A question

  1. Hi everyone...

    Tell me, do you think this statement is true? If so why?

    The patients we get on rehab are like those that would have been in med-surg 5 years ago.
    The patients we get on Med-surg are like those that would have been in the unit 5 years ago.
    The patients we get in the unit are like the patients that used to be in the funeral home 5 years ago

    Personally, I agree...


    --Barbara
    Moderator
    •  
  2. 16 Comments

  3. by   kids
    I agree.

    My Mom has been an RN for 30+ years, she says the patients she gets at her SNF would have been in the ICU 25 years ago.

    -nancy
  4. by   kewlnurse
    Your righy on Barb
  5. by   hsnurse92
    Is it OK that this happens and we don't do anything about it? Are we being patient advocates? Is this a dangerous situation? I'm an RN-9 years experience in rehab and I'm concerned that we are allowing a situation to develop that is just getting worse . Am I being (as I'm often told at work) too "anal"?
  6. by   mopsi
    This is true as far as I can see..I'm back in geriatrics and the acuity is out of this world..Skilled unstable patients are admitted left and right....And if they are a Kaiser patient ..good luck in getting them sent back if they start to go bad. Along with the increase in the number of patients it is overwhelming...No we aren't giving 1/2 as much care as we were able to even 5 years ago...Maybe with all this cloning they make a breed of "STEPFORD NURSES" Size 6...always ready to serve..endless energy..and the best cappped smile to ease your pain...LOL
  7. by   CashewLPN
    ok... this is my opinion....

    due to the advancements in medical abilities in recent years, we must be more highly skilled, better educated, and more organized than ever before...
    (and I mean we to mean all nurses)
    And, I think we should come equipped with jetpacks, leg bags, and rollerscates too...

    (only an idea)

    --Barbara
  8. by   shrpgrl
    This is so true. When I started 8 years ago in rehab if the patient wasn't stable or needed blood etc. they were sent off. Now giving blood is an everyday occurence and we get admits from the ICU and cardiac stepdown frequently. We are getting patients the second day post op. However they do not feel the need to adjust staffing just keep adding more work.
    Our admit packs are now between 20 and 25 pages depending on diagnosis. We have to FIM all activities every shift as well as do pain assessments and graphs every time a patient has pain. We have IV sheets, I & O sheets, bladder and Bowel flowsheets, Cpm flowsheetsm just to name a few. They keep piling the paperwork on and then complain if we have overtime.
  9. by   Sleepyeyes
    Yep.
    I started in LTC when I was 16. Night meds were left out and labelled for us to give (I was an NA--no certification back then either)--I remember one 86-yo pt was on seconal; had been for 30 years. Another favorite was chloral hydrate....

    Doctors were not even called if it looked like the pt. was sick enough to die, let alone sending the 90-yo pt out for a CABG and then taking them back 3 days postop.

    MOM and heat lamps were used for stage IV, tunnelling decubs that smelled like gangrene-- no atb's, nothin'.

    Now acute care happens all the time in LTC....but the staffing at the LTC' s is still not pretty.

    I still think that even though we're understaffed, the level of quality care has improved dramatically for the elderly.

    Anyone else remember LTC before regulations???
  10. by   amylou85
    This is sooo true- the patient acuity has gone up. And now you get step down units. Icu, ICU step down..etc....
  11. by   Thunderwolf
    Yes, I agree that we kick'em out or step'em down faster and sicker now.
  12. by   RNKITTY04
    I have only been a nurse for 3 months now but am really surprised at some of the pt's we get. Last weekend I had a 54 y/o bilat stroke, loc questionable, peg tube, picc, foley, incont of bowel, pinpoint pupils of different sizes. unable to respond to even the must basic commands. Seriously how much rehab is this guy gonna do? I dunno, maybe this is normal for rehab but just kinda makes me wonder. Maybe he has good insurance?
  13. by   kaseysmom
    Quote from RNKITTY04
    I have only been a nurse for 3 months now but am really surprised at some of the pt's we get. Last weekend I had a 54 y/o bilat stroke, loc questionable, peg tube, picc, foley, incont of bowel, pinpoint pupils of different sizes. unable to respond to even the must basic commands. Seriously how much rehab is this guy gonna do? I dunno, maybe this is normal for rehab but just kinda makes me wonder. Maybe he has good insurance?
    Personally, and not to be a downer, but based on the information you stated - it doesn't sound like they will go above and beyond normal rehab to attempt at getting this guy rehabilitated. I am sure they will try to get him to atleast a minimal functioning state again - but probably not much more than that. There are lots of questions people ask themselves when beginning rehab - is there another disease process that may be debilitating to the pt?? Lots of things will play a large part in the rehab process. Just a thought =)
  14. by   jkaee
    Quote from RNKITTY04
    I have only been a nurse for 3 months now but am really surprised at some of the pt's we get. Last weekend I had a 54 y/o bilat stroke, loc questionable, peg tube, picc, foley, incont of bowel, pinpoint pupils of different sizes. unable to respond to even the must basic commands. Seriously how much rehab is this guy gonna do? I dunno, maybe this is normal for rehab but just kinda makes me wonder. Maybe he has good insurance?
    I know what you mean...I just started acute rehab and we have had a patient now for several weeks.....CP arrest w/anoxic brain injury. Peg, Picc, foley, numerous IV abts, trach with frequent suctioning. Pretty much unresponsive. I have a friend who is a case manager and she states that they will do all this "rehab" for a patient's family just so that everything that can be done is done, even if the docs think there's no chance for any true rehabilitation. It stinks though when you still have 8 patients and have about 2 of these types thrown in the mix.

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