Sub-Acute Skilled Nursing Facility

CapeCodMermaid, RN · Mar 12, 2014

It's difficult to say. Some skilled facilities do all those things. Mine does not do vents but we do all those other items you listed.

Benj2610 · Mar 12, 2014

Thanks CapeCodMermaid... I guess any experience is good experience & I don't have a lot of options (I need to be employed) but I'm nervous about how this might look on my resume if I want to work in a hospital.

I'm also skeptical because it was hardly an interview (as if anybody that applies gets hired) along with it being per diem (until after orientation) indicates high turnover.

(per diem in contract position/travel nurse/part time kind of thing makes sense to me... but per diem when I only have 3 months professional experience thus far indicates high turnover).

pooh1258 · Mar 12, 2014

The last place I worked was an SNF and a Sub Acute Rehab in one building. One section was Sub Acute Rehab, the rest of the place was SNF. Sub Acute Rehab had three nurses usually - 2 LPNs that each had 20 patients each that they were responsible for their meds and tx (wound/dressing care, nebs). There was a charge nurse who was responsible for all daily assessments(split to about 15 for each shift) and any pts that were out of scope for the LPNs (usually a few), all care plan updates, admissions & discharges (usually a few each day from hospitals). There were 3-4 CNAs each shift too. Most of the people stayed in the Sub Acute between a week to 90 days. They get PT, OT, Respiratory, Speech services daily on this floor depending on what their admitting diagnosis is. They have to comply with tx plan and show some progression towards baseline if they "want" to stay in the Sub Acute area. Some moved up to SNF after 90 days if they maxed out insurance and weren't back to baseline/able to go home.

The SNF floors were one RN and one LPN(meds) for 40ish patients. Only daily assessments were for people with a certain insurance/admission status. RN was in charge of LPN and CNAs, did everything on the floor for the shift except meds (LPN did this).

The hospitals in the area where I was flat out told me in one way or another -"It's great you did something and we consider it, but that experience isn't necessarily applicable to our facility because it's not acute care." None the less, I got a job in another hospital facility out of the area.

Benj2610 · Mar 13, 2014

Thanks pooh1258...

Its exactly that last part of your post (experience) that's been on my mind.

jojo489 · Mar 13, 2014

I work on our sub acute rehab floor. We have 60 beds, 3 nurses (with 20 residents a piece) and an RN unit manager that basically does paperwork all day off the floor but is available as we need her. We get a mix of LPNs And RNs working on the floor and we're responsible for passing meds, all treatments, and writing/changing orders and keeping doctors updated.

We get patients from the hospital post ORIF or really any surgery and they come for rehab and like the poster above me said, usually their length of stay depends on how well rehab is going, usually a week to 3 months and we have PT OT and speech therapy. And if they're in rehab and showing no progress, insurance will cut them and if they're not ready to go home they'll usually end up on one of our long term floors.

I think it's a good place for a new nurse to start out...you get a lot if experience with a lot of different diagnoses and other things, like PICC lines and wound vacs. And time management. You'll learn quickly how important that is. And from what I understand, at least in my area, hospitals are okay with this sort of experience because you've had a small taste of what it's like to work a med surg floor and they appreciate that.

I was just actually talking to a soon to be nursing student last night and told him that even though he's going for his RN and probably has a plan to work in a certain place, if or when they don't hire him for having no experience, he shouldn't be afraid to try out long term care for a little while. He seemed to appreciate that little bit of advice.

Here.I.Stand, BSN, RN · Mar 15, 2014

LTAC=long term ACUTE care. LTACH=long term ACUTE care HOSPITAL. :yes: It's acute care that occurs on a longer term basis than what pt's are able to get in a typical hospital, usually weeks to months. The only thing LTAC has in common w/ the LTC is a similar acronym. This posting is not an LTACH...it's sub acute, and not a hospital.

Some nursing facilities have different types of floors. The last one I worked at had standard LTC, memory care, and sub acute rehab...so that might be what the "long term and short term" is referring to. It sounds like this one uses a team nursing approach w/ the LPN doing the med pass and the RN doing the assessments, care planning, treatments.

Esme12, ASN, BSN, RN · Mar 16, 2014

thread moved for best response