rehab in LTC vs rehab hospital

snooksmama · Jun 1, 2008

Hi,

Long term care may offer short term rehab, but in my experience (10 years) it seems that most are simply ecf's. I don't know if you are in a free-standing unit or one attached to the hospital; those that are in-hospital usually have a good rehab staff and are more focused on getting the patients home.

I work in a free-standing acute rehab hospital. It is more interesting because we see a variety of ages and types of injuries. CVA's, TBI's, SCI's, severe trauma. HOWEVER one thing you have to keep in mind about acute rehab is that it is very physical work.

I hope that this gives you some info, if you have followup questions let me know!

Maria

TheCommuter, BSN, RN · Jun 4, 2008

I worked on a rehab unit at a nursing home for the better part of 2 years, but it was structured much like a free-standing rehabilitation hospital. I usually had 15 of these types of patients during day shift, and about 30 at night. My former workplace liked to separate the rehab wing from the LTC wings, because they did not want the fully alert rehab patients to mix with the demented nursing home residents.

On this particular unit, we dealt with many central lines, IV antibiotics, CPM machines, feeding tubes, suture removal, surgical staple removal, complicated wound care, ostomy appliances, diabetic management, casts, braces, splints, cervical halos, and so forth. I once had a patient who was receiving TPN.

Most of my patients had recently underwent surgical procedures such as laminectomies, knee and hip arthroplasties (joint replacements), kyphoplasties, CABGs, hysterectomies, limb amputations, colectomies, thromboembolectomies, and abdominal aortic aneurysm repairs.

The non-surgical patients were typically admitted to our unit for recovery from CVAs, acute MIs, debility, various cancers, fractures, status post pneumonia, deconditioned states, failure to thrive, status post falls, generalized weakness, and other afflictions.

withasmilelpn · Jun 19, 2008

I work in a similar environment to Commuter. Our turnover in patients is typically 6 weeks, compared to the LTC unit which can be years. We have admissions and discharges amost every day. PT, OT and ST work with them up to 5x/wk 2-4 hours a day. There are constant changes in meds, tests and appointments, that can make for a very busy place to work! You need to be pretty organized, flexible and your assessment skills need to be top notch. Typically we get people released to us from the hospital too soon for insurance reasons, only to be sent back within a few days of admission. Can be hairy at times to deal with as your patient load is heavier than in the hospital and you don't have near as many resources.

Nurseismade RN · Jun 28, 2008

I just started in a LTC facility a month ago. I work in the rehab/skilled unit. I miss the hospital environment and was wondering if someone could tell me the difference between rehab hospitals and the rehab unit in a LTC? I've been thinking about seeking a job in a rehab hospital because this LTC just isn't what I had in mind when I went to nursing school.
Any feedback would be greatly appreciated.

working in a long term acute care hospital is challenging......I have been working in one for six months now...this is my second job...graduated in june 07...passed the boards July... my first job was not challenging. I love this one......its rehab with med surg and some telemetry, oncology...and more.....I get at the most 6 patients but 5 is the norm....and our patients stay at least 2 weeks....

some folks confuse LTAC with LTC (long term care)..........no comparison, they operate as a hospital....with no more than 5/6 patients.

Here is a great description of what you will encounter as a nurse in a LTAC:-

LTAC stands for "long-term acute care" hospital. LTAC hospitals treat critically ill, medically complex patients who suffer from multiple organ system failures - active disorders of many parts of the body. These conditions include cardiopulmonary disorders, wounds, kidney diseases, complex infections, and neurological disorders such as head and spinal cord injury and stroke. Because they are medically complex, our patients often are dependent on technology, such as mechanical ventilators, total parenteral nutrition, respiratory or cardiac monitors and dialysis machines for continued life support. LTAC hospitals strive to help patients recover through a carefully orchestrated multidisciplinary team approach.

great place to gain experience. Many new grads go on to specialties like ICU.....after 6-1yr exp.

First, to correct some common misperceptions:

LTAC is not LTC.

LTAC is not chronic care.

LTACs are not skilled nursing facilities.

LTACs are not rehabilitation facilities.

LTACs are not short-term acute hospitals.

hope this helps:)

FranNHRN · Jul 13, 2008

I have worked in both subacute rehab (which was a unit off of a long term care facility) and I currently work on an acute rehab unit in a hospital. The long term/or subacute patients are frequently sicker than an acute rehab patient because they cannot tolerate the 3 hrs per day of therapy. I received a lot of experience in the subacute rehab as far as IV's, TPN, and wound care. As someone mentioned, you get a wider range of ages in acute rehab. We get patients as young as 16. We also get very sick patients in acute rehab, that we've had to send to LTAC facilities. (I recently learned what that was. We don't have LTAC's in NH. We have to send them to Mass.) I hope I've helped a little bit. Good luck with what you decide to do.:wink2:

goodspiritsRN · Dec 22, 2008

I cant seem to find anyone on this site that works for National HealthCare Assoc. in their sub acute rehab center. I am interested in finding out what the pay is and what their experiance is. Can anyone help me?

Thornbird · Dec 30, 2008

I definitely prefer rehab hospital to LTC rehab units. I agree with what other posters have said. I especially liked that there is far more variety of patients. It seems to me that most of the patients that end up in LTC rehab either are just using up their Med A days before being transferred to the regular LTC. There are exceptions of course, but I feel this is the majority. I also prefer hospital staffing patterns. The nurse gets more time with each patient and I always feel I am giving better care. Most of the LTC rehabs I've worked in have been staffed the way LTC is - a lot of CNA's and not enough nurses. Also, a lot of LTC rehabs have minimal therapy staff and I don't believe the patients get the quality of therapy that they do in hospital.

I found hospital rehab nursing to be very rewarding in spite of the fact that it is physical and demanding. You get to see a lot of patients admitted practically helpless and discharged home to independent life.

outside_child · Apr 12, 2009

You get way more patients in a nursing home subacute rehab facility (10-12 patients) vs. a hospital rehab facility (6-8 patients). So the nursing home rehab facility have many more distractions. I have seen at one stand alone subacute rehab facility of poor planning ie. having the necessary equipment readily available (special beds) at the facility when the patient arrives. In acute care rehab, the patient better get what they need pronto.