[Kashia]

Primary exp is in acute care 5 yrs LVN. I am wanting to change to long term care and have gone to a couple different facilities through an agency. You get little of any orientation, expected to know everything, but the most overwheming part is passing meds on time ( ???) to patients and treatments when you do not know them or reconize them. I have felt absolutely overwhelmed each time! Are their any tips on how to do this, a special routine like in acute care?
Thank you

[SandraJean]

No tips. I do understand what you're describing though. Sorry.

[carolbear]

Going from acute care to long term care is hard enough, but to go from acute care to AGENCY Long term care has to be a nightmare. I can tell you from having experience in both settings, that the bet option would be to just do full-time LTC care at one facility. The trick to passing meds quickly in LTC is knowing your patients. Unless your on a medicare unit where there is a lot of turnover, you will know your patients, what they take and when the orders change. That is the key to LTC medication pass.
Good luck, I feel your pain!

[earle58]

a simple first step, is finding out who takes their meds whole or crushed.
who needs, fingersticks, insulins and other pertinent, scheduled meds.
then the rest is working your tail off.
best of luck to you.

leslie

[txspadequeen921]

Are you planning on working through agency and doing LTC or just going to work for a LTC facility? One thing is finding out who is crushed and who is whole that is the first thing I find out . That will reduce your med pass time by at least 1/4. I have found with me at least that the first day may take me a while but the second day I can cut my med pass time in half. Its all about knowing your patients and how they take meds, organizing your time and getting the priorities done first then fill in with the rest. Hope this helps good luck toy you.. Ive been there.

[snowfreeze]

expect a 3 hour med pass, and earle58 hit the fine points, who takes meds whole or crushed, what to hide them in for the cautious, blood sugars, tube feeds continuous and bolus. Trust the nurse aids who know the patients, they have helped me a lot. I went from ICU to agency LTC and sub-acute nurse, it was an eye opener. My critical care experience helped a lot in quickly assessing problems and knowing when to just get back to work and when to call a doc or the medics.

[Lovin' my job!]

What ever you do...don't prepour! You think you'll save time but you're only increasing your chances of errors. When I started I talked with the reg LPN and asked the questions insulins? tubefeeds? etc just as the other threads suggested and keep a piece of paper taped to your med cart to jot down notes. It's really just time. Just follow the procedure as you were taught and all will go well.

[nurse_clown]

my one part time job is in acute care. my other part time job is in long term care. i noticed a huge difference. in acute care, we just throw any size or type brief on the patients. in long term care, continence products are studied, counted, rationed and put on a certain way. in acute care we have DNR or not. in long term care we have "advanced directives": CPR or not and different levels of interventions. in acute care, we pass meds to 13 patients. in long term care, we pass meds to 40 residents!!! in acute care, we know there's a dressing change or treatment, we just document in the chart. in long term care, there's an actual treatment administration record that we sign. there's other differences and protocols that make each job vary. my director of nursing told me that i act like an acute care nurse when i'm there and there's nothing wrong with that. she considers it a good skill. we also have long term care policy manuals for everything. in acute care, we'll be lucky to find a policy in the manual. lol

[michelle126]

I also like to know of any major wound issues or pain issues or falls/ incidents to monitor and any iv meds.

[ingelein]

This is the nature of the sub acute unit beast.Understaffed, overworked= UNSAFE .We can change staffing ratios if we have a VOICE,ONCE AGAIN, I am singing the UNIONIZE song!How else can we affect CHANGE? Any suggestions?