[melrina75]

I have been in PhysicalRehab unit for less than a yr, but my floor has a horrible turn around with staff!! We have have through 2 managers and a number of nurses, CNAs, leave after 1-2 months! Our matrix is beyond obscene, management uses agency due to lack of nurses but complain about the budget so we have to work under matrix!! Patient falls increase, PressGaney scores well below average, unit morale is at an all time low! Quick example of our hell - Night shift/16 combo cranies,CVA, traumatic brain injuries- all with bed alarms and incontinent, 4 total kness, and 4 hips/3 license, 4 tube feedings, 3 trachs, 9 on IV antibiotics, 1 aide, no unit clerk/we're supposed to get 18 pts dressed before 0700, of course don't forget bowel/bladder retraining, MAR and chart checks, scheduled meds!!! I AM GOING NUTS!!
Just venting....................wondering if other rehab nurses experience the same on their units? Is this a normal rehab experience?! I've run my arse off before on an acute ms tele floor - I know how a nite gonna go crazybad - IV meds every other hr, codes, admits, ICU transfers, etc, but I have never had an experience like I have on this floor!! I fear for my pt safety and care. 2 bed alarms going off while I'm in the middle of assisting pt to BSC!
Please enlighten me and tell me if his sounds like s=every other rehab floor out there.........thank you

Sorry my post got sooo long!!

[dld]

In Cal. we have the 5:1 ratio. At night we have a charge and a break nurse with no pts. We have no aides. There are still times when bed alarms sound off and we can't get there. I am afraid your unit has poor management though. When the fall rate elevates and the hospital gets sued the management will take notice. Before we had the ratios we would often get stuck w/15 pts each with three aides on the floor. Now when we are short, the break nurse and charge nurse take pts. We wonder how we got along before the ratios. We don't have to dress pts in the morning, but we are really busy with meds, tx, caths, etc. that are all scheduled at 6 and 7 am. We draw labs also. Usually we run like crazy between 5-7 am just to get it all done, because among other things we are suppose to promote rest! The docs often write orders not to awaken the pt before 7am. The problems your unit is having don't get solved rapidly. It might take a minimum of 6 months to have staff trust the management again after things improve. If you want to stay at that unit I would talk to someone above the nurse manager to let them know why everyone is quitting, and tell them if things don't improve you'll leave too. Rehab units can bring in alot of money when they are managed correctly.

[SueIP]

I have just left a rehab facility that was basically as you have described. I would come in on an 11-7 shift and find I had 15 pt's with an Nurse tech.We would have numerous bed alarms etc and peg feeds etc etc ...and then we had to sit down and do all the 24 hour checks and do all the charting....madness really. We complained to our supervisor but the DON didnt do anything about it...infact 81 nurses have left in one year becaus eof the DON and numerous PT and OT etc...

It is a place waiting for something to happen...it is a shame as the staff are great.

I am now working in a hopsital and the max pt's I will get is 8. Such a difference.

PLease be careful

[NurseTech80]

I feel your pain...Im a Nurse tech and granted im dont have to deal with all the Pegs and Mars and meds ect.... but its usually a complete mad house ...I work 6a-3p and we have to have all our pts up dress cleaned washed up and ready for breakfast by 745.. thats after 30 mins of taking report... We usually have around 10 to 13 pts per tech... 13 pts in an hour and 15 mins is an accident waiting to happen... ton of bed and chair alarms and as quite a few Vail Beds...we get it done but is it really safe?