Tell me about sub-acute care nursing

  1. i did a search on this and did not find much info. about this. i'm starting a new job tomorrow. its on a sub-acute unit in a rehab facility.

    the don says this unit is a sub-acute unit, and the nurse to patient ratio will be 1:7-8. she says the patients here are very sicker than ltc patients and have a much higher acuity.

    she says there is a lot of skills involved.

    i will be working full time 3-11. if anyone has any insight, advice or etc it would be greatly appreciated. thanks !
  2. Visit NurseLoveJoy88 profile page

    About NurseLoveJoy88

    Joined: Jul '08; Posts: 4,125; Likes: 3,999
    RN; from ZM
    Specialty: 6 year(s) of experience in ltc

    6 Comments

  3. by   mazy
    That's a good ratio for sub-acute. Are you an LPN or an RN? The facilities I've worked in are usually anywhere from 1:12 to 1:17, absolute nightmare. You will be using a lot of nursing skills, and have a lot more autonomy (as an LPN) than in an acute care facility. As an RN you would be most likely carrying a full patient load and acting as charge nurse, although in a good facility RNs do the supervising of the rest of the staff and don't have their own patients.

    You will see some very medically complex cases and will need to have sharp assessment skills because things can go south very quickly. You need to know if that odd something or other that you see is not a big deal or if it is a sign of something more serious.

    You will be handling admissions and discharges, although mostly on the 3-11 shift you get the admissions. LPNs are expected to do admission assessments and care plans, initiate nursing care, verify med orders, get consents, work with families, delegate tasks to appropriate departments, etc., etc. RNs sign off on all LPN work.

    Lots of wound care, some of it very complex.

    It's a really good learning experience, but it is a fast-paced and very stressful environment.

    Best of luck.
  4. by   Forever Sunshine
    I'd take this job if I were you.
  5. by   TheCommuter
    I worked on a subacute unit at a nursing home as an LVN, but it was structured much like a free-standing rehabilitation hospital. I typically cared for 15 patients by myself, or sometimes 30 patients with a medication aide. On this particular unit, we dealt with many central lines, IV antibiotics, CPM machines, feeding tubes, suture removal, surgical staple removal, complicated wound care, ostomy appliances, diabetic management, casts, braces, splints, cervical halos, and so forth.

    Most of my patients had recently underwent surgical procedures such as laminectomies, knee and hip arthroplasties (joint replacements), kyphoplasties, CABGs, hysterectomies, limb amputations, colectomies, thromboembolectomies, and abdominal aortic aneurysm repairs.

    The non-surgical patients were typically admitted to our unit for recovery from CVAs, motor vehicle accidents, acute MIs, debility, various cancers, fractures, status post pneumonia, deconditioned states, failure to thrive, status post falls, generalized weakness, and other afflictions.

    Subacute nursing is a physical and emotional challenge if you're doing it in a nursing home setting with too many patients. However, 1 nurse to 7 or 8 patients sounds great.
  6. by   NurseLoveJoy88
    i'm a lpn. i graduate with rn in dec. if its a good fit a may stay a while to build on experience.

    i look forward to this great opportunity to learn and build on my skills.

    i will keep you all posted. thanks for the insight !
  7. by   sweetnurse63
    Great opportunity for you to build your experience and skills, you should be fine, wish you the best.
  8. by   JenniferSews
    I agree with the others. I run 15 patients and that is challenging. 12 is very manageable and I'd be THRILLED with 8. The patients are sometimes sick, and sometimes theyare so sick they become hospice patients or convert to long term care. But it's so incredibly rewarding to see them get better over their time with you and then d/c. You get to know your patients very well, like in a LTC setting. But in the end they discharge, so you don't take care of the same person for the next 10 years. I love it, and will probably always do sub acute nursing. It wasn't what I wanted in nursing school, but I'm glad I landed where I did. Good luck!

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