Heading to sub-acute unit at an LTC...what should I expect?

Christine2009 · Nov 8, 2009

I just finished a clinical rotation on a subacute floor and it was incredible. I also went in with no experience suctioning or trache care and learned sooooo much.

First off, our instructor demonstrated how to properly suction and ambubag a pt and found that when I had to do it myself, it was very easy.

Trache care is quite simple just remember to hold the trache in place when providing care....many times a pt will cough and the trache can become dislodged.

All in all, it was a wonderful experience...best of luck to you

wsp4905 · Dec 22, 2009

Also, watch out for sputum coming out of trachea when they cough. Only will take getting nailed one time, for you to steer clear, I learned that fast!

Qbert · Dec 23, 2009

If you are uncomfortable with something like trach care or suctioning, feel free to ask your instructor for a demonstration!

remember, when suctioning a patient via trach or NT tube, to watch the O2 sat. and make sure it doesn't drop. there is a bit of technique involved but it is quite easy to learn. and tracheal suctioning usually doesn't hurt the pt.. don't be afraid =)

TheCommuter, BSN, RN · Dec 30, 2009

I once worked on a subacute rehab unit of a nursing home.

On the subacute rehab unit where I once worked, we dealt with a lot of 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, kyphoplasties, CABGs, hysterectomies, limb amputations, colectomies, thromboembolectomies, and abdominal aortic aneurysm repairs.

The non-surgical (medical) patients were admitted for recovery from CVAs, acute MIs, debility, cancer, fractures, status post pneumonia, deconditioned states, failure to thrive, status post falls, contusions, and generalized weakness.

Expect to do plenty of charting and paperwork, as many of your residents will be on Medicare as a payor source. Medicare charting guidelines are stringent, and it is the proper documentation that generates money for the facility.

pagandeva2000, LPN · Dec 30, 2009

I once worked on a subacute rehab unit of a nursing home.
On the subacute rehab unit where I once worked, we dealt with a lot of 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, kyphoplasties, CABGs, hysterectomies, limb amputations, colectomies, thromboembolectomies, and abdominal aortic aneurysm repairs.
The non-surgical (medical) patients were admitted for recovery from CVAs, acute MIs, debility, cancer, fractures, status post pneumonia, deconditioned states, failure to thrive, status post falls, contusions, and generalized weakness.
Expect to do plenty of charting and paperwork, as many of your residents will be on Medicare as a payor source. Medicare charting guidelines are stringent, and it is the proper documentation that generates money for the facility.

You are gaining phenomenal experience towards your RN! Kudos to you! I wish I can gain those sorts of skills where I am, but the med-surg units in my hospital really don't have all of that. I have done IV antibiotics, ostomy (as an aide), and scant dressings, but I would love to get my hands dirty like that! You are really fortunate.

TheCommuter, BSN, RN · Dec 30, 2009

You are gaining phenomenal experience towards your RN! Kudos to you! I wish I can gain those sorts of skills where I am, but the med-surg units in my hospital really don't have all of that. I have done IV antibiotics, ostomy (as an aide), and scant dressings, but I would love to get my hands dirty like that! You are really fortunate.

I resigned from this facility a while back, because nursing homes don't really have ratios. I typically had 15 of these patients during day shift, and about 30 of them during night shift. As you can see, subacute rehab patients are usually sicker than your typical little old lady on the long term care wing of a nursing home.

pagandeva2000, LPN · Dec 30, 2009

I resigned from this facility a while back, because nursing homes don't really have ratios. I typically had 15 of these patients during day shift, and about 30 of them during night shift. As you can see, subacute rehab patients are usually sicker than your typical little old lady on the long term care wing of a nursing home.

While admiring your skills acquired, I did wonder after posting HOW MANY patients you were personally responsible for. Of course, it is great that you gained all of this experience, but I would have been nervous about my license as well, because there would be no way that I would be able to prove all of that care without taking short cuts. How much longer before you complete the RN program?