very very over whelmed!

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Specializes in ICU/CCU, Rehab, insurance, case manager.

ughhh this job is killing me! I took a positon as a Nurse Manager of a 40 bed rehab unit. I generally have a couple of admissions a week as well as Planning discharge meeting one day a week and One whole day is devoted to patient care conferences. I spend about 90% of my day on the phone answering phone calls or dealing with staff issues..aka bickering! My major issue is their expectations for the unit. I have 4 CNA's to the Unit so thats 10 patients each. 2 LPN's which do the medicaiton pass. They expect that all the patients are up and ready my their appointed time but that also call bells are answered promptly. now if the majority of the patients are 2 Assist when is there time for the multiple call bells to be answered. I try to help out but it burys me in deeper and later. at this point I do not get to eat or take any breaks thru out the day annnnndddd I am there 45 minutes late each day. I love the job but i can't take it anymore! this job is undo able they have gone thru 3 nurse managers alone last year in its self. I swear i just want to go back to the ICU and get my sanity back!

Jamie

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

Yes, I've found that rehab nursing is similar to hell on earth. I absolutely loathe coming into work and having to deal with the overly needy patients, family members who expect you to perform wonders with minimal staffing and supplies, and a greedy management team who seeks to maximize profits at the expense of the sickest patients.

I'm disgusted with rehab, and will be job hunting next month.

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I agree with The Commuter-

Rehab nursing is hell. I will never do it again, that's for sure.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Rehab nursing is hell.
It's no wonder that the vast majority of the rehabilitation units in my city have extremely high employee turnover rates. The demands of this type of nursing are unique and incredible.

My workplace has not had a permanent, stable night shift nurse for the rehab unit in over 6 months. Every nurse who accepts the position quits without notice within a week, so my place of employment has been staffing the open spot with overtime labor and PRN nurses.

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Years ago, I worked in a horrible rehab unit. One of the big bosses held a meeting, and brought us pizza. One of the braver nurses (bless her) stood up and told him "We don't need pizza- we need help out there!" The exec was so confused, and dumbfounded. He had no idea what was going on. He just stood there with a stupid look on his face for a couple minutes, then said "Well, here's the pizza." He put the boxes of pizza down and walked out.

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Specializes in ICU/CCU, Rehab, insurance, case manager.

the behavior on our unit just keeps getting worst and worst. I have a young male ~50ish that on purpose keeps soilling himself them hidding it or worst leave it in his room. My attitude in nursing is not to tolerate behavoir like this. if you give them an inch they will take a mile. well my boss the DON thinks i should tell him that its alright that he does it and continue to remind him each time to use the call bell if he has to go. I feel this is enabling his behavior. I hvae spoke to him several times reguarding this and it makes me ill. I will not accept nasty behavior just because this guy is to lazy to use the call bell.

I truley hate hate hate rehab nursing, i am applying other places way way out of any sort of LTC or rehab. I interviewed on friday for an insurance job. keep your fingers crossed.

Jamie

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Every unit with 40 beds or so should have a manager and assistant manager. It is too much for one person. I always looked to work on units that had 24 to 28 beds because I noticed they were less chaotic and that the managers were more assessable. Unfortunately, few years ago upper level managment decided that NMs with units of that size should have to supervise two units. AAAAAARGH! Not to long ago I did a post that noted that the turn over rate for nurse managers is accelerating. You never used to see positions posted in the newspaper for nurse managers, well at least not very often. Now the want ad sections are full of manager positions. You have my sympathy. Until upper levels of managment realize that work loads are impossible from the top to bottom out on the units the revolving door will continue to spin at ever accelerating rate of speed. God bless.

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I have heard some horror stories about working rehab. Such expensive care, great profits for the rehabs but the same old story....not enough staff!

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Specializes in Med/Surge, Psych, LTC, Home Health.

Yikes. I have been considering a possible transfer to my hospital's rehab unit. I believe it is only 20 or so beds. Still, after reading all of this I might want to reconsider.... :)

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Yikes. I have been considering a possible transfer to my hospital's rehab unit. I believe it is only 20 or so beds. Still, after reading all of this I might want to reconsider.... :)
Rehab is not that bad if you only have 7 to 10 patients.

However, I have had up to 28 of these higher-acuity rehab patients by myself due to critically short staffing. On most days, I had about 15 rehab patients. I'd hate to admit that they didn't receive the type of care they deserved.

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Specializes in inpatient rehab (general, sci, tbi, cva).
I have had up to 28 of these higher-acuity rehab patients by myself due to critically short staffing.

28 patients? That is insane! There is absolutely no way you can adequately take care of that many patients. Overwhelmed is an understatement. Drowning may be more appropriate.

I thought my unit was understaffed (often 7 patients per nurse with one tech on AM shift--and need to transport pts several floors away to therapy). We are the stepchild unit, because of where we are in the hospital (away from our other two units) and it sucks. People get stuff like MRSA and Cdiff, because nurses and techs rush between rooms and don't get cleaned up properly.

The most I have seen on a night shift at my hospital is 13 to 1 nurse with three techs. That's not safe, either, but at least there are more bodies to toilet people and help reposition or clean them up.

Some of our rehab units, however, did not have nursing managers, so that made them completely useless (PTs and OTs are great, but they can't pass meds or do treatments). Our nurse managers don't get it, either, because in these situations, they are supposed to come in and cover. I have yet to see that happen. Occasionally, we have them help pass meds, but most of the managers barely answer call lights. (Our CNE, believe it or not, is the exception) I saw our last manager wear scrubs on one day--Halloween--because she had "cute ones to wear". This is also a red flag--if they don't wear scrubs, whether management or nursing education, they are not serious or willing to jump in to situations (I have encountered only two in my job who weren't wearing scrubs who jumped in on a code, one was said CNE and another our Case Manager Director--also an RN).

Most of the management doesn't want to get their hands dirty anymore. That's why I'm going to a rehab unit where the nurse manager actually works (wears scrubs, fills in, etc.) I'm just waiting to get my final offer and then I'm sending my note to the boss, with a two week notice.

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Specializes in inpatient rehab (general, sci, tbi, cva).
the behavior on our unit just keeps getting worst and worst. I have a young male ~50ish that on purpose keeps soilling himself them hidding it or worst leave it in his room. My attitude in nursing is not to tolerate behavoir like this. if you give them an inch they will take a mile. well my boss the DON thinks i should tell him that its alright that he does it and continue to remind him each time to use the call bell if he has to go. I feel this is enabling his behavior. I hvae spoke to him several times reguarding this and it makes me ill. I will not accept nasty behavior just because this guy is to lazy to use the call bell.

I truley hate hate hate rehab nursing, i am applying other places way way out of any sort of LTC or rehab. I interviewed on friday for an insurance job. keep your fingers crossed.

Jamie

This guy was on my unit recently. He just didn't want to unfasten his Depend to use the urinal.

I refused to let him go to therapy until he helped me clean himself up (with me as standby--passing stuff). I got to score him as continent one day of the almost 30 that I cared for him.

He made me so mad one day, I asked him what made him do it. I told him, "M. all I wanted to do was score you as continent today and you messed that up. You're not on Lasix anymore. What happened?"

Another part of the problem is some people like the "hotel" aspect of the hospital. At home, no one's around to clean you up. At the hospital, they are and are graded on it.

Some days I just want to strangle people who can and won't be continent!

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