, complicated wound care, ostomy appliances, diabetic management, casts, braces, splints, cervical halos, and so forth. I once had a patient who was receiving TPN.

Most of my patients had recently underwent surgical procedures such as laminectomies, knee and hip arthroplasties (joint replacements), kyphoplasties, CABGs, hysterectomies, limb amputations, colectomies, thromboembolectomies, and abdominal aortic aneurysm repairs.

The non-surgical patients were typically admitted to our unit for recovery from CVAs, acute MIs, debility, various cancers, fractures, status post pneumonia, deconditioned states, failure to thrive, status post falls, generalized weakness, and other afflictions.

[suzanne4]

Ratios that are mandated by the states that actually have them in place only apply to acute bed hospitals, not to rehab facilities or to LTC.

As far as what you can handle is up to you, but if you have been away from nursing for years, would not recommend anything like this to start off with. Your skills are going to be rusty and this is not the place to be learning. They also do not give an orientation of more than a few days in most cases, and that is not going to be enough for you.

[evilolive]

My ratio on 11-7 is 1:32 if we have a full unit. I also have 2 CNAs at night. I can only imagine what would happen if I had two "events" happening at the same time. Thank goodness when things have started to happen, the other residents have been quiet.... I am just dreading the day!