Any tips for a new RN starting off in a nursing home?

supervisorhatchet · Jul 26, 2013

Know what you know, and all the rest.....ask lots of questions. Use your peers to help you gain knowledge! There are never any dumb questions, and mistakes are just new opportunities to learn!

EmeraldCoastRX · Jul 27, 2013

Be eager to learn. Find out quick who the vets are and ask to do your orientation with them; RN or LPN. Learn the CNA's and what sort of leadership they respond to the best. They can make or break your shift. Take notes and keep them with you. You're always up against the clock! Knock out all of the "additional" tasks every chance you get and don't put anything off for "later" if you have the time to do it now. Things have a funny way of stacking up quickly. Never say the "Q" word (Quiet). Treat your patients as if they were your own family and they will become your family.

No matter how stressful a shift has been for me, I always leave with something that has made it worthwhile.

Most important is to enjoy it and remember, no matter how bad it seems, it can always get worse. :-D

BlueLightRN · Jul 27, 2013

CYA. LTC was HELL for me. I got away as soon as I could. I wish you better luck than I had. I hated it. But I don't want to color your views. Just be very careful and don't let them push you around.

PerfectlyPlump, ADN, RN · Jul 28, 2013

Be eager to learn. Find out quick who the vets are and ask to do your orientation with them; RN or LPN. Learn the CNA's and what sort of leadership they respond to the best. They can make or break your shift. Take notes and keep them with you. You're always up against the clock! Knock out all of the "additional" tasks every chance you get and don't put anything off for "later" if you have the time to do it now. Things have a funny way of stacking up quickly. Never say the "Q" word (Quiet). Treat your patients as if they were your own family and they will become your family.
No matter how stressful a shift has been for me, I always leave with something that has made it worthwhile.
Most important is to enjoy it and remember, no matter how bad it seems, it can always get worse. :-D

Please elaborate. What kind of leadership DO they respond to ?? I had a hard time in LTC with this, and wish I had known how to establish myself with the CNA's better.

CindyLou1983 · Jul 29, 2013

Thanks everybody!!!! I'll be on the floor for the 1st time tomorrow. A LPN with 15 yrs experience will be training me. I'm excited and can't wait to start taking care of the residents and get to know them. I used to be a CNA myself and know the residents do become a part of your family. :)

NurseNightOwl, BSN, RN · Jul 29, 2013

I'm starting as charge RN (as a new grad, yikes!) on the rehab wing of a SNF this week, so I'm right there with you OP! I know a lot of people are wary of LTC, but geri is my passion and nursing school just reinforced my (personal) distate for hospital nursing. We'll figure it out and be just fine, I know it!! :)

EmeraldCoastRX · Jul 30, 2013

Please elaborate. What kind of leadership DO they respond to ?? I had a hard time in LTC with this, and wish I had known how to establish myself with the CNA's better.

Leadership is the process of influencing others to accomplish a task/goal/mission by providing purpose, motivation and a sense of direction.

I've found that keeping my team informed, helps them see the purpose and importance of their role. You'd be surprised by the number of aids who know to reposition a pt q 2 hrs, but do not know why. I always take time to explain the "why" or the purpose. Yes! There is always time to do this! "Let's walk and talk." I'm infamous for saying that at work.

The motivation part can be tricky because it can differ from person to person, person to team and personality to personality. I give the veteran aids the respect that they deserve. I'm respectful, but also very assertive when I need to be. I believe that by respecting them, they will respect me and this motivates them to work hard for me. That respect and motivation trickles down the chain. When I have a lesser experienced aid or even a "lazy" aid, I don't let things slide. I address things immediately. Sometimes this goes back to providing purpose. Understanding the "why" motivates them to be better or CARE for that matter.

The sense of direction is a combination of the first two and also setting the standard. Let them know what is expected of them and make everyone accountable for their own actions. Acknowledge what's good and address what is not. I'm a hard ass, but I'm approachable. When a correction is needed, I try to start out with a positive, followed by the negative and finish with another positive. It works wonders. You may find that the negatives continue. In that case, don't be afraid to make an example out of someone. I've had to walk a few aids down to the DON's office, but the problem is generally solved after that. I let the aid explain why they are there, which goes back to making them accountable for their actions.

Not everyone will like you as a person, but most will respect you as a charge nurse. Leadership doesn't require making everyone happy, but does require getting the job done. In our case, the job is providing excellent patient care.

NurseGuyBri · Jul 30, 2013

Here's my advice from a LTC DON: Respond quickly to pain, if someone comes to you with a small concern, check it out. Listen to your nurses and nurse aides. Do not alienate them, bring them in to you. Do not ostrasize anyone in front of other people. It is the most difficult job you may ever do, remember that. remember also that it is possible to succeed, but in order to do well you *have* to respect everyone, even in times of duress. You'll do great!