Advice regarding staffing in SNF

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I am a new RN who has worked for 6 months in a SNF. Overall, I enjoy my job because we work with many acute cases directly from the hospital and I have learned many new skills and feel that I am continuing to learn. The drawback is the patient:nurse ratio. On average, I have 8-12 patients with 0.5-1 aide. This means that I often need to help with aide work (which I don't mind if I had time!) but with PICC lines, feeding tubes and LVADS to deal with, I feel that I cannot give anyone the proper amount of time. I often leave work wondering what I have missed since I was running from one room to another. We are also required to punch out on time and no OT is allowed. This also means that I need to cram in my charting, often writing the same thing that I wrote the previous day. So I feel that I am not giving the proper care that I should be giving.

I have read many posts on this forum about pat/nurse ratios and I realize that many SNF/LTC are like this so I am not surprised but I feel like I am working in unsafe conditions and have started looking at new jobs. My concern is if this is the new normal in other facilities such as hospitals, clinics, etc? or are these horrible ratios contained only to SNF/LTC facilities?

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Specializes in Care Coordination, MDS, med-surg, Peds.

I have many many times in a SNF, been the only licensed nurse, on day shift, for upto 60 PTs. With CMT to pass meds and 2-3 CNAs. It is hard!!!

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I have worked in SNF & subacute for many years. 12 residents is a very light assignment. Unfortunately patients are sicker in both the acute and SNF.

In my last subacute job one LVN had about 8 patients and all had trachs/many were on mechanical vents/all had GTubes/most were 100% total care. So each LVN has trach care, suctioning, tube feedings, meds, treatments, showers...and it was very doable once you get into a routine.

In a typical SNF, each licensed nurse will have AT LEAST 20 residents on day shift. It is hard work but so wonderful, once you get a routine down and prioritize really well. A lot of it depends on the quality of the CNAs too!

I wish you a lot of luck and happiness in SNF nursing!

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