Going From Med-Surg in Hospital to SNF - Advice?

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Hi all,

About to move to my dream location but am making an odd career change to do so - I have a little less than a year experience at a Top 10 Teaching Institution on a busy busy Med-Surg floor, and am going to be making the move to a SNF. It doesn't seem too different then what I do now as far as functional tasks, maybe just more repetitive. I am worried that I'm going to be making a step backwards careerwise, although I love geriatrics, and am looking forward to having longer-term patients than 3-7 days at the hospital.

Just looking for general comments (good and bad). Thanks! ;)

One thing that you may find frustrating is the lack of "immediate" procedures .. ie labs .. Even if you order stat labs, they need to come out draw them bring them back then wait for the results.. Same with x ray, etc. Things are not as readily available as they are in the hospital so where on a med surg floor you might have your test done and results in within 45-60 minutes, things take hours (at least at my SNF). So, if things can't wait and they absolutely need an EKG and labs and whatever .. Out they go to the ER.

Also, yes your patients typically have a longer stay, your patient to nurse ratio will probably be doubled (or more), so you still don't have tons of time with them. Although I will say, there is something nice about coming in, knowing the history on patient X and being able to ask in report what the status is with xyz issue or see how they are progressing with PT etc.

I like my sub acute SNF floor.. Trying to figure out if its "for me" or if I'll move on, but I'm learning lots :)

Specializes in ED, Long-term care, MDS, doctor's office.

I really would try to stay in hospital nursing for a bit longer if you can...You can always transition from hospital to SNF, but once you are considered SNF nurse, it is very difficult to get back into a hospital:(( You will also find that you will probably have 20+ patients, many who are complex and you still are expected to get all of your work completed in a timely manner. Another down side is that many nurses who you will work with do not have the critical thinking skills that are needed to care for these more complex patients. Your hospital experience will be very valuable to you, but you may find that other nurses who lack the hospital experience do not catch abnormalities as easily & you will most likely be finding a lot of extra issues which need to be dealt with (abnormal labs, condition changes with patients, etc.) Good luck to you:)

I worked at an SNF for a few months. It was horrendous. I'm not trying to knock SNF nursing - some people love it. I was constantly running from the moment I clocked in. You don't have enough time to spend with your patients. I'd be constantly pulled in all different directions. I would so love to get a hospital job but I think that door has closed. I felt that when I had to call the hospital regarding a patient the hospital nurses looked down on me. I often had to work by myself on a floor with 25 patients. I hope you are happy with your choice.

Specializes in Adult Nurse Practitioner.

I have done hospital, skilled, then hospital nursing again. They are two distinct nursing styles. SNF is slower paced. Your patient load is much higher and you do not have the support mechanism you may be used to in the hospital setting however you develop a much more personal relationship with your patients and their family/friends. You are extremely dependent on those you supervise. Would I do it again? No...I did not like waking up from a deep sleep and know that "so and so" just passed away. Now, with the cuts from medicare and medicaid, it is going to be tougher and tougher to provide the care I feel appropriate.

Thank you all for the feedback, and the honest feedback. It's unfortunately a huge step forward for a lot of personal reasons, so I won't be able to say no. I am very nervous, but, I network for myself well - so I hope that if it ends up being "horrendous", I can leave after six months or so. :nailbiting:

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