I have a few suggestions...
Feel free to pick and choose as needed...
1. Read everything and anything you can get your hands on about time management, delegation, conflict resolution ('management' type stuff). It seems like sometimes those types of things are what can really help a person in LTC-it is great for everyone of course, but if this is your first ever nursing job....LTC is full of dynamics. My experience was that the medical end of nursing was the least of my problems at least in the first six months!
2. Listen a ton, say a little when you are orienting. Ask tons of questions of course, but try not to get sucked into the pool of personal opinion. Figure out the dynamics of the workplace-and try to stay out of them.
3. Make sure that you are going to get a good orientation. Use the "I am a new graduate" card and I mean REALLY use it. LTC is notorious for shortening orientation....
4. I don't know what your particular situation is, but I would suggest at least aiming for part time work for a while-repetition is key when new.
5. Value all opinions until you get to know all of the players. You won't know who is just trying to buddy buddy the new person etc at first. But don't ever ever ever devalue the opinion of LPNs or CNAs that have worked there longer than you have. Nothing gets crazier than what happens if the 'group' thinks a newbie is coming in really strong and opinionated-especially as a new nurse. I am not saying that you will be like this of course-I am just basing this on things that I have seen. You get a little more leeway if you have some experience but that won't come for awhile.
6. Check out the policy and procedure book of the facility. Check and see when it was last updated-that might give you a clue as to if the facility is on top of things or not...:P
7. See if the nurses are following the P&P book....
8. Read up on pressure ulcers, venous stasis ulcers, wounds.
9. Read up on dementia, look up the term "Theraputic fibbing." I found that a lifesaver. Never taken something rude or angry a person with dementia says to you seriously.
10. Get online and watch Teepa Snow. Just Google her name. She is amazing...and will give you amazing tips for working with dementia. She is spot on.
11. Brush up on your labs. Remember that some nursing home patients will have chronic 'off' lab work...so don't freak out unless you have the whole picture.
12. Med passes in LTC can be nuts. If you know you are going to have the same wing the next day, save your sheet. Write down the med times on the sheet. Get a system. Highlight off things as you go. Ask the other nurses what they do to keep organized.
13. Find out what the process for incident reporting is. They will probably tell you this, but don't ever chart that you filled out an incident report. Incident reports are for facility evaluation. If you enter that you filled one out in a patient chart it is admissible in court if I understand correctly.
14. Use common sense. If anything looks 'fishy' don't hesitate to get out. Not all LTC are the same...some are amazing, and some are risky to work in.
15. Have a wonderful time. I hope this helped even a little. I am sure there is more I could tell you if I could think of it....LTC can be very difficult but very rewarding. I wish you all the best!