Differences between LTC and Rehab?

[TheCommuter, BSN, RN]

I am a fairly new nurse with experience in only nursing homes with stable geriatric residents. Next week I am going to start a job as a rehab nurse at a local rehabilitation center. The patient census is going to be 55 patients divided into 3 nurses plus 1 medication aide; therefore, I'll likely have 18 patients to care for. These patients tend to be sicker and higher acuity than the more stable nursing home residents.

Would someone please tell me the major differences between LTC and rehab? I was told that 18 patients to 1 nurse is too many for a rehab unit. A medication aide will pass my oral meds, but I will still need to do blood sugars, injections, tube feedings, IVs, new admissions, and charting. Please help. Thank you.

[bargainhound, RN]

I hate to give a negative response, but I have worked both areas.....and

18 sounds like way too many even if a med aide is passing oral meds........you

still have to be responsible for supervising the med aid and making sure she

does not make a mistake.........it sounds like way too much to me.........

[grentea]

I just started on a rehab unit in a hospital and I'm almost at my limit when I have six patients. I know you wouldn't be passing your meds, but you still have to make sure they're the right ones. I think 18 is way too much. There are many other aspects of care other than passing meds like doing dressing changes, walking patients, making sure they're moving around properly, contacting the doctor with problems, charting, etc. If you have a few patients who are unstable in addition to that, that would most definitely be too much. In LTC the patients are more stable. We often send patients back to nursing homes once they are stable.

[CapeCodMermaid, RN]

18 residents? On 'sub-acute' units in Skilled facilities there are usually more than 18 residents....one might be 3 days postop new hip or knee, one might be 1 day postop ORIF....18 seems manageble to me...especially if you're not bogged down doing PO meds.

[TheCommuter, BSN, RN]

Thanks for the honest responses. :)

[RNKITTY04]

18 patients in Rehab is insane. I routinely get assigned 5 with 1 new admit.

the poster that said 18 is do-able is just flat out wrong.

Last night I had 3- Q4 tube feeders, 3 on IV antibx, all 5 needed wound dressing changes, all 6 were R/L CVA that are mostly max assists, they have to be turned Q2. 2 were hoyer lifts. ALL had to have meds crushed for either TF or with thickened liquids.

Now lets talk about the family and their 5 million questions, the new orders from the Docs oh and all 6 were accuchecks also. And please don't let me forget the charting I need to do on all the restraints and netbeds.

18 patients? yeah right! Good luck with that!!

[curiousauntie]

In the area that I live and work, most "rehab" units are in long term care facilities with either a hall or district that is kept for the "short-termers", the rest of the unit being long-term care. In this environment, the ratio is usually 30 residents to 1 LPN/RN with 3-4 CNAs and an RN unit manager covering 30-60 residents. One nurse for 18 residents? I hope my nurses don't read this, there will be a mutiny!