LTC vs. Rehab Patients: Who Is Priority?

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During this COVID pandemic, my roles in my facility have switched constantly.  Prior to COVID, I was a unit manager for a rehab unit.  Once COVID hit, they designated me to manage the COVID unit until we no longer received referrals.   During this time, there were not enough patients to fill up two rehab units, so they moved me down to the LTC unit along with the rehab unit HUC.    

Now, we are receiving more rehab referrals so my old unit is opening back up again (although we are currently only accepting 50% capacity).  Because we started taking more acute patients again, I naturally thought that they would want me to return to my old unit and that the LTC unit would be split between me and my co-manager again.   However, this week I found out that this isn't necessarily the case.  First,  I am still expected to manage the entire LTC unit in addition to my new rehab patients.  Second, I found out that they didn't necessarily want me to return to working in my office on my old unit.  Apparently, the intention was that the HUC would return to the rehab unit and I would stay down on the LTC unit, none of which was communicated to me.  

The problem is, the rehab patients are more acute than the LTC patients so, in my opinion, my priority should be staying closer to them in order to keep better tabs on their medical management.  They also have many more assessments/follow ups/doctor visits than the residents on the LTC unit do and it is hard to keep up with any of this if I'm down on the LTC unit.  The rehab patients have more wounds/skin issues that I need to keep track of as well. 

 Probably, they were hoping that I would remain as a second nurse/staff member/resource person on the LTC unit, but really, the only help they need down there mostly involves feeding and toileting people and possibly helping with medication administration.   If I am expected to be managing the care of acute rehab patients, it doesn't really make much sense to designate me to assist with feeding residents, some of whom take over 45 minutes to eat and often only consume 25-50% of their meals.   In my opinion, the answer is to ensure that the unit is staffed appropriately with CNAs who can assist with those tasks and not to assume that I would be available to do that while also maintaining responsibility for the growing number of acute patients that are coming in.   

In the very least, one of the concerns the HUCs have is that with the growing number of patients being admitted, there is not enough time for them to complete scanning or uploading of documents into the resident's medical records.  I have repeatedly offered to assist with this, as all they would need to do is show me how to use the scanner, but that never seems to happen either.  I figured if they really wanted me to stay on the LTC unit, that would give me something to do.  

Anyway, are my concerns valid? Would you prioritize acute patients over LTC patients (simply because the first group requires more medical attention)? 

Specializes in Rehab/Nurse Manager.
4 hours ago, JadedCPN said:

But you think uploading and scanning documents should be met by the manager? Again I think you say the answers that people want to hear and might make sense, but in reality the reason you don't want to do these tasks is ultimately because you don't want to do these tasks.

In hindsight, offering to help scan was probably the least helpful thing I could offer to assist with.  Not to mention it has never been one of my responsibilities and might have been seen as trying to take over the HUC's job when there were likely other things I should have been addressing 

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