Any advice for a new nurse

  1. I am a new graduate, about to start a new job in a skilled nursing unit at a long term care facility. Is there any advice that anyone might have to help me in my journey?
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  2. 8 Comments

  3. by   karol
    Beck. Good luck with your new job and congratulations! I've only been a RN for five years and in a ltc facility. I have found that the residents respond better to me and all staff who treat them like they were separate personalities, and with dignity. I also find that if they like you, they forgive mistakes easier. Also I have found that being a team player, coming in when scheduled and with few complaints about scheduling gets you further also. Your first priority is the residents health, and his rights. We are their advocates and if we don't follow that we are not doing what is right them. And I can't stress the importance of documentation!
    If you don't document it, it didn't get done!
    I hope I didn't scare you, but it does take time and effort on your part. Good luck in your new job and the new year.
    karol
  4. by   laura
    I was a new grad just this last March, so I know how you feel. It can be very overwhelming at first. One thing that I found very helpful is that when I do my med passes, I ask if they need anything else, like tylenol, etc. It saves a lot of time instead of going back into the room 15 minuetes later with it. I have also found that it saves time and headaches to greet family members when they come in and let them know how the resident is doing. If they know you will tell them what is going on, it builds trust and I have found that they stop asking for details of the residents entire day. Good luck and don't give up it will get easier.
  5. by   Heather27
    Beck:
    Just remember...the other nurses were "new" at one time too...so were the doctors. LTC is a challenging field in that residents get used to routine and so do the staff...Sometimes new blood is good for them. You need to try to fit into their routines, but also don't need to become the nurse you may be replacing! I have OFTEN heard "The other nurse didn't do it that way." Well, that is okay..you are not the other nurse. As long as your care is within procedure, protocol, prudence, and safety parameters, you will be fine!!! All the best!!
  6. by   Linda
    Becky,
    Congratulations.. And good luck...LTC is a very tough job in the field. I have been an RN for 4 years and started in LTC.. Recently I gave it up and moved to the hosp.. Acute care general medicine unit...It is a Geriatric floor...Still tough.. Best advice I can give.. Document, teamwork, treat your nurse assistants with respect always..praise them in public whenever you can..touch your patients..smile..and never take your job home with you ..it is very unhealthy..there is a big demand in this field because of the stigma of the nursing home..Stick with it though. Your job will always be in demand..and remember.. Angels can't be everywhere so God made Geriatric Nurses to fill in for them..and that elderly person you so graciously cared for just could be a relative reincarnated....think about it.

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  7. by   Terra
    First, AMEN to Linda's reply. Long term care is an extremely challenging field. Not everyone can do what you are doing. Always remember that no matter how "ornery" your pts may be, they are due your respect. they are someone's grandparent, husband, wife. Treat them as you would want a precious member of your family to be treated. Also, develop a good working relationship with the other members of your staff. Sometimes, the CNT's know more about your patients than you do. Value their opinions. Listen when they tell you that something is not right with a patient. Be aware of the other nurses on your staff, and be ready and willing to help them, if needed...They'll be there for you. Because of the changes the LTC industry is going through (with PPS, etc.)It is vital to the wellbeing of your patients that you work together as a team, and put their needs first. This work can be discouraging sometimes, often frustrating, but ALWAYS rewarding. Good luck and God Bless!!
  8. by   bj54
    Way to go Linda and Terra,
    I couldn't have said it better myself. Team work is soooo important, especially in LTC.
    One thing I would like to add is about building relationships with your residents. This is their home, they are people too. They have senses of humor, concerns for their families, etc., just like the staff does. It's okay to have some humor with a resident.They may tease you back, and if they do, it is great and good for all concerned. I asked my 94 y/o Uncle, about the way he viewed the world around him and guess what he said; just like you do, I've just had more experience with it all. He was a quiet man and he enjoyed the teasing and laughter. He just couldn't make his body function as well as it did when he was a younger man. His mind was in great shape, sometimes, better than mine. LOL Hope this helps you out a bit.

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    bj
  9. by   einlpn
    Welcome! Someone else has already given you the best advice you'll need. Remember that all the residents are someone's mother , father , sister , brother etc. It will guide you everyday that you may become frustrated when a resident asks you for the 10,000th time where is my room? Everytime I get frustrated I think how would I want the caregiver of my Grandma to be . I respond kindly each and everytime!
    Good Luck!
  10. by   RNsRock
    Welcome to this field, I started working on a skilled nursing unit right out of school too. I am still working there. The other nurses have pretty much said it all. Teamwork, teamwork, teamwork. I cannot stress that enough either. Let me give you some advice that has helped me. Some was passed on to me from other nurses, the rest I figured out on my own.

    1. Paperwork is a pain, but it is a necessary evil. Not documented, not done. It's as simple as that. My biggest problem is still making time to chart! I can do the work, it's the time you spend writing that takes up your time. The best time to open your charts I have found is after you give your am meds. That way, if you have a prn or something like that you can just chart it after you did it since your chart is already open. Trust me it is easier than trying to remember everything you did right before you leave!

    2.When in doubt, ask. You will quickly learn which nurses you can turn to. Unfortunately, not all nurses remember what it was like to be a new grad.

    3.Assessment is the one skill you absolutely must develop. Again,look at 2. After report I always start the day by assessing and chatting a little with my patients. That way I know if there are any new problems, needs, or prn meds to give with my morning meds. Make sure you check your vital signs, sometimes your CNA may forget to report something abnormal. It happens even with the best of them!

    4.Medication administration is also important. Do not ever give anything unless you know what it is. New drugs come out everyday. Check your med books or call pharmacy if you must. I have seen scary things happen when nurses have simply followed doctor's orders regarding medications. Follow your instincts if something does not feel right.It is also a good idea to write down what your vital signs are in the morning, that way you know whether to give or hold BP medicines and such.

    5.Doctors are human too and they make mistakes too. Don't be afraid to question an order you do not understand. It is your license on the line regardless of their mistake.

    6.Dressing changes won't seem like such a chore if you set a time to do them all, like after charting in the morning. You may even do them while doing your assessment or after meds. You will find you have a little bit more time in the afternoon if you do that in the morning or vice versa.

    7.Above all, you are caring for a special group of people. It can be frustrating at times, but remember, a kind word more often than not will soothe the most bitter soul. Don't take it personally, keep in mind these people are sick, that is why they act that way. If you lived to be 90 wouldn't you want to be left alone too?

    8.Objectiveness is one thing I see a lot of nurses struggle with. Remember this is America and people come from all over. You may not agree with their cultural,or religious practices but they have that right. It is not up to you to change it or accept it, but it is your job to respect it.

    9.Keep in mind your patients form a part of a family. Include them in their care. They need that too.

    10.Above all have fun with your patients. You will learn so much from them. If you have the time, (big if, but it could happen), listen to their stories. They are our country's living history.

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