I've looked through and searched several pages but cannot quite find much about this topic with many good answers.
Does anybody here work as a NP in a SNF/nursing home/assisted living? There are many postings in my area through independent companies placing NP's in these facilities and was wondering how the work was, if pay any better or worse, what a typical day is and anything else that might be helpful.
I went rounding at a local SNF with one of my preceptors and it didn't seem like bad work.
@Oldmahubbard, interesting post! I am an RN interested in geriatric and psych, and I have been wondering whether to go to a Geriatric/Adult NP or PMHNP program. Working as PMHNP sounds interesting. If you don’t mind me asking, what do you like/dislike most about your job and how hard was it to get into LTC for psych? Thank you!
I work in a 64 bed facility. We are a little different as we only have rehab (short term beds), no long term. I easily see 15-18 patients per day. I love my job and the autonomy that I have. Been doing this for 3 years.
Hello, I found this thread as I have been offered a possible position in a LTC facility/rehab. The position would be part time and I would have some clinical duties, staff development and other. I was approached about this possibility and need input to make the best informed decision.
I am a FNP and am reentering the work force after a 10 yr break from raising kids. I have been a clinical faculty for BSN students the last 5 years and want to go back to work as NP part time. I have not experience in LTC/Rehab. From what I read, the workload can be heavy with lots of paperwork and facilities have many state and federal rules and regulations to follow. My question is how steep is the learning curve for a FNP? Do you need adult gero experience ( I have primary care background)? Any tips or advice is welcome. Thx in advance. SH
This is a reply for Susan D.H. I admire you for taking a break from nursing to take care of your family. Kids grow up way to soon; before you know it, they are teens and off to college. I have LTC experience as an NP. I am a geriatric NP, so I love this population. Its a whole different world than primary care, thus yes it will be a steep learning curve. There are many challenges. When you work in LTC, you will have a mixture of custodial and rehab (skilled) patients. Think of the nursing home as your mini-hospital; staff nurses will be calling you for orders and you're "the doctor". You will have a panel of patients that you are in charge of managing. At various times, you will have to "skill" your custodial patients who get sick (e.g. Convert for custodial status to skilled status, when you give IV fluids, order more than 2 days of PT, etc. Certain procedures like IV makes someone "skilled" and no longer custodial). Or you will have short term admissions only (SNFs love those $$$). There may be intense pressure to keep patients from being admitted to the hospital, pressure to limit "skilled" days (they are expensive compared custodial days). You will many times have to speak with family about hospice enrollment (expect some No's). Dont start treatments without getting the OK from the DPOHC (at least a notification not just permission, e.g. Aricept). Invest in the app Epocrates to get the latest meds, med doses, treatments, labs, dx definitions. Get the monthly subscription and not the free app (which is bare bones). There are other apps like Prescribers Letter. There are SNF politics and drama, but hopefully you will be removed enough from those, because you are in and out. The good new is: If you work for an insurance group or company- they will provide a mentoring/partnering physician; he/she should be available for all kinds of difficult medical cases, as well as joint visits/rounding. The company will also have guidelines, standardized procedures, resources on-line, education classes. You will/should have an NP manager; you can approach him/her for any operational/admin/charting problems, and also issues you may want to discuss before calling your doctor. You will have other NP colleagues to *** and moan with, and there will be monthly meetings/social gatherings. There will also be specialists that patients already have, so you are not the end all, be all. If you are hired by a physician in private practice/solo, then this may be more of a challenge because you may not have all the support that a company provides that has an army of NP's. I wish you the best of luck.
PeaceofMind19
2 Posts
@Oldmahubbard, interesting post! I am an RN interested in geriatric and psych, and I have been wondering whether to go to a Geriatric/Adult NP or PMHNP program. Working as PMHNP sounds interesting. If you don’t mind me asking, what do you like/dislike most about your job and how hard was it to get into LTC for psych? Thank you!