After working my first nursing job in an inpatient drug rehab for 2.5 years, I was hired by large SNF company, with 29 facilities in the region. I'm currently in orientation which is scheduled to last 1-3 months. The patient load is about 25/nurse. At the facility I'm training at, there is an LTC side and an Acute side, but I will be transferring to an all-acute facility after I complete my training. There is an electronic record system that seems efficient and easy to use. I haven't noticed a shortage of supplies (but this is my first week). We have med-aids pass a lot (but not all) meds when census is high, and when it gets low, then the nurse takes over that duty. Compared to the specialty psych environment I came from, this is much harder work. Compared to my clinical experience at the hospital during nursing school, this is still slightly harder because of the high patient load. I find it intimidating to have to be responsible for 25 people, but I suppose it's better than some other places, plus it looks like we have decent support (DNS, RCMs, CMAs, etc.) The nurses do a lot of hands-on work (especially wound and skin care). The RNs also work very closely with the CNAs to feed, transfer, and maintain hygiene. Everybody changes diapers, including the RNs. There's much more dementia at a SNF, and that's a big difference between it and a hospital. Working with patients who have only basic communication skills, and sometimes no verbal communication at all is something that boggles my mind. But to summarize, and address your question once more, I think SNF nursing is harder than hospital nursing. The benefit is that if I can succeed in this environment, then I think I will be well-prepared for hospital work. No problem!