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.