Patient to nurse Ratios... the first ever rehab nurses poll

  1. okay guys... this is the big question... actually a point of curiosity... i want to know what is the max nurse to pt ratio for you all! I max out at 12.... I usually have 1 CNA.... and yous?

    Be Brave! Fill it in!!! Make your number count...

  2. Poll: How many patients do you typically have?

    • I'm lucky and have just 4 or fewer patients

      6.11% 8
    • I have about 5 pts, and I can deal with this

      14.50% 19
    • I have 6 pts, just 3 rooms, all full...

      9.92% 13
    • I have 7 pts... not too bad

      9.16% 12
    • I have 8 pts... ok... I can do this!

      10.69% 14
    • I have 9 pts, and well... this isint as easy as it was when i started...

      6.87% 9
    • I have 10 patients and boy, its getting a bit crazy

      6.11% 8
    • I have either 11 or 12, and its a tad crazy

      8.40% 11
    • I have 13.... thirteen!

      1.53% 2
    • I have either 14 or more... it is insanity!!!!!

      26.72% 35
    131 Votes
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  4. by   VA_CCRC
    I worked in Rehab for 3 years and absolutely loved it! I found it very rewarding. I think most Rehab units use the 'team' approach to nursing. We would typically have anywhere from 9-15 patients per team. Things started getting quite chaotic around 11 or so. I have even seen up to 17 patients. The RN would lead the team and would have the help of CNAs. The CNAs would typcally have 5 or 6 pts each. Rehab nursing is hard work. I now work on a surgical unit where I have 4 or 5 pts. I don't think other nurses realize how demanding rehab nursing is. A typical rehab day...let's say you have 10 patients ( a good day) may be transfusing blood on one patient, extensive dressing changes on a couple of pts, peritoneal dialysis on one pt, a new admission on the way, an impulsive pt that keep walking off the unit...etc.. Not to mention all the other typical stuff, vomiting, hypertensive episodes, c/o pain, routine meds. Oh did I mention that all the patients get out of bed daily, attend therapies, always coming and going off the unit, NONE of them have foleys, splint schedules, bowel training schedules. ARGH!! It is very demanding work! Rehab nurses should be applauded for all their hard work and dedication!!
  5. by   tiger
    sorry but i can't answer the poll because it doesn't specify how many cnas you may have on or if you have a med nurse. those things change our numbers. if there are all liscensed and we are full staffed--i have 4-5 pts. if we have one or two cnas--i have probably 6 to 9, if you have a med nurse plus two cnas the number increases. so, there you go.
  6. by   wendilynn
    I've been working Rehab for a number of years. We have 90 rehab beds. My unit has 32 of those beds. We usuallly have 4 nurses and 2 cna's. They are trying to run our unit with 3 nurses and 3 cna's. I just worked the weekend and 3 nurses and 3 cna's just doesn't cut it. With 10-11 patients per nurse and with everyone needing toileting at the same time, everyone needs pain medication at the same time and so on and so on and so on. There is only so much a nurse can do to meet the needs of his/her patients.

  7. by   RachetRN
    I am a nursing student and this past week did rotations through rehab at Childrens Hospital. It appeared to me that the average day held 4-6 patients for the RN's on duty. The Nurse Techs about 7-9 patients. I am rather inexperienced and took care of four patients, doing all the Tech and RN stuff with the only exception being the administration of medication (my instructor was not on the floor with me). It made for a tiring 12 hour shift, but it was manageable. I was even able to help out the Tech's, RN's, and Teammembers with other stuff off and on during the day.
    However, I need to add that med's take up a lot of time and I worked with a great RN that was really into showing/teaching. Support within the team is a must. Also, if I were to do Rehab everyday I truly feel any more then 6 patients (AND that includes having a good tech that is experienced and trust worthy) would be my personal limit -- as far as feeling truly safe!!
    Last edit by RachetRN on Sep 23, '01
  8. by   FLArn
    I work on the rehab unit of a SNF and our unit has 60 beds. I work the 11 - 7 shift and before Jan 1 we had 3 nurses (no difference made between RN and LPN) and 3 CNA's; now after the new ratios went into effect we have 2 nurses and 4 CNA's.
    Our long term unit also has 60 beds and was working with 1 nurse/3CNA's now has 2 nurses/4CNA's
  9. by   daisymae
    Hello from Arizona. I am an RN since 1977. Done med/surg/tele stepdown/floated to icu/er/code team. First shift was nights. Only remember a few things from that time. Not a night person. Out for 10 years having a boy and a girl. Next round of nursing was in neuro med/surg/neuro intensive observation. I learned a lot. Got bored with all the patients that would wake up and get shipped out. Found out they were all going to a nearby rehab hospita. That place was my next job. Loved it and got my CRRN. Now I'm working in a rehab unit inside an acute care hospital. We have 20 bed unit. Our staffing matrix includes LPN's. And yes, they "team lead". Or "evaluate" as the state board says they should. Anyway, for 20 patients we have 1 RN, 2 LPN's and 2 techs. Does that seem lopsided? Yeah..... We also carry on our floor, 7 medical overflow beds. We haven't used any of the medical beds this year, thank goodness. I think mainly because we don't have the staff that can be brought up there to take care of medical patients. (We would normally get a medical nurse from the regular acute floor to cover the medical patients on our unit). Our actual staffing matrix list used to go up to 24 patients I could cover on the 3-11 shift. Yes, that means me covering some of the medical patients and LPN's managing the rehab patients. And you know how busy medical patients can be. I got stuck with that one time---no more. Staffing was going to do it to me again a year ago and I told them to reevaluate and contact the supervisor while I went to my Director. Thank God I was supported. I really think I could have thrown up in order to leave. I had enough stress, yes, I could have thrown up, easily. 2 weeks ago we had 20 patients, 6 discharges and 6 admits. 3-11 shift did 5 of the discharges and all of the admits by 9:00pm. And I was the only RN until 7pm. I didn't know which way was up. Generally I love my job. The physical aspects of it are getting tough. I've already sustained 2 injuries in the last 3 years. But the nice thing about rehab is that you need to be directing your patients anyway. "This is how you need to be getting up and down-let me show you". I've been training the rest of the staff to be thinking the same way. Why should we be tugging on people when we should be teaching them how to do it.

    Oh my. Look how long I've gone. Sorry .

    I'm not anal. Just don't want to bore anyone. Well, anyway, I love to quilt in my off time. A friend of mine and I went quilt shop hopping in March around Arizona. We hit 18 quilt shops and had a blast. I need to work extra to pay for all the fabric I bought. What fun ! And one thing I've learned recently. Don't take your friends, family, coworkers for granted. One of my coworkers, an LPN, is in the hospital with cancer. She looks like she's dying and I didn't know it. She had been in the hospital for 5 days and no one knew it. I had left a few messages on her answering machine without following up why she hadn't called me back. I feel very lousy. WAKE UP CALL. Don't let your opportunities pass you by................ Joyce RN CRRN Arizona

    It's nice to put info with names........thanks for listening
  10. by   jones58
    I work on a LTC/rehab unit and we have 35-40 pts. I work the 3-11 shift. We are supposed to have 1 RN and 1 LPN, and 4 Aides. Many times we only have 3 Aides. The LPN (me) passes most of the meds. The RN is not supposed to pass meds. She is supposed to do paperwork/care plans, etc. and public relations. Rehab nursing is busy. Those pts. know what they want. They ALL want pain pills at the same time, or they want a pain pill 10 minutes after you asked them if they wanted a pain pill! They ALL want to go to the bathroom at the same time. They ALL want to get ready for bed at the same time. Each aide has 10-13 pts. to wash and help to bed. I don't think they ever go to sleep though, because when I leave at night (always late) they are still asking for things. I know many shortcuts and I do much more than one thing at a time. It's a real fun fast ride! I love it, and it's fustrating at the same time.
    Last edit by jones58 on Apr 21, '02
  11. by   NannaNurse
    I work with SSMRehab in St.Louis. Our unit, at DePaul Hospital holds 22 patients. Our load is down to 13 this week, so it has been nice. We even sent nurses home due to low censes.
    Even with a full house, we'll only have 7 plus 1. I worked LTC Skilled/Rehab for too many darn years. It will be a long darn time before I go back! I love the hospital...lots of support!!
  12. by   jhf0174
    I work PRN for a small Rehab hospital in southern IN --- approx 60 beds, though rarely full anymore! Right now census is hovering around the high 20's & low 30's. We count ourselves lucky not to be DTO'd constantly!!! Our facility changed from Acute Long Term to Acute in March and census has not picked back up, yet. We normally run with 1 supervisor (RN) and 1 nurse (RN or LPN, doesn't matter) for each 8 to 10 patients on 3rd shift with 3 NAs. Sometimes it's only 2 Nursing Assistants, but usually 3. I love it! It beats LTC & Med-Surg hands up. The supervisor usually helps out with chart checks & new MARs when we have a higher pt/staff ratio or difficult pts. We currently have 5 pts in vail beds r/t confusion/safety issues. We handle the ortho rehab pts, as well as brain injuries, burns, and quads. We do lots of in/out caths and bladder scans. We draw our own AM labs, so from 5A to 6A it gets pretty hectic. We get lots of supervised feeders. The therapies are awesome! It amazes me how much & how fast these pts progress. (Unlike how depressing LTC was for lack of progress & much decline.) In fact, I would love to travel rehab nursing. Anyone out there ever done it? I'd love to hear of your experiences.
  13. by   live4today
    Originally posted by Yeti1313LPN
    okay guys... this is the big question... actually a point of curiosity... i want to know what is the max nurse to pt ratio for you all! I max out at 12.... I usually have 1 CNA.... and yous?

    Be Brave! Fill it in!!! Make your number count...


    WHEN I worked a a nurse, I have had up to 14 patients on any given ward that I ever worked on. Sometimes there were CNAs, and sometimes NOT! Don't I miss those days. NOT!!! :chuckle
  14. by   Skywatcher
    we have a small 10 bed unit, so I can have 1-10 patients. Most of the time it is me. I get a C.N.A. when I get up to 4 patients. (if one is available and not pulled to another area of the hospital) At 8-10, sometimes they send me another nurse or a C.N.A. (again based on the "greater need" in other areas of the hospital) I think I need roller skates most days.
  15. by   pickledpepperRN
    Worst I ever heard of was a hospital-based neuro/rehab unit with many young head injury patients.
    Get this:
    1 RN with
    2 LVNs and 1 NA for 56 patients!
    21 ventilators!
    2 nursing stations!
    Very dangerous!

    Oh, to edit. This is not every night. There was a sick call. Normally they would have the above with one more RN.

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