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Discussion

RN:Pt Ratios

I'm considering an offer for an RN position with an independent inpatient sub-acute rehab facility. The pts I've been told are mainly CHF, ortho, and stroke. Pt ratio is 9-12 ( most likely you will have 12) with a designated CNA and extra help at AM.and PM baths/meals. I'm used to 5-6 ratio on a med-surg floor and inpt rehab. How foes this sound for subacute? Thanks :)

Featured Replies

Sounds fair. Some places I worked went up to 20. I moved to the east coast and it is up to 32

  • Author

32? Ouch! For pts and RNS. :(

Yep. I looked at rehabs when I first moved here from AZ. Screw that. And placed tried to only offer 18-22 per hour for BSN. I am now in med surg. Busy but safer and learning a lot

  • Author

They don't pay any different for BSN at the Rehab place. Benefits are better in the hospital for sure. Ie at the Rehab facility they don't offer evening differential only $1.50 more per hour for weekend shift :(

  • Experts

I work at a freestanding rehabilitation hospital where the nurse/patient ratio is typically 1/7 to 1/12, depending on staffing.

When I worked in subacute rehab and nursing home rehab, the nurse/patient ratios ranged from 1/15 to 1/45 depending on staffing and the shift involved.

Our ratio is 1:7 for inpatient rehab. Census also determines how many techs we have. Day shift is easier because you have PT and OT staff who can help out, such as scheduled time in the morning for ADLs for a certain number so they can evaluate their FIMS for washing and dressing themselves. When it's evening/night we typically have one tech for 11 patients, but will have 2 nurses. I think our directors have done a really great job with the load. Also, they won't take pts with TURPs and TPN feeding.

If we're talking about a SNF type of rehab then that patient ratio isn't bad.

I currently work on a rehab unit where ratios are one RN to 20-30 pts at any given time! This is my first job straight out of school which I am thankful for, but I can't help but dream about how nice it would be to work in a hospital where nurses have at most 5-8 pts. When I first started there was an RN and LPN on the unit which was so much better, but now I think there trying to cut back to save money. Soooo frustrating! I worked last night PM's and there were two new admits, one sent to ER and came back, 5 wound dressings, tons of orders, we have a G-tube pt, one on IV ATB with a bili-drain, stroke recoveries, not to mention Medicare charting, and the list goes on. I even had the med tech do my med pass and I still wasn't out until 1:30 am! I couldn't even step away to get a 15 min break let alone my mandatory 30 min break!! I'm starting to feel very run down and plan on not picking up any extra hours for quite a while. I wish it was against the law to have one nurse take care of more than 15 pts by him/herself. Grant it, about 5-6 or more long-term care, but still, I am on my feet running the entire night.

1:5-1:6 is the usual. I've had as few as 1:4 and there were a few night shifts I got 1:7 on an acute brain injury & stroke unit.

1:10 on day and evening (the shift i worked). And 1:15-1:20 on nights. We get a lot of med-surg overflow tho so it's pretty difficult. In fact, by the time I left, 7-8 of my patients would be fairly acute NON rehab pts and i'd had 2-3 actual rehab pts. That's why I left my FT position there and only work 1 shift a month per diem (I have a new FT job which I love). It was pretty awful to deal with every day.

I'm in Florida and just started at a facility where I was told my typical patient load would be 12. Just a couple days in I see the truth... 2 RNs split the floor of 45 to 50 patients on average. Yep 23 to 25 patients each.

When I asked about it I was told state law (Florida) says: rehab/short term 1 nurse per 20 patients, long term 1 nurse per 30 patients.

Would be great to figure out what other state laws say about ratios.

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