Got a job offer at a rehab hospital - need advice

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Hi everyone,

I need some advice. I'm a new grad and yesterday I got my first job offer from a rehabilitation hospital. Most of the patients they have there have either had a CVA, multiple sclerosis, traumatic brain injury, spinal cord injury etc. This is my VERY FIRST JOB as a nurse. I wanted to know if there's anyone here who's worked in that kind of environment. How is it? Is it a good place for a new grad to start? Is it a good place to improve on your med-surg skills? The nurse recruiter told me that I'll be responsible for IVs, caths and the like. I'd like as much exposure as I can get.

PS: I would have preferred to start working in a hospital but most of the hospitals in my area are not hiring new grads until May/June and i don't think i can wait that long. :crying2:

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Specializes in psych. rehab nursing, float pool.

You will learn allot, trust me. It is not like it use to be with all stable patients and such. You will learned so much in regards to the multiple co-morbidities that our patients have. At this time while we are considered sub acute. Our acuity scales are actually on par with the step down unit of ICU... no wonder we feel harried at times...

You will do great. The thing we all dread yearly is the taking of that darn FIM score testing. WE all hate it, but unless we pass it we cannot work in Rehab hospital as it is how our facility payment is judged and paid...... but don't worry we all learn how to do it.

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Specializes in Geriatrics, Transplant, Education.

I LOVE rehab---it is also my first job as a nurse--I do Geriatric Rehab & we see everything-- COPD/CHF exacerbations, joint replacements, head injuries, wound vacs for chronic wounds, IV antibiotics, diabetics needing insulin teaching, as well as occasionally End of Life patients. While my unit is considered "subacute", I run my behind off all day long, and very often have had to send patients back to the hospital when their acuity changes.

I love the teaching involved in rehab--they are with us for longer, so I have more time to teach them about their disease, meds, treatments, etc. Also, being in a facility that does not have a doctor in house 24/7, my assessment skills are critical, and I have a lot of autonomy, which I love. I also feel I get to know my patients very well, because I am the primary nurse for a set group of rooms--typically, I am the one to admit them (most admissions come in on 3-11 in my facility), and I'll be their 3-11 nurse M-F until they are d/c'd.

Good luck in making your decision!

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How long have you worked in rehab and how many patients do you typically have per shift? The nurse recruiter told me that once I'm done precepting, I'll have a load of between 11-13 patients per shift cuz I'll be working nights. Is that typical?

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Specializes in psych. rehab nursing, float pool.

I have been there 10 years, typically staffing on dayshift is as follows. if working primary care meaning no cna it is no more than 4 patients including new admissions. If with a Cna then we usually start with 6-7 patients but with new admissions can go up to approx 9. Night shift, most often for being primary it is still only 4 patients, with a Cna can go as high as 10 but usually is kept around 8.

Whether one is an Rn or Lpn the patient load is the same, the exception being if one is the Rn Charge nurse in which case they usually try and give them less patients.

Good luck to you. I love rehab and see it as the best of both worlds.

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Specializes in Geriatrics, Transplant, Education.
How long have you worked in rehab and how many patients do you typically have per shift? The nurse recruiter told me that once I'm done precepting, I'll have a load of between 11-13 patients per shift cuz I'll be working nights. Is that typical?

I have been working in rehab for 5 months today--3pm-11pm. We have our unit divided into three "teams"--team one has nine beds, team two has nine beds & my team, team three has 8 beds--so I max out at 8 patients (today when I go in I'll have two empty beds due to discharges, so I am expecting some admissions to be heading my way). Before I got off of orientation, the unit had 22 beds split between 2 nurses, so it used to be 11 each. now we have 26 beds split three ways. At night, the rehab nurse takes 22 of the rehab patients, and the LTC nurse down at the other desk takes 4 rehab beds along with her 18 LTC residents. So yes, I would say 11-13 is probably typical for nights, but this all depends on how your unit works.

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Specializes in med surg.

Hi! Congrats on being a new grad!

I started off at a rehabilitation hospital as a new grad a year and a half ago and am still working there. You really get to see a little bit of everything and you will still have IVPB's, Neb tx's, wound vac's, stumps, trachs, GT's/PEG's/TF's, dialysis patients, PICCs,portacaths I/O caths (especially with spinal cord), halo's, craniotomies/ bone flaps, Burn patients... LOTS!! So yes, I believe it would be a great place for you to learn and start to get a great base for your med/surg skills.

Good thing about rehab (my opinion) is that you can really get to know the patients. Most are there weeks and some months even. I love seeing the progress patients make. Especially alot of the brain injury patients- some will come in coma awakening and leave walking and talking doing great. Amazing.

As for ratios- i think it is the norm for rehab units/hospitals to have higher ratios due to the patients being "more medically stable" Our day ratio (7a-11p) is 1 nurse and tech to 5 or 6 patients. Night is one nurse and tech to 8-9 patients. I work 7p-7a shift and it can get pretty crazy with 9 patients.But i think our hosp. tries to get all the high acuity patients they can. Hopefully with your 11-13 they are not all/most high acuity? That might be something you would want to ask them.

Good luck to you!!!

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