Sub-acute/Rehab advice & brainsheet?

Published

Hello all,

Earlier today I had an interview for a sub-acute/rehab facility. It seems like a good place to work and for me to start and get some experience (it's almost a year since I graduated), but the only thing I'm worried about is the patient ratios. The DON who interviewed me mentioned that on the LTC part of the facility, the ratio is 1:30 and on the sub-acute it's 1:18. I told them I would give them a final answer by the end of this week.

Also, does anyone have a good brain/SBAR sheet for sub-acute facilities/patient population?

Up Vote Up Vote ×

I work rehab with 1 wing being LTC. 1:25 in LTC is alright and 1:13-15 rehab side is doable. There are absolutely times the rehab side has 18 patients, but when we do, we are very stressed and can't provide the best care. If I were to switch places of employment and the employer stated the ratios you wrote, I personally wouldn't take the job. That's just me though. Good luck witj your decision!

1
Up Vote Up Vote ×
I work rehab with 1 wing being LTC. 1:25 in LTC is alright and 1:13-15 rehab side is doable. There are absolutely times the rehab side has 18 patients, but when we do, we are very stressed and can't provide the best care. If I were to switch places of employment and the employer stated the ratios you wrote, I personally wouldn't take the job. That's just me though. Good luck witj your decision!

Thanks for your advice! I'll definitely keep that into consideration.

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

In the subacute/rehab setting, time management is imperative. As insensitive as it sounds, remember that the subacute residents are not our personal friends.

While you should always be nice and respectful, there is no need to socialize with the same patient or resident for a lengthy period of time. In essence, hurry up and pass your meds, do the wound care, and move onto the next resident.

A 'to-do' list helped me remain organized. Below you will find one of my old to-do lists with names changed due to HIPAA. I worked on a rehab unit at a large rehab/SNF years ago and here is how I organized my shift. I worked 16 hour weekend double shifts from 6am to 10pm.

I normally had about 15 patients to care for. At the beginning of the shift I would look through the MARs and TARs and, as I went, jotted down the tasks that needed to be done in my notebook. My to-do list in my notebook was how I organized my shift, and as a result, I wouldn't forget to do anything.

9-23-20XX

DIABETICS, FINGER STICKS: Agnes (BID), Norma (AC & HS), Bill (AC & HS), Pauline (AC & HS), Rex (BID), Jack (BID), Ethel (AC & HS), Marjorie (0600, 1200, 1800, 2400)

NEBULIZERS: Marjorie, Ethel, Bill, Jack, Pauline

DRESSING CHANGES: Pauline, Bill, John, Jack, Lillian, Rose, Lucille

IV THERAPY: Pauline (Vancomycin), Agnes (Flagyl), Rex (ProcAlamine)

COUMADIN: Agnes, Rose, John, Lucille

INJECTIONS: Agnes (lovenox), Lillian (arixtra), Rex (heparin), Bill (70/30 insulin), Ethel (lantus), Mary (vitamin B12 shot)

ANTIBIOTICS: Pauline (wound infection), Rose (UTI), Rex (pneumonia),

1200, 1300, 1400 meds: Marjorie, Lillian, Rose, John, Jane, Jack

1600, 1700, 1800 meds: Rose, John, Rex, Lucille, Lillian, Laura, Louise

REMINDERS: assessments due on Agatha, Jill, and Louise; restock the cart; fill all holes in the MAR; follow up on Norma's recent fall, fax all labs to Dr. Smith before I leave, order a CBC on Rex...

2
Up Vote Up Vote ×
In the subacute/rehab setting, time management is imperative. As insensitive as it sounds, remember that the subacute residents are not our personal friends.

While you should always be nice and respectful, there is no need to socialize with the same patient or resident for a lengthy period of time. In essence, hurry up and pass your meds, do the wound care, and move onto the next resident.

A 'to-do' list helped me remain organized. Below you will find one of my old to-do lists with names changed due to HIPAA. I worked on a rehab unit at a large rehab/SNF years ago and here is how I organized my shift. I worked 16 hour weekend double shifts from 6am to 10pm.

I normally had about 15 patients to care for. At the beginning of the shift I would look through the MARs and TARs and, as I went, jotted down the tasks that needed to be done in my notebook. My to-do list in my notebook was how I organized my shift, and as a result, I wouldn't forget to do anything.

9-23-20XX

DIABETICS, FINGER STICKS: Agnes (BID), Norma (AC & HS), Bill (AC & HS), Pauline (AC & HS), Rex (BID), Jack (BID), Ethel (AC & HS), Marjorie (0600, 1200, 1800, 2400)

NEBULIZERS: Marjorie, Ethel, Bill, Jack, Pauline

DRESSING CHANGES: Pauline, Bill, John, Jack, Lillian, Rose, Lucille

IV THERAPY: Pauline (Vancomycin), Agnes (Flagyl), Rex (ProcAlamine)

COUMADIN: Agnes, Rose, John, Lucille

INJECTIONS: Agnes (lovenox), Lillian (arixtra), Rex (heparin), Bill (70/30 insulin), Ethel (lantus), Mary (vitamin B12 shot)

ANTIBIOTICS: Pauline (wound infection), Rose (UTI), Rex (pneumonia),

1200, 1300, 1400 meds: Marjorie, Lillian, Rose, John, Jane, Jack

1600, 1700, 1800 meds: Rose, John, Rex, Lucille, Lillian, Laura, Louise

REMINDERS: assessments due on Agatha, Jill, and Louise; restock the cart; fill all holes in the MAR; follow up on Norma's recent fall, fax all labs to Dr. Smith before I leave, order a CBC on Rex...

I really like this way of organizing pt. care for 10+ patients. I could see myself using this style. Thank you!

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Also, you had asked about a brain sheet in your original post. Below is a link to some free brain sheets, some of which are applicable to subacute rehab.

Report Sheet for Nurse to Use for Free | Bedpans

Up Vote Up Vote ×
+ Join the Discussion