[kek]

Hi all, I am possibly considering a job change into rehab. It is a 60 bed free standing rehab hospital that is all over the country. I've never done rehab before but I have done med/surg. I was told during an interview that the patient nurse ratio is - one nurse and one aid for eight patients. The patients are mainly strokes and joint replacments. Is this good, bad or just right? ANY suggestions, advice, warnings etc would be very much appreciated. Thank you in advance and Happy Thanksgiving to you all.

[renerian]

Is it one nurse being defined as an RN or it is possible one LPN is defined as a nurse and your also having to cover their patient load as well as yours? Just curious.

renerian

[PsychRN03]

Originally Posted by kek

Hi all, I am possibly considering a job change into rehab. It is a 60 bed free standing rehab hospital that is all over the country. I've never done rehab before but I have done med/surg. I was told during an interview that the patient nurse ratio is - one nurse and one aid for eight patients. The patients are mainly strokes and joint replacments. Is this good, bad or just right? ANY suggestions, advice, warnings etc would be very much appreciated. Thank you in advance and Happy Thanksgiving to you all.

My blanket statement would be it's good for the hospital, bad for your license, so just show me right out the front door to the next hospital. Of course my knowledge of a rehab unit within a regular hospital is that it's the dumping grounds when the other specialty floors are full. I don't know much about free standing units, but I might be inclined to stick with my previous statement. Also, you didn't mention what shift, but if you're talking about it being days, I'd say don't wait for them to show you the front door; rather run to the light.

[kek]

It would be 7am to 7pm shift and it would be me, the RN, and one aid for eight patients.

[RNKITTY04]

I also work in a free standing rehab, our ratios are 5:1 with 1 CNA.

[kek]

Originally Posted by RNKITTY04

I also work in a free standing rehab, our ratios are 5:1 with 1 CNA.

WOW! one nurse AND one CNA for five patients ???? and in Florida too ! That's great - where abouts in Florida are you? What type of rehab patients do you care for mainly? I would be jumping into the job off with those ratios. Good for you! ( unless of course they all have a very high acuity)
Or - is that CNA for the whole floor ? or as I read it first - just with you for your 5 patients?

Thanks

[RNKITTY04]

I work in Jacksonville Florida, and we have 1 CNA to each nurse. We both share the same 5 patients. I work on the stroke floor so most of my patients are CVA's. Lots of heavy lifting. Mostly PO meds, once in awhile an IV but thats rare.

[rngreenhorn]

I work in an acute rehab unit in a 250 hospital.

Our nurse/ patient is somewhat the same as rnkitty. The RN can sometimes have up to 8 patients, but the CNAs never has more than 4 patients (and they work very hard). So, if the RN has 8 patients, she has 2 CNAs. If the RN has 2-3 patients, she has total patient care, with no CNA.

We have a mixture of CVAs, TBIs, SCIs, ortho and neuro. Some of the patients are highly functional, needing help with few ADLs. And some e.g. quadrapalegics need help with all ADL's. The charge nurse makes assignments based on acuity and never gives all the "hard patients" to one RN or one CNA.

We stay very busy with this set up, but I seldom feel overwhelmed. Also, the therapy schedules are very strict i.e. the patients have to be dressed and ready for therapy by 0800. This would be impossible without the help of the CNAs. And getting the meds passed, checking off doctors, dressing changes etc. would be hard without the CNA because the nurse would constantly be toileting, feeding, changing linens, etc.

I think I would question a ratio of 8 patients with only one CNA. But, I think I could handle a group of 8 high functioning patients with one CNA. I certainly would be making some further inquiry before accepting that job.

[kek]

thanks rngreenhorn for your reply. I would love to find a job around here where the ratio was more like 1:5 or like you said - 1:8 but with two CNAs then. I don't think that is going to happen around here though. I used to work med/surg and was often charge for the 44 bed floor while having my own 8 patient load and no CNAs at all - this was on nights - I guess patients are supposed to sleep then right ? On days the nurses would have 6 patients each - sometimes up to 7 and on odd occasions 8 if a nurse had called in. Also on days they would only have 1 CNA for the whole 44 bed floor. I guess I'm wondering then if 1:8 with a CNA might seem okay to me after those days? I don't know though - I've never done rehab. Also, this is a rehab hospital to which patients are discharged to following their stay in a hospital. I'm wondering if these patients will be as sick as the ones I cared for on med/surg. These nurse patient ratios are what's bothering me the most - I really really really don't want to go back to a place that was as hell to work at as that med/surg floor was - now that was crazy!
Are there ANY nurses out there that think these ratios are do-able?????

I am wondering how two people can get 8 people dressed before 8am ..........especially when one of the people doing the dressing is also supposed to get all the meds given and the docs orders noted etc etc etc....

hoping - begining to feel panicy - 'where is the HELP ME button' ?

[ShortyLPN]

I'm not in rehab..but I should say consider yourselves lucky I've got 24 Alzheimers residents, approx 10 are heavy lifting...all the rest are wanderers with one aide....sometimes two if I'm lucky!