LTC Shift Beginnings-LPN FLOOR NURSES

Nurses New Nurse

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Specializes in LTC/Sub Acute Rehab.

I am a new grad LPN who will be working rotating shifts at a facility. I will have a preceptor with me but for me to get the hang of things I have to "participate." I refuse to be a bystander b/c I can't learn that way. I know that you have to receive report yes but what do you write on the report sheet? I know that this sounds stupid but I absolutely need to be a "active and competent" member of the team. I dont want to look stupid esp. when I get on my own. When I was in school, I gave report to the unit nurse when we were leaving but I never had to get report coming on, plus Im nervous b/c this s*** is "REAL" not for play! All we did in school was mainly personal care and pass meds to the 2-3 patients that we had. We didn't get the experience of observing phone orders (giving or receiving); and all of this has me WACKED OUT OF MY BRAIN! I mean, after you pass your meds, what the h*** do you do????:uhoh3: I JUST WANT TO BE CONFIDENT AND CAPABLE IN MY MIND and I don't feel that. Before I left school, 2 of my instructors told me that they would feel safe with me taking care of them b/c I know my stuff and I have to admit whether in the books and most definetly in clinicals (leadership incl.) I shined but now kind of in a way, I feel like my light has dimmed. Am I stressing out unecessarily or is this normal?

When I come in I write down any changes in status, new orders, any problems anyone had thru the day, PRN's given. I work nights, so any info about labs, tests, or dialysis patients going out the next day I write down to pass on to the morning nurse, especially if someone has to be NPO for tests even after I leave in the morning. Basically, at least from my experience, LTC is pretty much charting and report by exception. Things that are not normal for that resident like increased confusion, or pain. You don't need to write down everything the outgoing nurse tells you, and eventually you'll know what's crucial.

And you'll have plenty to do besides pass meds--treatments, phone calls to docs, lab, and pharmacy, paperwork, ect. Plus you're constantly interrupted during medpass, so it might take longer than you think LOL.

Specializes in Too many to list.

I also work nights in LTC at present. I work thru agencies. When I give you report, I will go by room number, and last name (unless I know there's a duplicate name). If nothing is wrong, I'll say so. If I gave anyone a suppository, a PRN med, if they are on antibiotics, had any kind of incident, did an assessment or vitals on them, I let you know. And as Heather said, if they are NPO, getting labwork, going out anywhere I'm telling you that, and handing you the tranfer paperwork. Oh, and if I gave insulin or did finger sticks, of couse you gotta know that. And, anything unusual that I'm concerned about...

When I work days (God forbid), I would take the report, quickly eyeball the patients if I can (not always possible on really large floors), make a list of who needs vital signs, and assessments, who got suppositories so that I can follow up, what the fasting blood sugars were, what doctor or family member needs to be called if any, give report to my CNA's (that's a biggie), hopefully I know if the CNA's need to leave anyone in bed for dressings so I can tell them, check the med book for what I have to give and flag it, same thing with the treatment book. If you have med techs where you are,check to see what meds they are not giving like narcs, insulins, tube feedings.

Specializes in Too many to list.

And deal with all the interruptions while you try to do the meds, and treatments. You might also be helping with feedings, changing the incontinent, giving a boost. Yes, it's alot, but you will be getting into a routine of sorts. Good luck. It sounds like you are well prepared.

Specializes in Peds - playing with the kids.

kudos to you for trying to be so well prepared. it is perfectly normal to be nervous, but you seem to have a firm grip on what needs to be done.

good luck to you!!

4leaf.gif

Specializes in LTC/Sub Acute Rehab.

I think I need to make a clairification. I have twice seen the statement "you seem to be well prepared." If those that have recently posted and recognized the SECOND POST, THAT WASNT ME, IT WAS THE EXPERIENCED HEATHERLPN. However, I do want to thank those that have congratulated me on wanting to be "active and prepared." I just wanted to get that out and in the open so not to take "credit" for the work and experience of someone else.

Please keep the posts coming, they are more than their weight in gold as far as Im concerned. I know that I wont be perfect nor should I try to be, I just want to display in my actions what I know in my heart and in my head (when pessimisim doesnt set in) that I AM A GOOD NURSE and that I was born to do this; it just took me over 10 years, 4 failed tries at persuing a finance degree, a managing cosmetology license, a screw up at a hospital job and 20,000 in student loans along the way to figure out that this is what Im supposed to be doing with my life b/c I am just naturally good at it. I just wish I would've known it when I initially went to the University of Cincinnati when I was 16, I could've been in less debt w/the gov. and I would have been a nurse for ten years INSTEAD OF A NEWBIE:lol2: ! OH WELL, you live, you learn, and get LUVS!

Thanx to all!

Brown Eyed Girl

AKA

NURSE FOR LIFE!

I think everyone is just saying that you are basically ahead of the game by asking the questions that you did so that you can be prepared. It shows that you want to go in there and try to be efficient.

I also go thru and write down my treatments, assessments, who gets temps/o2 sats/ect., who is my daily charting (O2 charting day, diabetics day, chronic pain day, ect), b/c some of those needs vitals, lung sounds, bowel sounds, stuff like that.

Plus you usually have to take care of the med tote on nights, check your crash cart, test your glucometers, and help your aides out if you can. Night shift is busier than people think.

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