My new grad experience at an SNF

[alltheway2013]

Hello all! I love this site and just wanted to share my 4 months experience of working as a brand new nurse in a LTC/SNF. I started off my first month with one week of orientation on the "long term care halls" where I had close to 60 patients. I was really overwhelmed and could not for the life of me get everything done on time. But let me mention this as I know not all facilities have them. I do have med aides and a treatment nurse, so that, im sure makes a world of a difference.

After about a month and half I got moved to the rehab/skilled hall where I have up to 22 patients. Here I have done many many skills like insert IVs, IV meds, insert foleys, ostomy changes, Peg tubers, IM injections galore, Resp tx, PICC care and removal, among numerous other things! I have had to call codes, perform CPR, assess sudden changes in pts and of course call docs and input orders. I have loved it and think it was a great start to my nursing career. In the beginning I heard it all from, nobody will hire you to you will lose your skills...this is not true at all! It took some time to find my mojo but I have and enjoy going to work. I will say you have to be determined and strong enough to be able to stay. In the short 4 months I have seen many come and go.

I wanted to share because I know alot of new grads are in the position of needing a job but unsure of where to go and hear the negatives of starting in SNF/LTC so here is a little positive. Yes I know having the med aides and tx nurse is a HUGE factor in my positive experience, but I am always on the move and hardly sit as there is always something needing to be done.

I will admit that I am getting bored at times because it can be repetitive but for now I am okay with it as i go through my RN-BSN program and plus have my baby :) I will eventually leave after the birth but for now it works.

[thenightnurse456]

I'd go for option 2. Rehab plus SNF so you'll get experience in 2 areas which will look better on your resume when applying for other jobs later on.

Avoid the registry, that is optimal for experienced nurses.

All the best

[nbamus]

Thank you thenightnurse456. I also believe it is too risky for me to work in the hospital at this time since I don't know what I am doing.

[garciadiego]

I also work at a LTC/SNF facility, although I am usually with the LTC residents, about once a month I'm foated to SNF Rehab unit, and if I had 22 residents I'm not sure I would ever find my "mojo". Your suceeding, which is nice to here from a new grad.

[eggyweggy, MSN, RN]

I am really enjoying my first year of nursing in rehab/LTC facility. I took the job after I had about 6 months of experience doing private duty nursing with trach/vent patients and I've been doing rehab/LTC for the past 6 months. I really enjoy it and I've learned a ton! I like the variety and skills I've been able to learn on the rehab side and I enjoy the familiarity of the LTC side when I float over there for a few days during each pay period. Management at my facility is very supportive and teamwork is great. Either the MD or the NP is in the facility four days a week and they are available by phone 24/7. I have up to 12 patients for rehab (with one aide) and up to 20 patients in LTC (with one aide). LTC is mostly passing pills all day with a few assessments/treatments for some patients. On the rehab side, I deal with PICC lines, focused assessments, wound vacs, g-tubes, catheters, colostomies, med administration via all routes, chronic illness, hospice patients, ETOH detox, and a million other things. The average patient stay is about 30 days and the continuity in assignment from shift to shift has really helped me hone my assessment skills and improve my time management skills. We have an in-house MD and NP who are in the building during the week and on-call 24/7. Management is very supportive, my co-workers are great, all of the aides I work with regularly are rockstars, and my schedule fits my life perfectly right now. I'm working straight days as a new-ish grad and my commute is less than ten minutes. I'm also finishing up my RN-BSN program next spring and this has been the perfect job for that. I wouldn't be surprised if rehab nursing ended up being my niche. I really like the level of acuity I get in rehab -- acute enough that I get to do plenty of nursing skills but not so acute that I always feel like I'm in over my head as a newer nurse. My confidence has grown tremendously since I started this job.

[eggyweggy, MSN, RN]

Actually, that was up to 20 LTC patients with TWO aides. Guess I don't have editing privileges. :)