Am I nuts to want a PRN SNF job?

[mclennan, BSN, RN]

I'm currently a BSN-RN with triple ANCC certifications (Gerontological Nursing, Ambulatory Nursing and Nurse Case Manager) with 7 years experience ranging from Public Health, clinic, HH and now case management. I'm 40 years old with a prior career in IT.

I work now as a case manager for a large medical group, sitting at a desk on a phone most of my 9-5, M-F week. Pay and benefits are good. But......I need extra money!!!

My co-workers and I were reminiscing the other day - about our humble beginnings, and most of us started in SNF/LTC. I realized how much I missed the "old days" of pushing the med cart down the nursing home hallway and working with old people (yes, I enjoyed even the abusive crazy ones). I used to work as a CNA/med aide in a small, high-end LTC that was a pretty, clean, quiet little place with decent staff & good morale. This was in the Midwest in the late 90s/early 2000s.

Do places like this even exist any more? Have ALL the nursing homes/assisted living places just completely gone down the toilet? Or are there still a few independently owned, small, nice places that are good to their employees? I'd love to get a part time/every other weekend/PRN job at somewhere halfway decent. Just to make some party money. Any DONs have insight on if I'd be laughed out the door? Anyone working SNF/LTC want to share what an RNs role is there these days? I really don't want to supervise; I almost want to do CNA work! I miss working directly with residents and answering call lights. CRAZY, I KNOW.

Thoughts?

[xoemmylouox, ASN, RN]

I don't see them hiring you for the floor with your education, but it's always worth a shot. I think PRN or part time would be fine for some extra income.

[netglow, ASN, RN]

Pretty sure you are overqualified. Nobody seems to care if you want the job and that the employer would really benefit from having you!! People these days don't seem to consider that. Every once in a while I hear of a nice little SNF/LTC but, of course they don't have openings because they tend to keep their employees. There is a very nice remodel near me, it's beautiful, and in a wealthy neighborhood but they consistently rate in the toilet because the new owners bought and remodeled for only one thing, $. And, of course if you apply you must in person so they can get a look at ya.

[RN&mom]

I work at a small (61 bed) LTC/SNF facility that is family owned. Third generation of this family owning it actually and there are several family members working there (cousins etc). We are generally quite well staffed, 2 CNA's called out and we still only needed to find 4 hours coverage. Though call outs are rare but we had a nasty bug going around... I didn't even know this facility was there until I saw the ad on Craig's list. I live about 40 minutes away and have shopped just up the street but they are on a side street, more like a residential place. It's nice, I like it much better than the facility I came from which was double the size. So yes they are still out there but they don't have the budget for huge advertising, generally it's the local paper and maybe a free site like Craig's List. I was also a CNA for a long time before I became a nurse and I love the smaller facility for the time I get with my residents.

[RN&mom]

Sorry I didn't explain the nurse's role. It's different for me because I am charge and while at some facilities that's just a title it's not at mine... But I'll give you a run down of what all my other RN's do.

All dressing changes, any narcotics, basically all other meds are given by med techs. Assessments on skilled pts are rotating, depending on room number that will decide which day which shift assess's them. Of course theres admissions & discharges, overseeing the med tech and CNA's. Doctors come 3X week, write orders. Wound doc comes once a week, when he comes you round with him. The obvious stuff like keeping an eye on the BM's & wgt's. I have a trach pt with a g-tube, so that pt alone is time consuming. I'm sure there's a million little things I'm forgetting (and probably some big things too) but you get the idea.

[BrandonLPN, LPN]

Wait, facilities that use med techs have them doing all the dressing changes now, too? Tsk-tsk.

Anyways, it's been my experience that a RN's role depends on what kind SNF it is. I work at a facility that's really more old school nursing home, all LTC. We don't do heavy duty rehab or subacute. Places like this will tend to have LPNs (or, god forbid, med techs if your state allows them) passing meds, doing dressing changes, vitals, charting etc. The RNs where I work are strictly "desk nurses".

The more common facility these days seem to focus more on rehab and subacute. These places have plenty of IV therapy, post ops, vents and stuff like that. They seem to use a mixture of LPNs and RNs. Both work the floor pushing a med cart.

You might have a hard time landing a floor job in the former. But I doubt very much that the latter would reject you as overqualified. Most SNFs of this variety would welcome the education and experience of a BSN RN.

[VANurse2010]

When we're talking about PRN, I doubt any of these facilities would reject anyone as overqualified - provided you're willing to work for the pay they offer.

[Morainey, BSN, RN]

I am light years away from your qualifications, but I work per diem in a SNF and I really like it. It's a nice change of routine from the hospital, and extra cash in my pocket. I don't think your qualifications would disqualify you if you were going to work a straight per diem position if, as PP mentioned, you work at the standard per diem rate.

[mclennan, BSN, RN]

Yeah, basically I'd love to find a situation where I could work a shift every other weekend with option for picking up more, for the standard rate - no big bucks, just a little something to keep my chops sharp & a little extra in the bank. I miss working LTC. It's just that I see horror story after horror story on here and wonder if it's really that far gone.

I'll "SNF" around (haha!) and see what I can find. I'll even offer to precept or train, whatever is wanted. Should be an interesting search :)

[jbecerra]

I think that with your qualifications you would be placed in a supervisory role...which is not too bad on nights. Have you considered teaching part time?? With your knowledge and experience, you could be a valuable asset as an instructor, like teaching Nurses Aides. Or even as a part time Clinical Coordinator, providing education and in services. Good luck!

[microkate]

I actually just lucked into a really nice SNF as a new grad. Clean, well-staffed, everyone has been really friendly and helpful. There are plenty of aides. The pace is hectic but manageable for a new grad, so I'd guess for a seasoned nurse it would be easy. I know they keep a number of nurses on file for per diem work, and most of them can get a couple shifts per week if they want.