1. Trust me, your instincts will tell you when a place is a decent SNF. Ask to talk to floor nurses prior to working like during the interview.
2. Red flags of micro managing are usually picked up once you start working for a place. Look out for new policies being made up everyday.
3. Decent ratio depends on where you are, what shift your doing, and so forth. The most I've seen at night is 1:30, sometimes I've had that much working 3-11. Hopefully there is better. Most important you have to be comfortable.
4. Documentation ehh? I suggest you make friends with the MDS nurse
Used to do MDS, and we read a lot of bad notes! Generally Medicare pts are qshift, and if they are getting PT/OT/ST/RT chart it. Example, Pt rec'd PT this shift. Also chart O2 usage. Chart on FC, IVs (what type, what drug, yada, yada). Chart wounds (measure please)!!! Are they better, worst? ADLS: Is the pt total care? Does he eat by himself? As always chart what you did for the pt. And please, please pt's on psych drugs NEED to have documented behaviors. I cannot tell you how many times I've had a nurse tell me a pt is combative, but the notes say nothing, and the MAR has a bunch of Ativan entries! :bowingpur
P.S. I kid you not I once read a nursing note that said, "Pt ate a big ole piece of bread." I almost fell out of my chair laughing! So much for I&Os!