How is it like to work on a rehabilitation center?

Silverdragon102, BSN · Nov 13, 2008

Moved to rehab nursing forum

1studentnurse · Dec 17, 2008

Some people think rehab hospitals or rehab centers are a little like nursing homes, but I've never worked in one, so I can't comment on that. I have worked in a private rehab hospital attached to a hospital (with OR, ICU, ER) and it is very much a "hospital" setting. Everyone has their roles and rehab nurses work with rehab patients, monitor vitals, pass meds, do dressing changes and treatments and help patients reinforce what they're learning in therapy. Now I work at a VA hospital (SCI center) and a lot of what we do is very similar to nursing homes--we get people with really nasty pressure ulcers and we heal them up as doctors and the rest of our team (therapists, etc.) monitor them as they go along the healing process. Occasionally (not much) we have rehab patients, but out of about 20 right now, we only have 2. Rehab is very schedule-oriented, and if patients in the private sector, especially, don't go to therapy, they don't stay long in rehab, since most insurance won't pay. This is not the case with the VA. If they take you, usually you can hang around for a long time. I started earlier this year and some of the patients who were there on my first day are still there. If you have any specific questions, feel free to send me a note.

nervousnurse, ASN · Dec 31, 2008

I work in a free-standing rehab hospital. We do not have a lot of IVs and Central Lines, but occasionally we do, and about once a week, we might have a blood transfusion. Our patients are there for debility, CVA, joint replacements, spinal cord injuries, and traumatic brain injuries. On day shift, it is extremely busy with admissions, discharges, orders, family problems, doctors, etc. We pass A LOT of PO meds (RNs and LPNs), and of course every other type of med, but mainly PO. LOTS and LOTS of prn PO pain meds...especially while our patients are in therapy or soon after their return. Some of our patients are there for the rehab, but at the same time are in acute renal failure or having chest pain or a brittle diabetic with horrible wounds, and the unfortunate patients who come to us with Stage III decubs:cry:, and we are getting more and more wound vacs........

They go to therapy in the morning and the afternoon, which can take a lot of our time, since it is sometimes very time intensive to get them into their chair, dressed, clean and dry, pain free, etc.---it is amazing to see how the therapy improves them over time. :yeah: It is SOOO funny to me that many people think that while they're in rehab, we have free time----yeeaaa, there's LOTS of charting, "FIM" scores, admissions, discharges, orders, family members wanting to complain (or say something POSITIVE once in a while!!)!!! ....the usual!

We also have patients who go to a supervised dining area for dysphagia, and sometimes, finding a licensed nurse who can supervise during all three meals is a challenge! We give bowel and bladder training to our

spinal cord injured patients, LOTS of general teaching, and LOTS of physical work helping patients with mobility---it can

be "back breaking!" :nurse: The brain injury patients can be very tricky to work with, as they are unpredictable sometimes

and like to wander, (obviously they are HIGH fall risks!) and/or try to hit staff, etc. Giving meds to traumatic brain injury patients is also very tricky because they don't always affect them the same way.

Many times it takes SEVERAL of us just to get a patient from toilet to wheelchair to bed---

our staffing is usually one nurse (RN or LPN) and one tech to 6-9 patients. Sounds like great staffing, but as everyone

knows, sometimes ONE patient can take MOST of your time and ALL the staff available!

We are all ACLS trained; however, if a patient is going to code, we call 911---in that sense, we are like a nursing home. Also, we have no lab, no x-ray, no ancillary departments. Many times, patients have to leave the facility for doctor's appointments and tests....this can be a struggle because if they have no family/friend to go with them, a tech accompanies them.....which leaves the nurses and techs remaining to pick up the slack....sometimes the tech/patient is gone for MANY hours, so it is a situation that really ticks me off! I also HATE it when patients have to go to an outside appointment and it takes forever, and they are in PAIN and hungry/thirsty when they get back!!!