Subacute Rehab nurse/patient ratio

[blueeyes87]

Hi I was wondering what the norm for a subacute rehab normally is. I'm a new LPN and have worked at my nursing facililty for a month now. At the moment I have 14 patients, and there's 1 aide and myself. I find myself scrambling to get things done. Call lights are always going off, and I have a very good CNA that tries his best to answer call lights fast but I usually have to help. The admissions person said our unit will be full, 17, by the end of the week but they are unwilling to give us either an extra nurse or an extra aide. Just wondering what you guys handle?

[mom2cka]

Can you check with your state board of nursing? I don't know if there are true legal ratios, just recommended guidelines...

[CapeCodMermaid, RN]

The Massachusetts regs state: Sufficient Staffing. The regs do not say how many nurses per resident is sufficient.

[TheCommuter, BSN, RN]

I just arrived home from my job in longterm care on the night shift. There are four units but the facility will only provide three nurses so one of us must cover two floors. last night I had 25 residents on one floor and 43 on another. I am also required to supervise as I am the RN and my coworkers were both LPNs. I have searched everywhere trying to uncover what the legal nurse to client ratio is considered and have been unsuccessful. I love my residents but have no time to give much needed TLC along with dispensing medications, performing treatments and dealing with staff issues. Does anyone know where I can find a state by state listing of allowed ratios? I would like to find out if I am putting my license in jeopardy or asking LPN/RN coworkers to perform illegally by taking on too many clients. I worked very hard to earn my license and don't want to lose it by working for a short-sighted, budget conscious but foolish employer.

Only California has legally mandated nurse/patient ratios, and they apply only to acute care facilities such as hospitals. LTC has no legally mandated ratios that include a fixed number of residents per nurse.

[CV-RN]

Thanks for your replies. Now I know why my state board of nursing was so unhelpful - the rules if they exist are ambiguous. Frustrating for anyone who wants do a throrough, consistent job for all clients. From CV-RN

[fabiusgile]

I need a new job..... 3-11 we have 20-30 residents in the subacute.. With myself and a working supervisor. so like 1.5 nurses. I run run run.

[Guest296136]

I just started working per diem in rehab, I work 3 12hrs on a med/surg oncology unit. The subacute unit I had 15 patients last night, I didn't clock out until 8:30am when I was suppose to be done at 7am. I was fine until 5am when I had to start meds, everyone wanted pain meds on top of the other meds, had to do my own blood sugar and vital checks, not to mention EKG's and bladder scans. I just started so I am sure I will get faster but this was terrible for me, I never clock out late and always get my work done on time.

I was told that the subacute unit follows the same standards as a nursing home, therefore staffing is based on that, I don't see how this is allowed, these pts are 3 days post total knees, hips, cva's etc. How can the staffing be the same as a nursing home?

[CapeCodMermaid, RN]

Because the reimbursement is the same.

[OlderRNinGA]

16 to 18 patients where I work. Along with rehabbing knees and hips, we have dementia, CHF, syncope, wound care, tube feelings, IV antibiotics, and much more. No bed rails, alarms, or restraints to keep patients from falling out of bed or wheelchair. CNAs have up to 12 patients. If I have two patients with sudden health changes, everyone's meds are late, blood sugars get missed, etc. The pace is insane and most of the time I don't know much about my patients other than "he's a knee." it is very difficult to provide the kind of care I would like to provide.