REHAB NURSING

[Jckids]

I am an RN working on a 30 bed acute rehab unit which is attatched to a level 1 trauma hospital. WE usually run at 24-27 patients. On the day shift we have RN's taking 5 patients (sometimes 6) with the aides taking 6-7 and we also have LPN's (2 on days). We are trying to find ways to have the LPN's used differently other than another body to do care. We recently had them educated on FIMS so they can do that now. Our case mix index is around 1.3-1.4 sometimes above the national average. Can anyone tell me how your unit operates and what the LPN's are doing to assist the RN's?

Thanks

Jckids

[Sam. W, MSN, APRN]

5 patients per RN? My facility is one RN has 20 to 25 rehab patients and 2 CNAs to help in the rehab unit. It is crazy.

[calivianya, BSN, RN]

I worked at a hospital rehab in nursing school as a CNA. Ratio was exactly the same as OPs, and that was the hardest physical labor I have ever done. 1 CNA to 6 patients really meant I did not have time to get stuff done, and I felt sorry for the poor nurses with 6 patients. Eight or more patients as a CNA meant that somebody didn't get breakfast until almost 10 AM, and that's when the nurses helped and fed patients, too. When just about everybody is a 3 person assist and a total feed, and everybody is getting up to the bedside commode multiple times a shift, not to mention having a TBI or two who is actively trying to kill you because "why you stabbing me, bro?!" is the reaction to taking a blood sugar, even a 5 patient assignment is pretty bad.

We had LPNs taking full assignments, so we worked them just like the RNs. Of course, the RNs had to do the patient's assessments, so it put a lot of extra work on the RNs who might only have six patients but would be charting assessments on 12.

[TheCommuter, BSN, RN]

I work in acute rehab. Our LPNs function as primary nurses who take care of their own patient loads. The typical nurse/patient ratio here is 1:8, regardless of whether the nurse is an RN or LPN.