Is taking 10 patients too much

I recently interviewed at a rehab facility and they tell me they can give you up to 10 patients. Where I work now I typically will take 5-6, 7 patients when we are really busy, and this is taking care of patients who just had surgery or post op day 1 or 2. When I have 6 or 7 it can get overwhelming when they are the one's will run you to death all night. They told me their nurse patient ratio is like this because they are a sub-acute facility. I don't have any medsurg experience and I would get some at this rehab facility but I don't feel comfortable with taking 10 patients. They said they do have patients that are sick, so why in the world would you give one nurse so many patients?
Because sub acute is NOT acute care, even though they take very sick patients; in theory, the acuity is supposed to not be as much, but it really is-it is what it is, and most places are operating on an outdated premise and per their "bottom line" and reimbursement, there's "no funding" in having ratios like an acute setting.If you decide to take this position, the best way to be organized is to find a brain sheet-you can use the search button and find a plethora of brain sheets here on AN. Learn to organize with vitals, insulin and BG times, teaching, IV, etc. Best wishes.

Quote from Squirrely18They said they do have patients that are sick, so why in the world would you give one nurse so many patients?

Quote from westieluvShort answer, because they can, and if you "only" get ten patients in sub-acute rehab, consider yourself well staffed. At the facility where I used to work, the patient load on the crazy busy afternoon shift was 16 patients to a nurse. My daughter-in-law works in sub-acute rehab now, on day shift, and she has had to take up to twenty patients, depending on the staffing. These patients are only a couple of days post-op and still quite ill. Years ago, they would have spent at least 2-3 more days in the hospital. Before I accepted that position, I would ask them point blank, "Will I ever have more than ten patients during my shift?" They may lie, but hopefully you will be able to squeeze the truth out of them if that number is just a come on to get you to accept the position.

I think the biggest question you need to ask is what is the support staff/CNA ratio? That makes an enormous difference, especially in rehab.

1 nurse to 10 patients is a very normal nurse/patient ratio in subacute rehab. Remember that it is not acute care, and therefore, the patient population is not as sick as what you'd encounter in a hospital setting.When I worked in subacute rehab I had up to 17 patients on day and evening shift and up to 34 patients on the night shift.

Remember you are interviewing THEM, as well as they are interviewing YOU. Ask any and all questions you can think of, bring a notebook and write down the answers during the interview. You are a licensed professional.

I have worked at our in-facility acute rehab and sub-acute rehab. Acute rehab is easy to take that many patients because they are, by definition, able to tolerate three hours of rehab a day. They are with the therapists a lot, and they are often motivated to do their own ADLs.Sub acute is less rehab time but OT will schedule many for ADLs so the nurses and CNAs don't have to do it. PT will do ambulation and get them up to the chair after. Sub acute can also take those that need longer-term antibiotics. You are also not going to experience the quick turnover of acute care, either. Discharges are known days in advance, not hours. You can always get admissions, however. You will not have to monitor VS as often, and you will not be getting order after order to implement. I can go an entire shift on subacute without new nursing orders on my patients. All this is to say, you can't go by the numbers; you must take into account the setting.In my opinion, 10 in sub acute is very doable, especially if you have CNAs. You still need to be alert for changes, though. In the time I've worked those areas, I have sent a handful back to acute care for things like chest pain, acute abdomens, and sepsis.