LTC-What is meant by "The skilled nursing area of LTC"

FLArn · Nov 6, 2012

The skilled area is the section of the facility where the patients who are having PT,OT,ST and skilled nursing care IV ABT, etc. usually immediately after having a stroke, MI, or surgery for knee/hip replacements, CABG etc. They are usually in the facility for only a few weeks. This is the "money making" area of the facility as opposed to the residential or long term side which is the stable (reasonably so) patients who live there indefinitely. The skilled side is today's equivalent of yesterday's hospital med/surg floor. We get people on the 2nd or 3rd day postop. There could be IV's, Trachs/vents, TPN, traction, BiPap/CPap and these patients are more acutely ill and require frequent assessments.

Blackcat99 · Nov 6, 2012

Thank you so very much FLArn. I will study up on these skills.

Blackcat99 · Nov 7, 2012

I forgot to add that I am also looking for a good nursing clinical book which would be helpful to use while working in the skilled nursing area at LTC. If anyone knows of any good books that would be helpful in this area. please let me know. Thanks again.

AngelRN27 · Nov 7, 2012

Please note that not all patients in Skilled Nursing have to be as acutely ill as described above. Any resident in long term care that cannot care for themselves completely and therefore is not part of the Assisted Living (ALF) portion of such a facility, falls under Skilled Nursing.

VANurse2010 · Nov 8, 2012

It's the part of the nursing home where intractable frustration and demands on your time outside all realms of reality reign supreme.

Blackcat99 · Nov 8, 2012

So that's why they suggested I go on the skilled nursing side? It's totally impossible. Yikes!!!!! :eek:

CapeCodMermaid, RN · Nov 8, 2012

Please note that not all patients in Skilled Nursing have to be as acutely ill as described above. Any resident in long term care that cannot care for themselves completely and therefore is not part of the Assisted Living (ALF) portion of such a facility, falls under Skilled Nursing.

In Massachusetts, that is not true. We are called a skilled facility because we provide skilled care, but not all residents have what's considered a 'skill'.

You will learn all sorts of new things working on a short term floor. We've just started to put in our own PICC and MID lines something you'd NEVER do if you worked at a hospital. The business is changing and those facilities and nurses who can change with it are the ones who will thrive.

AngelRN27 · Nov 12, 2012

In Massachusetts, that is not true. We are called a skilled facility because we provide skilled care, but not all residents have what's considered a 'skill'.
You will learn all sorts of new things working on a short term floor. We've just started to put in our own PICC and MID lines something you'd NEVER do if you worked at a hospital. The business is changing and those facilities and nurses who can change with it are the ones who will thrive.

I'm not sure what you mean when you state that "not all residents have what's considered a 'skill.'" ... I made no reference the the *residents* having skills LOL. Your response supports mine. I simply meant that not all residents in a SNF are as acutely ill as described above.

BrandonLPN, LPN · Nov 12, 2012

What bugs me about facilities that have a "skilled" hall and a "LTC" hall is that I don't see a big difference in staffing between the two. I see the nurses in the skilled hall who have 3rd day post ops, just had a MI, on IV ABX, etc. And they *still* have a ratio of nearly 30:1. I get that the object is to create a less expensive level of care than the hospital. But you can't give a nurse 28 patients and expect him to provide an almost acute level of care. Just not possible.

Anne36, LPN · Nov 12, 2012

Before I started working in Long Term Care I had this idea that it would be mostly passing meds and doing treatments. That is what sucks up most of my time, but I did not expect all the assessments, careplans, calling Dr , vital signs q shift (really?) , etc that need to be done as well. I cant believe I made it through my shift last night without having to call the Dr, order tests, or some other intervention. I did put 2 residents in the Dr book however. I think the Nurse to patient ratio needs to be cut in half for what is expected, I am in the middle of med pass at dinner , trying to get all my diabetics covered and then I have a resident O2 sat go down to 81, wont comply with her nasal cannula, physically fights me off when I try to take her O2 or put her cannula on. If I have to intervene with a sick resident, Im in big trouble with my med pass. There isnt even anyone there to answer the phone, I thought that the Nurse was not supposed to be interrupted during med pass? (Thats a joke)

thenursemandy · Feb 23, 2013

I'm starting a FT 2nd shift job on a skilled/rehab hall. I'll have 10-15 residents and 1-2 aides. :) I've worked Dementia, LTC and Assisted Living, but not Rehab. I'm looking forward to having so few residents since I've always had 20-30 in the past.