Help? New job...patient load for rehab/skilled care unit

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    Hi there,
    I am on the hunt to begin something new in my nursing career. I was blessed enough to get three offers this week. I turned down the straight up med/surg unit and am leaning towards working in a hospital on a rehab type floor. (its called skilled care unit? kind of like long term care, kind of like rehab per the manager). Sorry if I sound clueless, when I applied thought it was med/surg. The manager said most patients are IV free, no trachs and not a lot of feeding tubes. Now here is my question. It is a twenty bed unit.... Two nurses and one cna. So I could have about 10 patients. This scares me only because I keep thinking med/surg and that would be way too many...I'd be comfortable with 5-6 patients maybe 7 on nights. But these patients are obviously less acute. Any thoughts? Is this a safe load? I also like it because manager says I can float to med/surg if I'd like. Seems ok, but just want some advice. Thank you for any help!
  2. 3 Comments so far...

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    Just curious.. why did you turn down the medsurg position. I would have started there before a rehab floor. You need to delvelop skills and med surg would help you to do that. I left an emergency psych position as a new grad. It was all psych and barely any emergency! I had a position in a hospital but I resigned because of multiple issues. I interviewed with several ED managers and they all said ," So, even though you worked in ED psych, you really have no skills?" What an insult because I did, they just weren't enough. Now- I work in a freestanding facility across from a brand new hospital. It has part subacute and part ltc. I only work as a subacute nurse never in LTC. I have 20 pts max with two cnas. I am responsible for everything unless there is a charge that shift. I do all meds, Finger sticks, ekgs, tube feedings, colostomies/illeostomies, cpm, wound care/wound vacs, traches with suctioning, chf protocol, neuro checks,pain management, respiratory txs, o2 therapy etc. I have learned more in the two months that I have been there than I ccan even tell you. I take off orders, put in IVs, call to pharmacy, call the drs, call for labs, deal with dietary and nutritionist as well as pt/ot. etc. btw did I mention 20 pts...!!!! I tell myself everyday when I want to quit " Hang in there, get your skills and move on" I would love to work medsurg because 6-10 patients would be a dream!!! If you are assertive and fast and practice safely which is key because if you don't trouble will find you, it is a great place to start. Again I came from ed psych which is a piece of cake compared to subacute care. I was told by HR that 1 yr of subacute would get me a job but LTC will not (back in the ED).
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    I just started my first job as a RN in an acute rehab hospital. I've been told the patient load is typically 6 depending on acuity. Many patients are on tube feedings, the SCI floors have a decent amount of trachs, there is the occasional central line to deal with, and a fair amount of TBI patients have bone flaps. If patients start going downhill they can be transferred to the ED in nearby hospitals but once stable they come right back to the rehab hospital. Other than that I know the typical patient stay is 28 days. Like I said I'm pretty new to the field of nursing so I can only offer a general outlook of what my setting looks like. I was pleasantly surprised (and half-scared) to find out there is a decent splattering of med-surg along with rehab nursing. I imagine the patient loads will always depend on the acuity level.
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    Thanks for your feedback! Just to answer your question Taramb7263, I have already worked Med-Surg for over a year and although I got a great foundation, Med-Surg just isn't for me. I love geriatrics and enjoy working in the less acute areas. I like education and actually enjoy primary nursing, so was looking for somthing that would let me do more of that. Thanks again for your feedback


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