Career Spotlight: Working in a Skilled Nursing Facility

These days, newly licensed RNs often start out their careers with a job in a nursing home because hospitals have become more reluctant to hire inexperienced bedside nurses. Many of these nurses want to put a couple years of experience under their belts and then move on. But it’s worth it, at any stage of your career, to consider whether a nursing home might be right for you.

Job opportunities at SNFs may be on the rise as the population ages. According to the U.S. Census Bureau, the number of adults 65 and older will double from its 2012 level by the year 2050—to nearly 84 million people. Because of this, the aging-in-place movement is also picking up traction, yet for many elderly people aging at home will not be a viable option.

Unfortunately, nursing homes have been stigmatized, as media investigations have uncovered cases of neglect, elder abuse, and even assault. This is just one more reason that nursing homes need compassionate, dedicated nurses who will stand up and advocate for their patients. Working at an SNF means you’ll be caring for some of the most vulnerable patients out there: the frail, the cognitively impaired, and those without involved family members nearby.

There are several ways an SNF job may differ from bedside nursing in a hospital. Here are a few comparisons:

  • Nursing homes tend to have higher patient to nurse ratios—possibly as high as 15 to one—because the patients are assumed to be more medically stable. Staffing formulas often rely on a higher number of LPNs and nursing aides to assist patients with bathing, toileting, and feeding themselves. Yet, as hospital stays grow shorter, the patients who transition to SNFs may still have PICC lines, ostomies, infectious diseases, or wounds that need constant monitoring and attention.
  • Time management skills and efficiency are essential when you’re in charge of 15 patients on your own. There is still quite a bit of paperwork and documentation to handle, and you may be called upon to update family members as well.
  • Because the inpatient population doesn’t turn over as rapidly as it does in hospitals, you’ll be able to form close bonds with your patients and their families. You’ll be able to share in birthday and other family celebrations, visits from therapy animals, personal milestones, etc. You’ll also be working in a comfort zone with some patients, where you know their needs and are able to deliver an exceptionally high standard of care.
  • Collaborative care becomes an important focus, as you work closely with LPNs, physical therapists, speech therapists, occupational therapists, case managers, and pharmacists.
  • Your pharmacology skills and knowledge also become of greater importance, as you’re in charge of dispensing medications on a long-term basis. You’ll be watching for troublesome side effects that develop over time, as well as dangerous drug interactions and dosing errors. At the same time, you may feel that you’re not using clinical skills like drawing labs, starting IVs, etc.
  • As with all bedside and direct patient care jobs, burnout is a risk. One study found that over a third (37 percent) of nurses at SNFs report symptoms of burnout. You may also be working for lower pay: according to the U.S. Bureau of Labor Statistics, RNs employed by SNFs earned an average of $8,270 less in 2012 than nurses working for traditional hospitals.

If you enjoy working with the elderly and building closer relationships with your patients, a career in skilled nursing facilities may be for you. You might even see yourself earning certification in geriatric nursing or moving into a management position. Education can help you make a difference in the lives of your patients. Would you like to empower yourself with knowledge through an online RN to BSN or RN to BSN/MSN degree? American Sentinel University is an innovative, accredited provider of online nursing degrees, including programs that prepare nurses for a specialty in case management, nursing education, and executive leadership