Is this normal?

[brendacg]

Hi all,

Ive posted here before and I've always received great feedback when I've had questions in the past. I've only been working as a nurse since July on a SNF and I've really tried to stick it out to get my experience to get a hospital job. Recently, our nirse manager left and so the DON has offered me the position. I've been trialing it this past week and it's really made me reevaluate my facility.

A couple weeks ago, we had our state survey. All the staff, administration and management included, had been working really hard for months to make sure everything was perfect. So our staffing was decent and it seemed like people had a little pride in our company. Now this week, it's like everyone is back to not caring about doing a good job. Our staffing is short again (on purpose, mind you), and back to the corporate agenda of cutting the budget. Back to sending staff home early if they accrue even 2 hours of OT. Now our administrator is going to switch physicians groups because our covering NP is wanting to send patients home at appropriate times while other departments are coming up with reasons to keep them. This disgusts me, especially when a patient is so obviously ready to go home, but because of the almighty dollar they are being kept for extra time.

I applied to a more reputable SNF today, which is too bad because I'm not one to job hop. Are there SNF facilities that don't operate in this manner or is this normal?

[SuzieVN]

Most SNFs are out of compliance with lots of stuff, and cram pre-survey to fix things, and they do it by adding staff, and calling in the coporate hounds. When all is clear, yes, back to normal. And every place tries to hold onto patients, get more of them, and keep them longer. It's the administrator's job to fill beds, simply said. It's everyone else's job to try to keep patients as long as they need to be kept. SNfs also have 'constant' UR meetings, care plan meetings, etc.- all the chiefs determine what's best for the patient, length of stay, whatnot. Sounds like the NP there is not on the same plane as the SNF staff- but in fact, she may be facing pressure from the insurer to discharge patients sooner than might be in their best interest. Lastly, I've seen loads of peeps get d/c'd home too soon, just to go through all that headache to be readmitted. There are a lot of forces at work behind the scenes, with different agendas. Ask if you can attend a utlization review meeting and/or a care plan meeting with the management- you'll get a feel for the complexities.