New to sub acute rehab!

[gingah828]

Hi all,

Just wanted a little advice. I am still a fairly new nurse and have been mostly in home health, private duty. I just started a new position with sub acute rehab facility. I have been working only PRN as this facility is going through the start up phase of opening , for the past several weeks I am scheduled once or twice weekly for 8 or 12 hours. I can go 5 days without being scheduled and in the meantime, we will have at least 2 or 3 new admissions. Last Sat I was scheduled as the only nurse with 2 CNAs for 10 patients, one being on hospice and at least 3 bordering on instability, fluid overload, kidney failure, stroke recovery, etc. This is with virtually no additional assistance from other units as this is the only operating unit in this new facility.

I get that I will not only be responsible for being charge nurse plus med pass and assisting with transfers, toileting, etc. I also understand that the ratio in sub acute rehab is 15:1. We are now at 15 patients as of yesterday and the overwhelm just continues for me as these people are really sick. I understand this is the way it is but we are also expected to run to the kitchen and deliver hot food, water, fulfill demanding requests from guests who are told they are going to be admitted into a "resort" facility. We even use glass carafes and glasses which seems like a significant safety issue to me.

The long and the short of it is that I am wondering if you have any advice on how to approach management as well as just basic survival tips. I have already let management know I am no longer comfortable with being the only nurse on the floor especially since we are now at the cut-off ratio of 15:1. Corporate is being greedy in terms of scheduling, hours, etc. So, I am not given enough consistency especially as a new nurse to this setting to feel like I am even getting a strong enough foothold to provide safe nursing as well as protecting my license. Thanks in advance for any thoughts, suggestions.