[jade-athyst]

Fairly new nurse here. I was just offered a position at a long term care facility. I would have the long term care unit of the facility, with forty patients. I was told I would be passing meds, answering doctors calls and charting for these 40 patients. The shift is 3-11, and apparently there will be an LPN with me from 3-9. There are no trachs on this unit and only one feeding tube. There would be dressings, but not many. I've never done LTC before, so I was wondering if this seems like a realistic expectation. Just passing meds to 40 patients seems a little daunting to me, but I really have no idea. The pay is above average, but nothing would be worth taking on a job I can't handle. So I was hoping for some opinions here, does this sound like something I could do?

[dragonflyRN]

How fairly new? In the end, noone can make this decision for you.

[jenmlee]

The biggest med passes on the 3-11 shift are typically at 1600, 1700, 1800, 2000. With the two of you there, it shouldn't be a problem. In my LTC, the dressing changes seem to be mostly on the 7-3 shift. I should say I work the 7-3 shift now and it seems a lot heavier. I have 26 residents I have to pass meds on (0730, 0800, 0900, 1000, 1200, 1400), 2 have tube feedings and one of those is a bolus feed, and these 2 have trachs. I also have 5 daily dressing changes, done on my shift.

Once you get to know the residents and how they take their meds it shouldn't be too difficult.

As far as charting goes, I don't know about where you live and charting guidelines, but here we only chart qshift on those residents that are medicare. As far as the other residents go, they are charted on an as need basis, i.e., status changes.

Hope this helps

[jade-athyst]

Originally Posted by dragonflyRN

How fairly new? In the end, noone can make this decision for you.

Graduated in May. Took a position on a cardiac step down unit at a busy hospital in July. Completed critical care course and orientation. Had to resign becuase we had to moe unexpectedly. Have been looking for similar position in this area and not having much luck. Finances are desperate and this offer is the only one I've gotten in two months.

I realize the final descision would be up to me, but I was hoping to make it a somehwat more informed decision. Thank you for the quick reply.

[Retired R.N.]

Originally Posted by jade-athyst

... I've never done LTC before, so I was wondering if this seems like a realistic expectation. Just passing meds to 40 patients seems a little daunting to me, but I really have no idea. ... So I was hoping for some opinions here, does this sound like something I could do?

Is there any way you could shadow the nurse who has this job now? If not, could you at least visit the site and get an idea of the actual conditions? I don't like to throw cold water on your plans, but a few months in ICU is not a very realistic preparation for LTC. For example, are the patients wearing ID bracelets, or do you have to learn to recognize each one of them? Are the majority of the patients alert and oriented? How many sundowners?

You worked long and hard to get your license to practice nursing. Don't jeopardize it by taking on more than you can handle.

[LesMonsterNS]

I'm wondering how many CNA's typically work 3-11 and what the LPN's responsibilities are. For an experienced LTC nurse it could be very doable, depending on those two variables. As a newish nurse, it will take some adjustment but it can be done.

[TheCommuter]

Dispensing medications and doing simple treatments on 40 patients is quite workable if you manage your time well and set your meds up before passing them.

[st4wb3rr33sh0rtc4k3]

Well, I think you can do it... But, I usually work with an LPN together we do the same tasks, for about a maximum of thirty patients... There is always an RN on call to pronounce deaths and mix IV medications...

I pass out the medications, do treatments, call doctors, documentation, delagating to tasks to the CNA's.

What will you be deligating the LPN to do?

[charityRN1991]

I was offered a job today as evening supervisor in LTC. Unit has 100 pts and 4 nurses including me. I would have to take a cart and supervise. I think I will say no way, just too much stress to try to do your work and do it the best and supervise too. I have had to work like this before and it was not pleasant. You can't take care of your patients with the other staff complaining to you and the families there with the issues they have. And this facility has had some issues that they are trying to resolve so I am sure that the families there are going to have issues. They want me to come help set up a short stay rehab unit. Now, how can I do that working on the LTC wing till it is done under those circumstances. I turned down unit manager because I want to do patient care. I wish I could just take care of my patients and go home..... And the pay stinks.....I was making $2 more at my last job almost 4 years ago in subacute.
They offered me a Baylor to start with then they decided that you can't get benefits even if you work an extra shift the way the contract reads....I don't think I trust these people.....and I was so looking forward to helping set up a subacute unit.