Nervous about beginning work in a Sub-Acute/SNF

Nurses New Nurse

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I was recently offered a position at a sub-acute nursing facility. I asked the nurse:patient ratio and was told 1:17 but it could reach up to 1:30.

Over the past few days, I've been freaking out from all of the horror stories I read about nurses' experiences in LTC/SNF/Sub acute units.

Any experiences (good or bad) or advice that anyone can give me? Things I should know, have, etc.? Tips?

I start in a week and I want to be as prepared as possible!

Yes, I am in the same boat. My facility said 1:10 ratio. I am concerned because the most I've had as student was 3 patients. Definitely would appreciate any tips and advice.

Specializes in Ortho.

Remember that you're a novice and don't compare yourself to others.

I was an LPN in a 69 bed facility for a year before we moved after I graduated RN school. There were 2 nurses on duty, front nurse and back nurse. We each had approximately half the beds that we were responsible for, and our beds were always full.

It can be a bit overwheming at times especially during 0800 med pass. (the biggest one) We didn't have med aides to help us pass our pills. We basically had to do full head to toe assessments on any 'skilled' resident each shift and focused assessments on any 'hot charts' that were on the rack for follow up on anything from a fall to a med change. So really even though I had 35 residents, they were low acuity and keeping them safe and off the floor was my main concern. Along with their meds 3x per day and whoever had treatments.

I can say I never had a dull moment there, and I learned a TON of useful information that I can bring to my new position in acute care. We all worked as a team and did what we need to care for our residents. Time management and prioritization are very important.

Good Luck!!!

I had a negative experience in this setting. I feel that even with lower acuity, 1:10+ is NEVER safe or effective care. I work medsurg now, and looking back to my snf/subacute experience, i took away 1) time management and 2) document, document, document. i now have 6-7 at most, and even then it's difficult to stay caught up some days. but i always make time to chart, not only is it a requirement, its the only way to protect my license. i hope you have a more positive experience with your job. not all facilities are the same.

Thank you, guys!

I hear a lot about time management and documenting. I was doing some research online and found sheets to help with keeping organized so I might try that out to remember med times, etc.

Hi Rnaria I was wondering if you wouldn't mind sharing those sheets. I am very nervous but excited to start this next chapter!! Yay, did it!

Hi Rnaria I was wondering if you wouldn't mind sharing those sheets. I am very nervous but excited to start this next chapter!! Yay, did it!

Of course! I'm going to make one specific for sub-acute and I will definitely send it over! PM me your email address!

Specializes in HIV.

If it "can" reach 1:30 it most likely IS 1:30, haha. I would never take a job with 1:30… unless I was completely broke and nearly bankrupt. I started in SNF and it can be dangerous depending on patient acuity. However, I feel that after working as a nurse for a while I could probably do better in an SNF than when I was a new grad. It's a learning curve like any job - just make sure you have enough support. And ask, ask, ask.

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