[Jan RN]

Can anyone tell me what it's like to work subacute rehab? What is a decent nurse/pt ratio? What skills must the RN have? I am considering a part time day job in this area. Just finished an RN refresher program and did my clinical on a rehab floor in a hospital, with pts having MS, brain injuries, stroke, renal failure, spinal cord injuries,etc.. Need to decide soon, so any comments are appreciated. Thanks, Janet

[TheCommuter]

I worked on a short-term subacute rehabilitation unit for 2 years, where the typical patient was discharged home within 2 weeks of admission. The typical ratio was 1 nurse to 15 patients for day shift, and 1 nurse to 30 patients for night shift.

I dealt with mostly postsurgical patients who were too deconditioned to go home. In other words, we were reconditioning (rehabbing) the patients. These patients were CABGs, knee and hip arthroplasties, thromboembolectomies, hysterectomies, post CVAs, fractures, dialysis recipients, and so forth. One time I received a gentleman who was badly beaten and robbed, and needed reconditioning. Many of my patients were middle-aged, and wouldn't fit the description of the average nursing home patient. However, the vast majority were elderly people.

I regularly gave drugs via IVPB and IV push, especially antibiotics. We frequently started our own IVs to create peripheral access. I removed sutures and staples, dressed complicated wounds, applied new ostomy appliances, operated nebulizers, ran CPM (continuous positive motion) machines, filled iceman machines, cleansed cervical haloes, ran oxygen tanks, concentrators, and PEG tubes. Trach care is also frequently included in the deal. Primarily, I gave out a whole lot of p.o. pain meds (Vicodin, Morphine, Darvocet, Ultram, Oxycontin, etc) for postsurgical pain mgmt.

There was always something to learn at my workplace, which happened to be a nursing home. The opportunities might not have been so obvious, so I had to be aggressive and seek them out.