considering rehab - is 8:1 with a CNA good?

I'm new to nursing and have only worked at two hospital: a small rural 70 bed hospital in AZ and this one in Oregon. Neithor place had ratios as you decribed. I can't even imagine being charge on a med-surg unit with my own 8 patients. Not sure I would stay in nursing.

I often float to a surgical unit at my current hospital. In that unit we have 5-8 patients (usually 5-6, occasionally 8), but the RN always has a CNA if she has more than 3 patients. The difference between the rehab and the surgical unit is the RN and the CNA have the same group of patients. So the RN won't have 2 CNA with 8 patients. It is tough with 8 patients with one CNA, thank goodness that doesn't happen that often.

Although the patients we get in rehab are less acute and more stable than a med surg floor, that doesn't mean they are less work. Most still require maximum help with ADL's. And that stuff takes time. It would be physically impossible to pass my morning meds, do my assessments, take vital signs, deal with doc orders etc, if I also had to have the patients dressed, washed, toileted and up; even with only 4 patients and no CNA (in a timely manner I mean). Yes, this could be done if the patients didn't need to be up at a certain time.

Anyway, I'm not sure I helped much. Rehab nursing is definatly different than med-surg. But, I like seeing the same patients day after day. I like getting to know the families, and watching the patient's progress. I'm not sure I would like it as much if a constantly overwhelmed.

Where do you live? Maybe you should think about moving west, if that is a possibility. I know the hospital in AZ, that I left, was working on implementing a 4:1 ratios on med-surg. It could be I just happened upon descent hospitals with good ratios? I definetly feel better about my situation after hearing your story. Maybe, I'll refer to this post when I have a rough day in the future.

Hi kek - I am reading these posts with great interest as I am looking at taking a rehab job as well. I,too, am nervous but mostly because I have been out of bedside nursing for about 15 years (doing quality, JCAHO, etc.- but still in the hospital setting). I have decided that I need to get out of management and the BS for awhile. I have researched several avenues of nursing (in trying to decide what I want to do when I grow up- HA!) and rehab nursing keeps coming to the top. It seems that it would be very rewarding -although physically taxing. At the free-standing hospital that I am considering the nurse/pt. ratio is 5:1 on days and 7:1 on nights. I didn't think to ask about CNA's (duh!). Thanks everyone for the education - it helps me to go into this thing with a litte more knowledge and less trepidation!!

I work eves in an inpatient Rehab; we get cardiopulmonary and some ortho (post CABG, COPD, knee and hip replacement/ fractures). We usually have one RN or LPN plus one aide for 5-6 patients on days, about 7-9 patients on eves and 15-18 nights. Because the patients stay about 2-3 weeks in Rehab they run the gamut in acuity according to how long they've been with us. I usually have one or two "train wrecks", 2-3 "walkie-talkies" and the rest somewhere in between. Because they do stay with us for a longer time we usually have the same patients and get to know their individualized care fairly well. That ratio works for me on eves as I'm past the learning curve stage with all but the newest patients in my group.

I did some agency at rehab and my night ratio (7p-7a) was about 10 to 1. I did have my very own CNA/PCT who was very helpful. I didn't find the work too taxing coming from acute care. I would have to say this ratio would be difficult if there were lots of dressing changes, treatments and ambulations, etc to do...most of these pts were postop knees and hips, CVA's, deconditioning... and only a few would be totals. Most were so tired out by the end of the day's therapies they wanted their painkillers and sleepers and to be just left alone...LOL!

very true MattsMom. By the time I get to work at 3 most if not all of my pts are in bed waiting for their pills and dinner. They get a shower every other day(CNA assisted) and then they just fall into bed and are sound asleep by 6p. Not everyday is wonderful but the majority of my days are good, I like my job I like most of my pts and I like the staff I work with.
Downside- Many family members at this time of day.
But all in all its not a bad way to make a living.

Hi, from snowy cold friggid Massachusetts. Is this free standing rehab in Florida, i have current florida license and need to get down there soon
thanks lauri

I worked rehab.6a to 6p we had 1rn. 1lpn and for 7 pts each..sometimes we had one cna .this was on weekends...on monday morning when the rehab was to start p breakfast the CNAs would come in at 5a and help get pts dressed baths were in evening p rehab..the patients ran the range of total care to independent ..10 pts would be an unreasonable load it seems to me

I used to work in a rehab unit with 8 pts.. one aide and a high acuity with one more twist--about 95% of my pts didn't speak english and I didn't speak spanish. I'm dumbfounded that I lasted 2.5 mons. I hated every single minute of it.