First Day in Nursing Home as a Practical Nurse

Nurses General Nursing

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I'm going to start my orientation next week in a nursing home(long term care) as a practical nurse. I'm just wondering what to expect so i'll be prepared, since am an internationally trained nurse. Any suggestion please. Thanks in advance

when you first arrive in the unit, you are going to get report from previous shift nurse, count narcotics and start your first med pass. i assume you are going to work day shift since all new nurses have to be orientated for the day shift. know that the first med pass is very heavy, some patients take up to 20 pills. before you start your med pass ask a nurse orientating you whether or not patient take their medicine whole or crushed because lot of geriatric patients take their meds crushed. have a thicked water in your cart those who drink thickened water. in the morning, patients eat in the dining room so may you can start your med pass to patients in the dining room first. after med pass, you have to do the treatments, then the daily charting. i hope this helps

Specializes in Rehab, Infection, LTC.

Run!!!!!!!!!!!!!:clown:

Do make yourself a 'cheat sheet' or sorts about the patients -- how they get their meds, any special diets or restrictions, allergies, code/no code status, how well they can communicate, any hearing/visual limitations, any special devices, etc. This will help you get to know them quicker. When I first started in LTC, it took me months to learn the names and faces -- that was the hardest part for me. I don't know how many patients you'll have, but don't hesitate to ask a co-worker if you have any questions about anyone. LTC is stressful and you'll want to keep yourself as organized as possible and before you know it, you'll work out your own time frame and system of getting what you need done on time. Load up your med cart with everything you need to prevent extra miles on the feet during your shift. Also, carry extra pens, gloves, a pen light and your steth which will come in handy before the administration of certain meds.

Specializes in Geriatrics.

I guess what I can say for advice is- 1st, whole or crushed for pills, then find out the little "quirks" of each- such as, does Sally like the white pill before the pink one, Does Joe like his pills after his last bite of breakfast, Does Audrey like all her pills whole but the potassium in pudding, does greta not really care cuz unless you give her coffee with them, she will spit them out! In LTC you work in there home and have to attempt to become accustomed to there routine!! And it is stressful and time consuming, but in the long run- hopefully you will see that there is no better place in the world to work!!!

2 words...............good shoes.

Specializes in GI/ Peds?OB.

I am in the same boat........ hopefully we all get one that will float......... Sorry about the humor, its the only thing that keeps hair on my head with all the stress of a nrsing student.

I have no experience wking with older people. :eek: Please pass in formation on..... I am interested in a CHEAT SHEET TO USE WITH THE RESIDENTS.

Thank You!!

Specializes in Community Health, Med-Surg, Home Health.

I am appreciative of these suggestions myself, and I don't even work in a nursing home! I was always looking for hints on how to survive LTC in case it becomes a necessity to work in one.

Specializes in GI/ Peds?OB.

I am on my last semester and I need to just get a job. Five kids is expensive even if you dont include Christmas and husband is doing the best he can. I do have some cheat sheets, if interested, but I am hoping someone that IS working in a nursing home could supply some of there cheat sheets b/c it would apply directly to that kind of care. Take Care and CONGRATS to getting this far......:yeah:

Specializes in LTC/Behavioral/ Hospice.

Great advice above. All I can add is this. Make sure you know who your diabetics are and when their next meal is. If you have a lot of insulins to give in a short amount of time, you need to organize your time accordingly. Also, take note paper or your report sheet with you and write down your observations, anything you want to chart on later, any vitals that you need to report in your charting, etc, so that you don't forget. Good luck!

Add these tips:

Get to the facility early.

Grab residents' list with the room number; some facility usually have it at the front of the MAR, photocopy it.

know the residents on glucometer reading and what time they are due for it, note it down.

Note down the residents' on narcotic, if possible.

Know those who take their medication whole or crushed.

Get your Med-cart ready.

Ask questions; use all the resources available, the nurse nurse u're taking over from and the health care aide u're working with.

Good luck.

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