I wish to hold myself to some public accountability as I pursue this certification. Essentially, my plan is to revisit this thread a minimum of twice weekly to post my progress. Also, I hope to post some self-created practice questions based on what I have learned, somewhat similar to the Quizlet site.

Here are the facts. The test can only be taken in June and December. My test date is December 29. I have been self-studying via an Ebook that I purchased that contains 700 practice questions. I have also been using Quizlet. In addition, I attended a CRRN prep course that was sponsored by my workplace.

If you are planning to take this certification exam in December or June, or if you have any questions or comments, feel free to post.

I just wanted to get some perspective to help reassure myself that transferring to another floor in the hospital is the right move.  I currently work on the progressive care unit (PCU) in the hospital setting and find myself exhausted on my days off trying to recover from the physical and mental stress of work.  I enjoy the acuity of PCU and the skills I have developed, but find myself ready for a slow down.  A friend of mine works on the inpatient physical rehab floor and says it is a lot less stressful.  I have floated down there and the staff seems genuinely happy there.  The nurses seem to have downtime at night, which is nice.  Your patient load could be anywhere from 6 to 8 patients, on a rare occasion maybe more depending on the census and staffing.  But no heated high flow, chest tubes, critical drips like vasopressors, cardizem, insulin, etc., constant monitor alarms, and the constant hustle and bustle that is on PCU.  On physical rehab, they have the occasional IV fluid infusion or IV antibiotics and mostly po meds, insulin, etc.  There is no fear of the potential for me to get bored as I am in FNP school currently and could fill any downtime with homework and studying.  

While I am capable of the high acuity care and stressful workload on PCU, I am not a thrill chaser and wouldn't mind stepping down to a lower acuity unit to have some mental peace.  

Any thoughts or insights?

I have an upcoming interview for an inpatient Rehab RN position and was wondering if you have any advice on what questions I should ask during this interview.  I have no job experience in this field and am not sure what working as an RN in a rehab unit is like. My nursing position was recently eliminated so I am looking for something new and different.  Thanks in advance!

I.e.   free or low cost, all in one place, etc.?

Thanks in advance, magnolia

Thank you!

Wish you all a happy and blessed 2020 ?????

I applied for a Acute Detox Unit a few days ago. My aunt that works at the facility spoke to the DON as she referred me and the DON said she needs nurses for the new CSS unit opening. I’m excited but do not see much information about the nurses role on this unit. Anyone have any experience on a CSS unit as an RN? 

Thank you 

The night shift nurse asked me if I can just switch to night shift instead of day shift, so then I won't stressed out too much because night is slower than day shift. Another night shift nurse told me to give it a chance try night shift before I am quitting

Then the supervisor of night shift called me and told me that if I am interested to work for night shift, she would talk to the nurse manager and CNO so I can work with her.

I am torn because yes it's tempting to work night shift.

However, another part of me is exhausted to be a part of the system. Hospital is very profit driven. I didn't sign up to be a nurse for this. I have to go against my moral ethics several times for this business. If I score admission FIM too high for patients who are perfectly capable of doing their ADLs, I get the email from administration to lower the score so they can stay longer in the hospital.

If I want to change the foam dressing on an incontinent patient who had episodes of diarrhea, I am told no by the wound care nurse because corporate begins to limit the use of foam dressings for patients.

I am heartbroken, honestly.

My hubby told me it's because I'm still kinda new in healthcare. He's used to be like me before. The first time he worked as a healthcare professional, he was frustrated by the way healthcare works. However, he said it's either we have to adapt to the system or we're quitting the profession.

I don't want to quit the profession. But I hate to become part of the system, and I hate that I am powerless because I know I won't be able to fix the healthcare system.

I'm not Mother Theresa who's gladly sacrifice herself for others. But I felt like I have to quit the job before I begin to hate nursing.

Another retired nurse told me to try volunteer for undeserved, uninsured population, and it will remind me why I wanted to be a nurse in the first place.

Another part of me is worrying if I cannot get the job later on because I quit the job too soon (less than a year) and it's already my second job. I quit the first one (less than a year) because I thought second one would be better, and they both opened my eyes very widely, that all hospitals here are money-driven.

Any thoughts? Thank you.

“Patients always sleep through the night. You should have it easy!”  This has been said to, but never by a night shift nurse anywhere. When moved into a facility environment for an extended stay, patients sometimes don’t know night from day. An “easy night” is non-existent!

I love physical rehabilitation nursing and actually have my certification in this area as a CRRN.  I describe myself as a “fixer” and get excited when a patient shows progress. Sometimes this is a slow process; other times it can be overnight. 

For three years, I worked the night shift in a rehabilitation facility.  My position was on the traumatic brain injury unit (TBI). I have many stories, “enough to write I book,” as they say.  Let me share a few of them with you now.

"I'm a Monkey"

A patient that had some post-op swelling from an open skull surgery, was loud enough one night that his roommate was awakened and put on his call light.  I entered the room to assess the situation but didn’t find the patient in his bed.  This was especially strange because this patient was in a “net bed.” For those of you unfamiliar with this apparatus, it is a tented, mesh cover that is held in place by a trapeze bar the length of the bed. Ours were solid fabric at the top and mesh on all four sides.  This keeps the patient safe but does not tie them down.  I could hear the patient singing and looked around the bed. All sides were up and zipped. Hmm… His singing stopped, and he giggled. I looked up inside the tent, and somehow, he had been able to reach up and grip the bar, then pull his feet up around it as well.  He was swinging and when he knew that I saw him, he stated, “I’m a monkey, I’m a monkey!” It took two of us to convince him that he was not a monkey and he needed to get back down into the bed.  The man walked out of the facility the next week with no residual effects from his surgery and no recollection of that night.

Rural Victims

Many of our patients were victims of the rural community in which they lived. One of our head trauma patients went over the handlebars of his motorcycle because of slipping on horse dung in the road. Short stay, but an interesting story! He insisted he didn’t need a gown, only his boxers, and his cowboy boots.  The occupational therapists convinced him they needed to see him dress himself, thank goodness, and he always had clothes on before he made it out of the room!

Another young girl had fallen from the hayloft in the family barn, only to be found by her younger siblings much later, in a coma.  Her mother insisted on staying in her room, and the rest of the family in the waiting room for her entire stay. They got permission to do so from the administration as their religious beliefs directed that they take care of their own, and they lived far from our hospital.  She made terrific progress after a few weeks of aggressive therapy, and her care was able to be completed at home as her family was trained to continue her rehab in her own environment. From diagnoses of a stroke to intense head trauma, our patient’s recovery was sometimes mind-blowing and immediate, yet others were very small forward steps of improvement.  We never knew what to expect, as every human body repairs itself differently. 

A Haunted Facility??

I haven’t mentioned that our rehab facility had formerly been built as a tuberculosis hospital during the early 1900s.  Rumors of it being haunted were ramped among the nurses and associate personnel that had been long-term employees.  Of course, the night shift only added to the mystique and did not bode well for some.  Around 4:30 a.m.one morning, I went up to put lab specimens in the refrigerator near the lab, which was in the old section of the hospital. I heard laughing and a ball being dribbled in the hallway.  As I stepped back on the elevator, I thought, “Someone had better quiet those kids or the whole place will be awake!”  As the doors were shutting, I realized, 1) we have no pediatric patients, and 2) no patient rooms were in this area of the hospital at all! 

Many nights, our patients would report seeing things, or we would find them talking to thin air and they would swear there was someone in the room.  Was this the head trauma or our resident ghosts?!  One night, a patient that was not to bear weight on his right leg was found trying to throw a chair through a glass window. He was screaming, “Fire! Fire! Fire!” Our nursing assistant had to literally tackle him as he ran down the hallway, trying to get out of the unit.  Needless to say, he needed to have another surgery to repair his fractured leg.  Another patient insisted on being put in another room as there were spiders all over the walls.  She was there for therapy after a hip replacement, as overflow from one of the orthopedic units, with no head injury whatsoever.

Staff would talk about windows opening and closing when they were locked, seeing people walking at the end of the hallway where there was no entrance or exit and patients were bedridden. Lights would go on and off when no one had been in the area.  Our supervisor came to the unit one night and stated that she and the security guard had just investigated the basketball court outside for trespassers, just to find that the exit door providing the light to the court was locked, the light they had seen was cold, and the teens they heard were never there. Another supervisor was locked in the chart room all night when he was the only one with the key! He turned the handle and walked out when the sun came up, with no barrier explaining his confinement.

The Best of My Nursing Career!

Whether supernatural things were at work or the patient’s brain injuries were the culprit, my job on the rehab unit those three years was the most interesting and memorable in all my 32 years of nursing!  I had so many tales to share with my co-workers, and unexplainable events to remember!  The work was exhausting, but I learned so much from the LPN with whom I worked, and with the other staff that was invested entirely in the patient’s recovery.  The interdisciplinary team was focused on each patient’s progress, and most often, the patient was able to recover immensely with our assistance. Unfortunately, as with many other facilities, the hospital was closed due to operating issues.  Those nights were the best of my nursing career!

The Life of a Night Shift Rehab Nurse-Word.docx

I am a new grad who starts on a neuro rehab unit in two weeks. I'm very excited to get started but was wondering if anyone had any suggestions of good resources or advice as to what I should be doing to be as ready as I can to start.

Thanks so much

I had my last LPN clinical at a rehab hospital and I loved it so much. I hope this job is similar!

Isn’t normal to see rehabs with a 1:18 nurse-patient ratio? How hectic can things get?

I'm asking these questions here to avoid sounding foolish to a potential employer. Any insight is appreciated! Also, can anyone suggest or link me to a good article that explains the real-world relationships between acute care, LTAC, rehab, SNF, etc.?

Question for everybody who works in rehab. I recently began working in a Post acute Care facility which is really a skilled nursing facility that focuses on Post acute Care only, no long-term care patients. when I am receiving a new patient from the hospital and going over the admissions paperwork with them I trying to explain to them how the facility works. At my facility the ratio is 1 nurse to 19 patients, so clearly nurses are not rounding on the patients every hour which is what the patients are used to in the hospital. I have been trying to find a way to explain to patients that the nurses are always on standby should you need them but that rounds are not completed like they were in the hospital, but sometimes I feel like I am letting them down or in some way telling them that they won't have as much accessibility to the nurse as they did in the hospital. How do you orient patients to the facility without making it seem as though the nurse will only see them for medications? I always tell them if they need me to turn on the call light and I will come and check on them but sometimes I feel like they expect me to be coming into the room every hour just like what was happening at the hospital. Any suggestions on how to make this more clear. Thanks so much!