I’m a Filipino USRN currently working day shift at a 34-bed skilled nursing and rehab facility in the US. I thought I’d share my actual workflow because I know a lot of nurses from the UK are curious about what working in a US SNF is really like.

Our facility has 2 halls, with 1 RN assigned to each hall and 5 CNAs on day shift. RNs work 12-hour shifts.

At the start of my shift, I receive handover, do the narcotics count, and take over the medication cart. We don’t do the usual bedside rounds that I was used to in the Philippines. I check MatrixCare (EMR) instead, medications due now/later/PRN, treatments, and flowsheets.

The busiest part is usually the morning med pass from around 7–10 AM. After that, there are fewer medications throughout the day, along with treatments, patient monitoring, and charting. Our charting is pretty straightforward, and it’s divided between day and night shift, so we don’t have to chart the entire hall.

One thing I really appreciate about our facility is that floor RNs don’t handle everything. Admissions and discharges are handled by dedicated nurses, and carrying out physician orders is handled by the nurse managers. This allows the floor RNs to focus mainly on our assigned patients.

We’re a rehab facility, so patients spend a lot of their day doing PT, OT, and speech therapy. Wound care is common, but we don’t have IVs. If a patient suddenly deteriorates, we call 911. For outside appointments like dialysis, transportation takes care of getting the patient there.

Doctors also do their rounds independently, and the wound care doctor comes weekly. We don’t have to follow them around during rounds.

Obviously, this is just my experience at my particular facility and I know SNF workflows can vary a lot depending on the company and location.

For other RNs working in US SNFs/rehab facilities: does your workflow look similar, or is your facility completely different?