Acute Rehab vs. Med/Surg

[Hooligan]

I'm currently on maternity leave and do not plan to return to my original place of employment when it's over. I was working on a very busy adult medical/peds unit. This was my first year out of nursing school and have not been terribly happy with my hospital or unit. I'm currently looking at another hospital and they have positions available for acute rehab and med/surg. Can someone explain the main differences between the two specialties. From what I've read so far, the main difference is the lenght of time you have with your pt's. Which for me seems like a good deal....especially since I'm part time. I rarely ever had the same pt.'s more than once. On my adult medical floor we had tele pt's, hung blood, did peritineal dialysis on occasion, had pt's with wound vacs (never had to place them or anything), CBI, etc....from what I've read in some of the other posts, acute rehab seems to be more of those same kind of pt's only you have a higher nurse/pt. ratio. Why is that? In my last hospital we would have up to 6 on evenings and that was more than enough for me. At 6 I felt I was tapped out and there were way too many nights where if I managed to pass all my meds and my pt's were breathing I did an ok job. I don't like feeling that way. Anyway, if someone could enlighten me more about the differences between acute rehab and adult med/surg I would appreciate it. Thanks!

~Bean

[tuffy11]

I work on acute rehab. Our patient's stay includes 3 hours a day of a combination of physical therapy, occupational therapy and speech therapy depending on diagnosis. Most of our patients are orthopedic 75 years or older. Usually have had bilat knees or hip surgery. Sometimes stroke or spinal injuries. We work on getting them trained to safely do adls at home ,increase strength and have pain controll. Many times due to pain meds and npo before surgery bowel is and issue. Bladder issues are big in stroke and spinal patients.

[TheCommuter, BSN, RN]

I currently work on the short-term subacute rehab unit at a nursing home, and typically care for 15 patients by myself.

The majority of my patients are fresh postsurgical cases: laminectomies, hysterectomies, arthroplasties, kyphoplasties, limb amputations, CABGs, shunt placements, and so forth. I also have patients who are recovering from afflictions such as CVAs, MIs, cancers, fractures, chronic kidney disease, end-stage hepatic disease, uncontrolled diabetes, debility, spinal injuries, non-healing wounds, and the list goes on and on. These patients are much higher acuity than the traditional nursing home patient.

The rehab patients at my facility receive physical therapy, occupational therapy, and sometimes speech therapy. Working on this unit is hellish due to the high patient load combined with the acuity. I wish I only had 6 or 7 patients!