Rn ratio rehab/nursing home

[Mqnurse43]

I have been offered a job in a nursing home rehab facility. However, I was told my ratio would be 1:40. I've never heard of a ratio this high and I am hesitating. Is this safe and is this a norm now?

Thanks!

[River&MountainRN, ADN, RN]

How many CNAs will you have working with you? 40 is not comfortable for me, but I've heard it's doable with GOOD help and if the population is stable.

[Orion81RN]

Combined with Rehab, that's a big heck no from me! Never ever ever ever. Unfortunately, I do see it.

[_littlemissBSN, BSN, RN]

That's not uncommon for nursing homes. I was offered a job at a transitional rehab with potentially 35 patients and impulsively said yes since I really wanted to work at that time already. I was a new grad and I could not sleep for a week because I realized I wasn't really comfortable with the job and workplace. The patient load was just too much for me and I wanted to be able to deliver a focused patient care - which is impossible with 35 of them. I eventually told the hiring manager that I'm withdrawing and effectively rescinded my application days before my orientation.

Yep, it might be doable, but I couldn't do it even though they are supposed to be stable. Looking back, I could not be grateful enough that I did not pursue that job. What does your gut tell you? Follow it. If you are not comfortable with the patient load, I would advise to look somewhere else.

[VivaLasViejas, ASN, RN]

1:40 in LTC is not unusual, unfortunately. But in rehab, the ratios should be closer to 1:10-15. Some rehab patients are really unstable or need a lot of care (fresh CABGs, new strokes, IV antibiotics etc.). The last SNF I worked in was usually closer to 30 patients, but there was a treatment and medication nurse, plus the charge nurse and at least four or five aides on days and evenings. Even so, the staffing wasn't really adequate, but we were told we were staffed well above state requirements.

The last I heard, they had cut back to 2 nurses and five aides for the whole building on 11-7, which held upwards of 90 residents on high-census days. A new corporation bought out the facility and cut staffing and services to the bone. Every one of my friends who worked there when I did has since left, including the DNS and executive director. It was a shame, because for an old and sort of rickety facility, there were a lot of quality workers who had a passion for working with this population. The new company revamped the building, but when I checked out their CMS ratings a few months ago, they were down to two stars (it was a four-star facility when I worked there). They also had a number of citations for poor care. In what universe is that OK? Makes me afraid to get old and need a place like that someday.

[mtmkjr, BSN]

Inpatient rehab here... 5-6pts per nurse, Nurse techs have 6-7