new Rehab nurse and pt to nurse ratio?

[ougreene]

Hi

I have been an office LPN nurse for 10 years, recently became an RN and have gotten a job as an RN at a rehabiliation center/long term care.

I would like to know what others have as a patient to nurse ration? I may have up to 20 patients and was just wondering if this is typical, since I am new to this field?

[TheCommuter, BSN, RN]

When I worked subacute rehab in LTC, I typically had 15 to 17 patients on day shift and up to 34 patients on night shift. On occasion, I would have up to 30 patients with a medication aide on day shift if our staffing coordinator could not find sufficient numbers of staff.

[ladydi94956]

I am looking at getting a job in acute rehab and the ratio is 4:1 but this is in a hospital and its California. We have set ratios and because we are a specialty, this is why it is 4:1.

[BackfromRetirement]

Rehab in a LTC facility.....not your typical rehab hospital. with Medicare and Medicaid cutting back on "nursing home" reinbursements, many facilities have hired a full staff of PT/OR/ST therapist to bolster the bottom line income. Without our therapies, our facility would probably go broke. Unfortunately, our guests get used to the beck and call for every little need. One recent case was discharged home after 100 days of reconditioning, and the same afternoon called us back to see if she could come back. While she was with us, our CNA's accommodated her every whim in the interest of client satisfaction. After all, nursing care is a competitive business now. however, she exhausted her insurance coverage and PT had reached maximum benefit. Our excellent patient care for this single lady did not foster independence. The CNA's were constantly told "I can't" by this lady. I feel certain that PT and Social Work did everything under the sun to facilitate her return to living alone as she was before. She has hired help during the daytime at home. In LTC with the limited staffing, it is quicker to do her bidding than to stand there and encourage her to do for herself. Now we have created a dependent client, when the whole purpose of her stay was to regain the strength and mobility as before.

[SitcomNurse, BSN, MSN, EdD, RN]

ok, as an rn in ltc, i am the coordinator for the nursing rehab department. the nr department consists of me, and 80+ cna's in a 350 bed facility.

we do the program mostly on the day and evening shift, but nights gets in on the show when we have a night get up who is on a dressing & grooming program.

i do the evalutaions, provide the resident specific inservices, create the first flow record, and alter the plan of care as needed for the start up.

i ensure we do not exceed our ratios of 4:1 res to staff for rom or ambulation programs.

i check the mds's for accuracy and the flow record(not yet electronic medical record) for completion.

i do the audits to see if we are in compliance with the policy & procedure, which basically emulates the standards for a nr program, which is capturable by the mds.

i come in on off shifts as needed, stay late, or arrive early.

i provide inservices on how to do the program, what is considered nr and what is not. when youare capturing minutes.

i do walk with the people who need the extra time, feed the residents who are having trouble getting the program, or to demonstrate to the aide what the heck i am talking about.

otherwise, i might as well be a considered supervisor or nurse manager.

the aides have a maximum of 10 patients in a day, but their individual assignments may have only 2-3 persons on program. we do not have rna's where i am. every cna is a rehab aide. some cna's have no-one on program for months, then . bing! three on program.

i cant make a ratio other than the one provided by the regulations. no more than 4 residents receiving program at any one setting per 1 staff member provideing the program under the guidance of the rn.

hope this helps.