Nurse to patient ratio

  1. I work at a LTC/rehab facility. I know that state mandates 1 nurse to 40 patients and that's fine for the LTC side but not rehab. We normally have 3 nurses for a total of 16-17 patients per nurse. The patients we get are straight from the hospital and they are all high acuity care. The work load is normally ok to manage with three nurses, but you never get done on time because you chart on every patient. Sometimes they only put two nurses on the floor and given the state that some of these patients are in I don't think it's safe practice at all. In one hallway alone right now they're are two peg tubes; one with a bolus feeding twice a shift, a trach, about five IV's that are all due at the same time and a million accuchecks. Given that this is my first job, I don't know if this work load is normal and if that's how rehabs are normally staffed. I rather work on the LTC side because things are easier to manage. Although I do have a lot more patients and the med pass is heavy, it's pretty manageable. I don't mind working the rehab side either if they staff three nurses but there have been one too many times when I have had to work with just one other nurse. So my question is what is the staffing like at other rehab facilities ? How many patients do you normally have ?
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  2. 8 Comments

  3. by   TheCommuter
    I used to work in nursing home rehab and would have up to 17 residents on day shift and up to 34 residents on night shift. The rehab side received post-acute residents such as hip and knee replacements, laminectomies, CHF exacerbation, s/p CVA, debility secondary to pneumonia, limb amputations, and so forth.

    I now work at a freestanding acute rehab hospital and the nurse/patient ratio is usually one nurse for every 7 to 9 patients when fully staffed. When understaffed the ratio goes up to one nurse for every 10 to 12 patients.
  4. by   McBambi
    Quote from TheCommuter
    I used to work in nursing home rehab and would have up to 17 residents on day shift and up to 34 residents on night shift. The rehab side received post-acute residents such as hip and knee replacements, laminectomies, CHF exacerbation, s/p CVA, debility secondary to pneumonia, limb amputations, and so forth.

    I now work at a freestanding acute rehab hospital and the nurse/patient ratio is usually one nurse for every 7 to 9 patients when fully staffed. When understaffed the ratio goes up to one nurse for every 10 to 12 patients.
    12 patients would be a dream for me. I'll look into an acute rehab hospital in my area. I don't feel safe at all at my job.
  5. by   Glycerine82
    I work acute rehab also and the nurses are 6:1 or 5:1 with a d/c and admit.

    CNAs are 8:1

    This is an inpatient hospital setting
  6. by   RN_2012
    The rehab unit I work on at a LTC center has 30 beds, two nurses day and night shift. Day shift also has a wound nurse. 3rd shift, has them all. Census is at 24 and I will have the unit myself tonight on 2nd shift.
  7. by   Kdisinger
    I work in a Rehabilitation facity that is an even mix of rehab/longterm care patients. We have several people who are actively dying, IVS, wounds galore, 15 accuchecks QID, colostomies and no g-tubes at this time but we often do. We have been running with 1 [ONE] nurse and 3-4 CNAS!! It's an absolute nightmare and yet somehow we are healing those wounds, checking those bloodsugars, running those IVs and sending those post-op patients back into the community completely rehabilitated. I work with some amazing nurses but we are all killing ourselves and the documentation has definitely seen better days. The sad thing is when State comes for our Survey they will more than likely eat us alive and it's us nurses who will be blamed. Something needs to be done about nurse/patient ratios!
  8. by   caffeinatednurse
    I work primarily on a short term rehab unit in a LTC facility. I have anywhere from 6 to 15 on the rehab side, with one to two CNAs. Lately I have been lucky & found myself with a second nurse for the last four hours of my shift. Usually they help with charting, meds or admits. On the LTC side, I have 18-22 and usually 2 CNAs.
  9. by   Nursemomo3816
    I work in a post Acute rehab, day shift. Most days we have two nurses, with 24-30 patients. +2 med nurses. We have tons of complicated wound care, IVs, ng tubes, lots of accuchecks and chf and copd exacerbation, some dementia patients.
    Last edit by Nursemomo3816 on Sep 28 : Reason: Didn't mean to post
  10. by   mslove
    I used to be fulltime, now per diem but about to leave. 40 bed unit, 4 nurses on day and evening (10 pt), 2-3 on nights. Very acute conditions, most are really just used as overflow from med-surg. They send over the difficult patients, the ones who need an extra day or 2 to recover due to comobidities, age, etc. The things they try to pass off as "rehab" is hilarious. Understaffed, poor management, etc. It's really not LTC.

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