Agency nurses in LTC settings

  1. To those of you who depend on agency nurses to meet staffing & care requirements......I am curious to know how orientation of agency staff to your LTC facility is accomplished. Have just been made aware that apparently agency staff are to have a quite similiar orientation to that of a regular employee. Generally we have had a new nurse come in 2-4 hours before their actual shift starts. Has anyone else had to deal with this? Also who picks up the tab for orientation?
    Any suggestions or ideas would be appreciated.
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  2. 19 Comments

  3. by   nur20
    MY Agency picks up the tab for up to 2 hours of orientation
  4. by   Sundowner
    My agency also will pay for a 2hour orientation. However, I must say that I find these orientations to be a little, well annoying. I also suppose that I am not the majority! I have worked Ltc for nearly eight years, I know my job, I know what is expected of me. While be it true that each facility is different in one way or another, be it paperwork or whatever. I can walk into any facility and do my job well without being oriented. Usually within a week I have all the nitches worked out and am familiar with all the little things that make each facility different.
  5. by   ktwlpn
    I briefly worked agency and went to 2 l.t.c.'s-the first gave no orientation at all-after i received report the nurse gave me a short tour. The other place told me to report one hour early for my first shift-I sat and waited for 55 minutes for the supervisor to come and orient me-she was working a floor due to understaffing. I just jumped in there-both places had a core group of regular staff who were very willing to answer any questions.
  6. by   Jackie8087RN
    I have been working in LTC for 4 years--the last 3 months for an agency. I have found that there is not much orientation for agency nurses. You are expected to be able to come in and get to work. Usually, someone is kind enough to give you the tour and review some paperwork briefly--but that's it. It's working out ok for me--so far!
  7. by   jhf0174
    The first per diem agency I worked for had no orientation. The one I'm with now has you go into their office and read special folders the facilities put together (on your own time, no pay). You then sign that you read and understood them. The agency makes up laminated cards that tell what is expected of you, for i.e. how code status is marked, what charting is to be done and where to find the information on which pts to chart on, other duties expected of you, any duties agency personnel are NOT allowed to perform at that particular facility, etc... The agency recently sent out a memo stating that not having the card with you at the facility was grounds for termination (?) As far as learning where things are, the facility staff has always been great about giving information. The reports I get from them are terrific usually, too. Most facilities that use agency in this area also have shortened policy & procedure booklets printed just for agency and located at all nurses' stations. I worked agency 1 yr as a CNA, and 2.5 yrs as an LPN and love it. I am considering trying traveling LTC nursing. Anyone out there tried? I could use some info from the experienced!!!
  8. by   KlareRN
    The state surveyors are now asking for "proof" that agency staff have been oriented. They especially want to see that agency staff know things like where fire extinguishers are, crash carts, how to work the paging system in case of an emergency, how to use the phones (to get a line; what number to dial to get a line, etc.). They are also asking for proof that the agency staff is aware of the abuse/neglect policy/procedures. The agencies in my area are willing to pay their staff for an orientation-usually by having them come to their office and reading a folder designed to give them a quick overview. Then- hopefully they are given a tour their first time in the facility.

    I do not think the orientation is supposed to be designed to "teach you how to do your job" as some assume it is. I never worked agency- but if anyone knows how to do the job- it is them! They are expected to fall into place and are held accountable just like the "regular" employees. They have to be flexible and understanding- (you know they get the heaviest halls with the poorest staffing in a lot of places). I think the reason for the orientation is to ensure that the agency staff are prepared to assist in an emergent situation.
  9. by   Sundowner
    I am with you on that KlareRn. The most annoying thing I have encountered is trying to figure out phones! I usually try and locate extinguishers and crash carts and what not, keep an observant eye out for these things. I learned a keen lesson last year when on my second day in a facility the state inspectors were in and decided to ask me where they eyewash stations were........boy was I happy that I happend to notice it perched on the wall right behind the guy! WHEW!
    Taught him to fool with an agency gal! Of course, he was aware that I got really lucky and then followed me on my med pass just to jack me I suspect. He busted me on a coulple things.....I didnt check a wristband, pull a curtain for a g-tube pt .....little things. I am suprised I didnt get slammed with worse.
  10. by   Brownms46
    Originally posted by PBU
    To those of you who depend on agency nurses to meet staffing & care requirements......I am curious to know how orientation of agency staff to your LTC facility is accomplished. Have just been made aware that apparently agency staff are to have a quite similiar orientation to that of a regular employee. Generally we have had a new nurse come in 2-4 hours before their actual shift starts. Has anyone else had to deal with this? Also who picks up the tab for orientation?
    Any suggestions or ideas would be appreciated.
    Are you saying that the only orientattion you give a new employee is 2-4hrs before the start of a shift??? You have got to be kidding!

    First of although I have rarely done LTC....but I would never go to any facility that didn't see the wisdom in orientating a nurse before letting them work on their own! Especailly with some of the sorry reports I got , the every few times I walked into a LTC in the last 22yrs! Second many hospitals do give an orientation of at least 4hrs, and many 8hrs! . And the facility is the one that pays for the orientation, as it is their facility the nurse is at.

    And as for doing it on my own time??? No way...time is money...and I don't feel I should spend my valueable time learning something about any facility that wishes to utilize my services! What other occupation could you take up their time for free?????
  11. by   canoehead
    As an agency nurse in LTC where residents do not wear armbands, and may not be in their rooms, how do you pick out who is who for med passes? How do you confirm you have the right person getting the right drug?
  12. by   Sleepyeyes
    Orientation? you gotta be kidding! I go to a facility "a little early" (agency manager said with a straight face) for orientation, and never got more than "oh, here's the med room, and here's the phones...."

    Since this is how it was for at least 10 different facilities, I guess that's how it is.
  13. by   BernieO
    At my LTC we give all new to facility agency nurses one shift orentation working side by side with another nurse. We have a flow sheet listing all the relevant data to our facility, paper work, emergency procedures, protocols, etc. The agency nurse must sign off on all these things before she works on her own. So far the system has worked well. As a plus, the residents feel more comfortable meeting the "new nurse".
  14. by   Brownms46
    Originally posted by canoehead
    As an agency nurse in LTC where residents do not wear armbands, and may not be in their rooms, how do you pick out who is who for med passes? How do you confirm you have the right person getting the right drug?
    Now that canoehead, is one of the reasons I don't do LTC as agency!!! I have run into the thing were you almost have to take a CNA along with you to indentify the residents! Even the ones who provide pictures are useless many times, as the pics aren't updated! You have residents who sit on other peoples beds, and who answer to what ever name you call them!!!! And as for it being the way of the world to not get orientation....to me that is just about the most scary thing I have ever heard...

    Even the position I'm taking now. I had a choice of starting an orientation class on the 9th, or going there, and just getting a one or two day orientation on the unit, starting on the 15th ,and then waiting a week, and getting the facility orientation on the 21st! I took starting a week earlier,and getting the orientation first! I just think you do better if you get a feel for the place you're at...rather than just jumping in, and trying to fly by the step of your pants. I have been at this a long time... but everyone is different.. Maybe I'm just a little gun shy, after some of the situations I have run into.

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