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

cilky · Mar 30, 2005

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

hi, rn kitty, can i ask where in Florida are you.. I would like to relocate to Florida soon and continue with Rehab. Any suggestions?

cilky

RNKITTY04 · Apr 1, 2005

Hi Cilky,

I am in Jacksonville Fl. After reading my last post I didn't mean to come off so grouchy, my jobs not that bad, I guess Ive just been PMSing or something.

Please forgive.

cilky · Apr 1, 2005

hi RN kitty

The rehab facility in florida? is this a hospital. I hope to be in florida september 2005 and i want rehab, and most ofyour rehabs are in hospitals as opposed to Mass where they are moslty in the long term care facilities, called subacute units

RNKITTY04 · Apr 1, 2005

This is a "free standing" hospital. We have 4 floors. 2nd floor is Brain Injury and Peds, 3rd floor is Spinal cord and Ortho and the 4th (were I work) is mostly CVA/debility. The hospital is well known in the southeast and is second only to the big rehab center in Atlanta. (forget the name)

Please feel free to email me at:[email protected] and I will be happy to give you more info.

jyoung1950 · Apr 9, 2005

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.
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Holy smokes - I'd feel like I was in heaven if I could work like that.

My home floor at the hospital I work at is Rehab.

Sometimes my load is 14 rehab patients with 2 nurses. Day shift there is hectic. Have to have all of them up, dressed, pottied, hygiene, etc. by 8:30 - 9:30 am for therapy.

And then if census is low in rehab, we rehab CNA's get pulled. I've had work loads of 20+ patients by myself along with the nurses assigned on days and evening shifts to boot! Spend the whole day getting patients on and off carts to go for tests, operations. Takes 2-3 hours to get all the vitals on them. God bless the nurses - 99% of them help me all they can.

At this hospital, a CNA's typical load is 10+ day shift; 15-20+ evening. I was pulled to PCU the other evening - had 16 to take care of.

Is this normal?

RNKITTY04 · Apr 11, 2005

No Its insane!! Im done with Rehab, start another job in 2 weeks. Wish me luck y'all.

NancyJo · Apr 27, 2005

My job before this one was in rehab. Was told in my interview that I would typically have 8 pt.'s and a CNA. She neglected to tell me to that usually we only had one CNA, sometimes two for a 38 bed unit, that we all shared. What a rude awakening. You can never ask too many questions. Needless to say, we couldn't keep CNA's as some would run them absolutely ragged and at times would have none. Our nursing numbers kept declining also and by the time I left it was nothing to have 12-13pt.'s on weekdays and usually two of us to split the floor on weekends. Talk about unsafe!

FEELYRN · May 9, 2005

Our ratio is 9:1 -- one nurse (LPN or Rn) and one aide -- unless we are short staffed then the numbers go up. We are a free standing acute care rehab with stroke, brain and spinal cord injuries, ortho and post op cardiac patients, with a mix of other stuff thrown in. In my opinion this is too many patients to give adequate care because many have intensive wounds that need dressed/packed, IVs and tube feeds, traction devices, etc. We also have co-morbidity issues like Alzheimers patients and dialysis. It can be trying, to say the least, but you learn so much every day.

FEELYRN · May 9, 2005

A PS to my post -- You learn every day, especially time management!!!

Rehab nursing is hard work, for the nurse and CNA, but also very rewarding.

chris_at_lucas_RN, RN · May 9, 2005

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.

I just had an interview at a rehab hospital for a PRN slot. I thought to get a few shifts a month where I was doing more hands-on patient care since I am doing fulltime psych nursing and I miss the patient care aspect.

I was told I would have 10-11 patients after a 10 day orientation "to teach you the paperwork." I was so relieved when they said I wasn't experienced enough! They said their pts had various diagnoses (all of which I recognized and remember well from school and my externing, plus a few from my clinical rotations), and they preferred the patients be transferred out a couple of days before they would have crashed.

(I thought the whole thing was a little odd, actually, but I was nice about it.)

I believe these bizarre staff ratios exist because nurses continue to work in them and because cheap foreign nurses can be had and don't know any better.

And because the bottom line is more important than patient safety, much less patient care.

It's discouraging, but unless we "vote with our feet," we have only our own profession to blame.

LIRN · May 22, 2005

I'm the MDS Coordinator in a 120 bed facility in Florida where 60 of the beds (3 units) are short term rehab, a good deal of the patients are orthopedic rehab. On the day shift there are 4 nurses for those 20 patients, and 9 CNAs. There is also a unit manager at the desk, and a unit secretary. Everyone's busy, but it works out OK. The rehab staff does a lot of the AM care with the patients, since occupational therapy is part of their rehab. The speech therapist feeds some of them every day (stroke patients). There is a big turnover of patients--some stay only a couple of days (like post CABG patients). The dense CVAs stay the longest. We have lots of PICC lines and IVs running at all times. Until recently, there were only three nurses, one for each 20 bed unit. THAT was not enough. The fourth nurse made all the difference.

Sapphy, BSN, RN · Jul 21, 2005

I work in a freestanding rehab facility where our census is usually 36 or 37.... during the day there are two nurses with patient assignments, one assessment nurse, and sometimes if we are lucky we get an admission nurse... ratio usually ends up 17 or 18 to one. In the evenings when I work... I always have at least 11 patients but usually 12... there are always RNT's on the floor...usually 3 so we each have one aide to help with showers and BG's and stuff. I have found it to be a huge learning experience...I am a new grad as of May 6t6h and I took my boards and passed on Monday. I have learned a lot about prioritizing because of this job and I must say, even though I rarely get out of there on time, I love my job. Part of it is that I am constantly busy so my evenings go really fast!