What is it like to work as an RN in a nursing home?

  1. I am very interested in working in geriatrics but want to know the REAL SCOOP from those who are out there doing it. All I hear is the negative, which is fine, if it is all there is out there . . . I would like to hear horror stories as well as anything good as well to get the big picture. Want to be prepared, you know?
    Also, which do you do more of: hands-on work, paperwork, or more supervisory work as an RN in nursing homes? THANKS!

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    Irene
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  2. 4 Comments

  3. by   jkh
    I've worked in long term care for 17 years, 9 as a nurse. I've worked as a staff nurse and as a medicare coordinator an assistant director of nursing. When I was burned out on paperwork as ADON I Returned to staff nursing, which does also have a lot of paperwork. there is daily documentation and if you work in a skilled facility which means Medicare there is even more more paperwork for those residents.

    Extra paperwork comes if someone falls or

    something. (Figure out why the fall occurred and prevent from happening again) Sometimes you do spend so much time with paperwork it takes from resident care. You do need to supervise the CNAs and know where they are and what they are doing while you are doing your job. You will be working short staffed and extra hours. They won't schedule over 40 so you always have a choice to say yes or no. Even as a nurse I have worked all 3 shifts as a CNA and a nurse and more overtime that I want. Why do I do it? You also get to know the residents and families, you will have your favorites and they will get to know you and you will be someones favorite nurse. You will get thank-yous and hugs in between the swearing hits and kicks (which is MORE paperwork when some has a behavior problem) Through your nursing skills, interventions and care you will watch a dependent resident become independent. You need good assessment skills and knowledge of the chronic disease process and monitor if it becomes acute and sometimes argue with a doctor to give an aggressive enough intervention. I could go on forever with both the good and the bad I hope this helps you decide on geriatrics and you love it as much as I do. Good luck!
  4. by   iamme8557
    Nursing home nursing can be very rewarding, especially if you happen to find a really good nursing home.
    I started out as an aid in 1975, back when there was not certification....just a week or two of following another aid who had been there for a bit longer than me. Baths, enemas, feeding, transfering....they didnt seem as sick back then.
    As an RN, I do work nursing homes occasionally for agency for extra money. If you like to deal with the same people everyday and the same problems and would like the chance to really get to know those you are caring for then you will like nursing home nursing.
    I went to nursing school with a good friend, we really complimented each other in school. Always looking for a challenge, always done with patient care and able to help other fellow students or help the staff with menial things or the "really good stuff" they saved for us cuz we did the menial stuff last time or earlier.
    She is a nursing home adminstrator in California, I am a critical care/flight nurse in Pennsylvania.
    Guess the challenge is what you make of it.
    Go for what is your direction and seize the moment.
    Good luck
    Deanna
  5. by   dawnpla
    I started out as a CNA in 1977, and graduated with my RN degree in 1989, all of my career has been in the nursing home industry. I currently am working as the DON in a nursing home. Working in a nursing home has been one of the most rewarding things in my life. For many of our resident's we are their only family they rely on us for all their love and attention. i personally feel that being a nursing home nurse makes your assessment skills top notch, as we do not have a Dr. available to us at all times we are their eyes and ears, they rely on us to give them all the correct information as well as being able to determine what is developing with their resident. I would encourage any nurse who is looking to improve their skills to work in a nursing home.
  6. by   ecb
    I work in LTC for over a year, I agree that the assesment tools you have will get fine tuned in LTC. You have to concede to get things done one at a time (at least i do) or else distractions will run you WAY out of compliance (that old 1 hour before + after rule) it is nearly impossible to pass meds to 32 people, dig and lopressor to at least half, and some of em walk around, in 2 hours. It gets done, but if the facility or your coworkers do not encourage teamwork, it can get pretty miserable! You really have to make the determination you are going to report any and all abuse, because people willing to fudge the lines tend to go into long term care, as do the chronic corner cutters. i am NOT saying that is who is there, but they either get allowed to stay or made to go, and it takes a team to make them go.

    If you find that you cannot live with the way a place is run, by all means try to help, but be careful if you compromise, I found it became a pattern i did not like, but had to go to another facility to get back on track.

    There is a lot of documentation, and you have to say a lot, in a variety of ways, over and over again. I became very frustrated when I could recognise my handwriting in more than 1/2 the notes, including my days off. When you are good, the Drs learn your voice, they might still get anyed at 10pm, but they are more likely to recognise your voice, and listen (but then again there will be one;-))

    I am not saying all I wanted to very well, so I will end, but do go there, it is WONDERFUL to help families learn the best aspects of care, and depressing seeing the patients coming out of hospitals (to die) and we not only get them better, but get them into rehab.
    Families are sometimes, (note that last word) as much our clients as the resident themselves, other times they are more the problem and WILL NOT accept any education, no matter how badly they {inadvertently} hurt their family member, and they tend to blame the caregivers for the injury that they themselves caused (diabetics and food, swallow problems and candy or drinks, weakness and forcing ambulation, refusing to allow medicare to take over when it is warrented so they can keep getting a SSI check, or the family who adds Dx after Dx that have no basis in fact, but make the family feel better for placing their grandparent which reduces care, not improves it)

    I do love long term care, but it has its pitfalls and I have seen a few of em, and that saddens me.

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    *** May we all have the serenity to accept what we cannot change, and the determination to change what we cannot accept. ***

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