what is "sub-acute"?

Our govt./health authorities in British Columbia are "busy" dimantling our hospitals (i.e.: closing down ICUs, ERs, med and surg. floors) and converting them into "sub-acute" (less RNs, more LPNs and more NAs). To date, the above have not given any clear definition of the term, "sub-acute" - nor have they given any nurse-to-patient ratio that goes with the type of care expected.

One worries that these areas will run as acute and the odd nurse that happens to be standing there will take the brunt. :imbar

If anyone happens to know anything about this...I would sincerely appreciate hearing/learning more about it! Thanks! :)

[redshiloh]

Oh yeah, our hospital is opening a 5 bed "Progressive Care Unit" The interpretation I got for subacute is 'stable enough to be out of an ICU bed, but NOT stable enough for a ward.'

PLEASE don't ask me why...who knows..I work for the fed government.

[Mint Julip]

Subacute is for patients who are medically stable but still require significant care. It's less intensive than acute care, but more so than traditional nursing home care.

[nursegoodlove]

Thanks for the replies mintjulip & redshiloh :) I think I want a job with the feds! I "wonder" what "significant care" is? And...if there will be significant numbers of nurses left/assigned to give this care? It is all so elusive & a genuine worry:o

[lsyorke, RN]

"converting them into "sub-acute"

I'm in New Jersey and worked on a sub-acute unit fo two years. Most are short term 21 to 100 days for the patient who doesn't need real long term care, but isn't quite ready to go home. You'll find alot of Orthopedic patients and long term IV antibiotic patients. The focus in a subacute is physical therapy, medication administration, and progressive independence towards discharge. These units must abide by the long term care guidelines. MDS's are filed on everypatient at 5 days and 14 days with the government.

Our patients were dressed in street clothes, had meals in a dining room, and a long schedule of PT,OT, and speech if needed. Criteria for reimbursement was a continued improvement by the patient, once they reached there best level of functioning they were discharged.

I loved working on this unit. You got to know your patients really well as well as their families, but they didn't stay forever like LTC. Our ratio was determined by the census. I was the only RN for the 16 bed unit and usually had 1 LPN and 1 Assistant working with me. PT,OT were also very involved in the daily care as well as recreation therapy.

[nursegoodlove]

:) Thanks Isyorke. That gives me a clearer picture of what type of patients are in "sub-acute", what the expectations are & the nurse to pt. ratio.

Are your LPNs "full-scope", i.e.: are they able to give oral, s/c, IM, IV meds in this area?

[lsyorke, RN]

"Are your LPNs "full-scope""

Our LPN's gave all types of medications except IV meds through a picc line or central line. I very rarely gave meds, but got involved with the discharge planning, team meetings and paperwork. But being the beside nurse that I am I loved getting involved with the daily activities on the unit.

[nursegoodlove]

Hi Isyorke. That's wonderful you enjoyed this experience. My worry was if the nurse - you - ever felt overburdened, overwhelmed, terribly responsible and overworked by the fact that you had 16 patients on your slate & if anything went "wrong" - you were "it". But, in your case, it sounds like you had a lot of good help, the LPNs were responsible for their share/practice and am sure - would know when to report if things cropped up (i.e. -pt turning sour). Thanks again :)

[renerian, BSN, RN]

I am hearing more like 25 patients to one nurse? Is that possible to do correctly?

renerian

[nursegoodlove]

hi renerian, the bar just keeps on "lowering" here. Frankly, I find this all rather frightening. :imbar

Where have our standards gone? Where is the nurse/patient safety quotient here. Can anyone spell l-i-a-b-le?

[renerian, BSN, RN]

I talked with 3 places and they all said 25/1 with an aide. Plus two said at times I would need to cover another 25 who had an LPN. Yes I agree it is scarey goodlove.

renerian

[nursegoodlove]

Thanks for the sleuth work renerian! I think will tell fellow nurses to be on the alert for this one! :chair:

I see you are "longing for the sea". I live in the White Rock area - just across the border from Bellingham, Wasington & we are blessed with the ocean (Pacific). I will send a warm, white, bubbly wave your way