Pt assignement of 7 or more in rehab

[SusanRehabRN]

this is my first post as far as a subject but i am at my wits end and want to know what you all think. first off i work on a 22 bed unit that is also part of a 360 bed hosp. the rehab unit is just over 1 year old. we are one of the few units in the hosp that is currently making money. our manager has this idea that she doesn't need a charge nurse even though we are full a lot of the time. she says all we need is a "lead" nurse which is what i am. now of course you know that the "lead" nurse gets no extra pay but has all the same duties of a "charge" nurse and carries a full load. their idea of a full load is up to 8 patients and occasionally more if staffing is low and we can't find any other nurses to work. (she keeps no prn or part time nurses to fill in when we need to be off.) anyway most of the time we are short on cna's too and most of the time we only have 1 cna for the whole unit. we also take higher acuity patients than we were told we'd have. i am 54 years old with lots of health problems. when i started here i was honest and brought all the up and the fact that i had also had back surgery and wanted to know if she was sure i wouldn't have to lift...she said told me no that there were plenty of people to help out. now we all know that hasn't worked out. pt and ot is busy and doesn't want to stop and help clean a total care patient when we need help. it's really miserable and i don't know what to do. please let me know how your units work ao i will have an idea if this is just rehab and i need to shut up or if you have any other ideas. by the way we have no equiptment to lift folks either. thanks!

[natkat2816]

Regarding transfer training - could you just go right to PT and ask them for proper training/inservice on transfering instead of waiting for the cold day that administration will get to it?

[pamperednurse]

I am the nurse manager for a 18 bed acute rehab at a 200+bed hospital in a rural community. We generally have 1 RN/1 CNA to 7 patients on days and noc. At 8 it goes to 2 Lic. Rn/Lpn and 1 CNA on days and noc we go to 9 pt's we have 2 lic. and 1 CNA. 9 on days gets 2 cna's and 2 lic. Then at 13 pts days get 3 lic/2 CNA and noc get 2/2. At 15 patients the noc shift goes up to 3 lic/2 cna's. It generally works- we do self scheduling with 2 lic and 2 cna schedule each shift. If censes goes higher we have call in and generally pay double time for extra shifts worked above one's hired hours. Kills the budget, but patient care comes first. We also, have a mandatory no lift policy going into effect in Jan 06. We have spent numerous $ on the ARJO lift equipment throughout the entire hospital. We have 3 mechanical lifts, a sit to stand device, and are waiting to install a ceiling lift in our double occ. patient room. We use this room for our bariatric patients. Our no lift policy is very strict-if one does not comply and gets injured, there may be disiplinary points assigned. Hopefully, you can use your judgement and get lift equipment, otherwise I would def. find a different place to work. One's own health is important. Administration support is needed for getting equipment. Good luck.

[wendilynn]

I work on an acute Rehab. Our staffing is 7 patients up to 8. We do have PCA's. I even think that's too much. Our acuity in Rehab isn't what it once was. We transfuse blood and blood products etc.......I would ideally like to have 6 patients. We have no charge nurses on any shift. I am the Nurse Manager / Educator and I am supposed to be the "charge nurse" as well as do everything else that I'm supposed to do..meetings....discipline....scheduling....education.

[suehp]

I have been in acute rehab for almost 3 months. (I moved here from the UK) The normal ratios we have worked with since I have worked here in Florida is about 10. The last few shifts I have had the pleasure of 8 which has been great as I have had the same patient assignment. Last night I had 15 and had one tech with me and shared another tech with the other nurse (who happened to be the Supervisor - she had to take 15 pts herself becuase of the shortage of staff) These numbers are ridiclous and so unsafe. I felt I wasnt doing my job properly and guess what I didnt get a break and left late. So much difference in havign 7-8 pts the previous few nights as i was able to spend more time doing my assessments and doing that little bit extra with them and helping the techs out who are awesome:kiss