How many patients are typically assigned to each nurse? How long does a med pass take for these patients?
At the facility I worked at we would have 6+ patients. Med pass would vary depending on number of patients and their therapy schedules.
Depends on your employer. A inpatient rehab will have max 6-8. A skilled nursing facility could have up to 25, but usually less depending on the acuity level they take. When I worked with 25 patients, it would take me about hour to an 1 1/2 hours, but that varied depending on what I was having to give. AM and PM med passes are usually the largest. It also depends on how the facility sets up the med cart. Sometime the med cart is organized and sometimes it is pure chaos and that effects how long.
As mentioned, nurse to patient ratios will vary by type of unit. I work on a 45 bed neuro rehab unit as a charge nurse. Our goal is 4-5 patients for days and 5 patients for nights. We try to avoid having the charge nurse take patients but there will be times the charge will take 1-3 patients to avoid having nurses take 6 patients. Of course, staffing can be a challenge and there are days where nurses take more patients.
We allow a two hour window for med pass with the exception of certain meds that must be given with a shorter time frame (diabetic meds, anti seizure meds, and parkinson's meds). This is especially useful during the morning med pass when patients are often in therapy. Naturally, patients that can swallow pills with water have a shorter med pass time than those who need them crushed and put in feeding tubes, and patients with more meds (like lung transplant patients) will take longer than others, so it varies a great deal. Our goal is to have morning meds passed by 10am (not sure if nightshift has a similar goal).
Depending on whether you get vent patients dictates or delegates how many you get, no vents 5-6 patients, vents or vent and 3, these patients all have surgical wounds plus they have bed sores or pressure wounds over the bony prominences, that can take hrs to do. The wound care nurse hides from this floor as you can imagine, so you have a momentous job on the documentation of community acquired or hospital acquired wounds that your head nurse wants to kill you for, the admitting nurse for missing a wound, and it gets charged to your unit. Bed sores are also graded and staged therefore have different treatments and gauzes with needed measurements. The surest way to success is to have a great reputation with all the techs in the hospital, so on any given day your tech will drop what she is doing to help you undress and turn and photograph your admission so you don’t wind up in the head nurses office charged with giving your unit a hospital acquired bed sore. Rehab nurses greatest challenge is team work because there is so much to do and only a limited access to perform the skill demanded of you. The goal of rehab is the patients success in therapy to get back to their highest level of function after catastrophic injuries, compete quads, high level paras, gunshot wounds, surgical wound infections, ABXs, wound care, class, food and a grueling schedule of physical and occupational therapy. They must learn to control their W/C or power chair and depend on someone else for everything even breathing, peeing and pooping wondering if they will ever again have an erection. They are looking at the others not knowing where their feet are; proprioception, because the Brain through the spinal cord controls motor, sensory, pain, temperature and proprioception. Some have phantom pain because of amputation, some need various amount of pin care with 1/2 NS and gauze, because they are wearing an Illizarov device, steel circles with pins in the tissue, that is holding their leg on to their body that was cut off by a boat propellor. Some are wearing a halo that needs pin care because their head and their spine is being held by pins in their head connected to a vest around their torso. The goal is to get them to learn and direct their care and most quit before they get started. There are psychological people all over the place working on their degree. It takes the greatest special people, not just as nurses, to love, encourage and inspire this population of patients, who are so broken that you have to put them back together before they can dream again. It is day by day, little by little, they are all your patients because as you are traveling from one of your patients to another, someone else’s patient will ask you for help. You must be well organized to survive and you will never work harder on any floor, I know, for I have floated and done overtime on 14 floors in 17 years at Jackson Memorial Hospital. I love rehab nursing because when you love people they love you. I was not of my own accord transferred out to Telemetry back when the hospital was fighting extinction when the Doctors and Nurses gave 80 million dollars of our own money in 2012, to save The county hospital and based on seniority the new CEO sprayed nurses to different locations, it worked. Forgive me for getting personal!
that depends in the ability of the patient to take medication and the type of medication, PO, IV, PR, top, SC
Typically with acute inpatient rehab, ratios are 1:6-7. Patients are usually in therapy for 3 hours and times vary by patients. Typically, your OT staff will assist with the bath/shower schedule as they work with patients during these activities to develop goals for discharge.
Depending on the hospital services offered, you may or may not do blood administration, TPN, care of extensive cardiac patients.
As far as a med pass, it does depend on type of documenting system. Most patients have several meds to take in the morning and afternoon before their therapy times and most meds will be PO, not IV.
What does help is the amount of assessments required. Assessments are allowed daily (unless your organization has a different policy). Focused assessments are completed but does decrease documentation requirements.
I worked the night shift (7p-7:30a) on a rehab unit. The bed count was 14. Usually, on average there were 7-8 patients. If that is the case, I'll take 4 and the charge nurse will take the other 3. Sometimes we had no Tech so we did everything, but if there were 10+ patients, there is often a 3rd RN until 11pm. The medication pass usually took 1.5 - 2 hours. Almost no one had an IV and the majority of medication were pain pills, stool softners, heparin and diabetics. The am medication took even less time (1hour). Always be aware that you can have up to 6 (rare).
At skilled nursing rehab center nurses can have as much ch as 16-24 patients (depending on which rehab facilities). Medpass takes a while morning till noon, again depending on the acuity level of the patients. Then you start medpass again before dinner.
My answer is solely based on the EMR requirements. Most meds are available to administer 1 hours before and 1 hours after the scheduled time. So, technically you have 2 hours before they're late.
20 over computerized customers but in person its the whole population of who all checked-in and discharged for being customers for the business side of caregiving.
In my experience 5-6 usually. Med passes can take a while as sometimes patients are getting therapy in the gym. In the rehabs I’ve worked the therapists have a schedule posted each day so nurses know therapy time and where to find patients. Med pass times vary depending on degree of aphasia your clients have.
It depends if you’re in a subacute building and you’re on a subacute floor you can have anywhere from 10 to 20 patients under your care as a nurse. Med pass for that many patients should take about 40-50 min. If you’re on a long-term care hall you can have anywhere from 18 to 34 residents the med pass tends to be a little bit longer at about an hour to an hour and a half if you know those patients if you do not and it’s your first time working with them your med pass is going to be anywhere from an hour and a half to 2 1/2 hours
Most of the time I have seven patients, I start right after report usually at 7am and finish at 9
My average is 8 patients as a night nurse. My med pass is 1.5 to 2 hours depending on how many medications are for each person o n and if I have to administer insulin it takes a little longer due to finding a second nurse for a two nurse sign off on insulin.
I work in a standalone rehabilitation hospital with 53 beds. An ideal patient load is 5 to 6 patients. As with most facilities, staff shortages abound. With our current night staff, we usually have 8 patients, but I have had as many as 13 before. Ideally, medications for my shift (7P to 7A), are passed from 8 pm to 10 pm on a good night. If the safety briefing or shift report goes long, you have 7 or more patients, have a lot of wound care to do, have an admission(s) in your section, or you have an emergency during that time, you may not finish passing everyone's medications until midnight. After that you start charting. Morning med pass starts at 5A and ends at about 0630. You finish and close your charting after your morning med pass. The AM shift is on the floor for report by 7A.
It is state dependent regarding patients/ rn. I do not know what a med pass is.
