Complete surprise, in a good way, LTC experience so far - page 3

by JBMmommy

5,524 Views | 28 Comments

I'm a new LTC nurse, been there a whole two weeks. I have to admit, it was the last place I had expected, or hoped, to be. Everyone that knows me would say "you'd be a great ER nurse" or something else acute care related (my true... Read More


  1. 0
    I started as a Charge Nurse LPN with 30 patients, 15 skilled rehab. 4 years later, I'm an RN Director of Nursing and I am so glad that you wrote this post. I am proud to be an LTC Nurse. It does take a special person to do it- what little time I do have spent walking the halway with a demented elderly patient, holding her hand and giving her just a minute of my time, is what nursing really is to me. I dont get a lot of patient interaction, but knowing that I can make the facility smooth, clean, and give good care coupled with those few moments mean the world.

    Do not listen to those that always say that you will lose your skills in LTC. You may not get or hone your ICU A-Line skills, but you will learn a plethora of other skills that are just as valuable. THANK YOU THANK YOU for your post, there is a place here for RN's, good ones. Welcome to the team!!!!
  2. 0
    Congrats on finding a job you love. I have been "1/2 a nurse, not a real nurse, and a babysitter" for two years according to some of my acute care colleagues. I don't care. I love subacute rehab and long term care. My facility is attached to a hospital and the ED staff loves to put us in our place when we transfer patients to them for evaluation. I know what I do is real nursing, and I am very good at my job. True, I couldn't do what they do. But there is no way they could do what I do. Don't let anyone make you feel bad. There are amazing experiences in LTC. Good luck.
  3. 0
    Thank you for sharing ... I'm also a new graduate RN but starting working for a subacute rehab facility before acceptance into nursing school and really grew to love the place over time . Unfortunately for me , after graduation in May with my BSN and passing my NCLEX in September I haven't been able to land ANY jobs in acute care or even the facility I worked for because of a very long hiring freeze. Just recently they announced theyre internally hiring RNs and I'm so excited to *hopefully* be hired! I believe any type of nursing specialty deserves respect and a certain type of person. Pay no mind to other people's opinions.
  4. 0
    @JBMommy
    I loved your post! You stated exactly how I also feel. I too started as a new Grad in LTC. Although I always loved working with the eldely I felt as though I should be working in the hospital for "more experience, learn more skills...ect) However, I have learned so much this past year working in LTC. We are not just a "Nursing Home" We are admitting more and more skilled residents, rehabs patients from hosp, younger elderly rehab patients,ect.
    I have learned that LTC is more challenging and you really have to know your stuff. The Doctor may be a phone call a way, but I am the one doing the assessment and what I find and report to him is what he bases his orders on. I also had to learn to know what to suggest to him exactly what I wanted from him, so you have to know your stuff.
    I love getting to know "my residents" and thier families and making there day a better one. I believe these people derserve the best care and deserve a caring Nurse watching over them. There really is alot of opportunity in LTC, especially if you want to make a difference.

    Thanks for the positive post

    Bea
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    Nurse Guy Bri,
    You seem to be on this site frequently. I would like to ask your opinion about taking the DON position. I am new to long term care and am going for my 3rd interview tomorrow for the DON position. I have no idea what kind of money to expect or to ask for. I have been an RN for over 20 years. Also I have to do a competency verification training test can you give me any ideas what that will be like. i anticipate about a 50 hour week. Oh, I should tell you it is a 60 bed facility. Aprox 20 of those are skilled rehab, the other are long term care. It is a large non-profit organization. There are 2 RCM's (resident care managers) one on each of the two units. Can you give me any advice as to things to say or ask at this 3rd interview. This one is the panel interview and the regional nurse consultant with be on a conference phone for the interview. Thanks in advance for any assistance you can give me.
    Harley
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    Wow! Good for you! I am starting to consider LTC because I suffered so much in med surg d/ t high acuity!

    Can someone tell me a little bit more about LTC? Anything will help. Please excuse my ignorance!

    Is LTC a nursing home , or the pts come there for recovery and to gain strength and independence and they get discharged home?

    Is there a pharmacy in LTC? Can you page MDs like in the hospital?

    As a new grad , will LTC help me improve my skills and expand my knowledge?

    Will LTC help my critical thinking?

    Would it be a good place for a new grad to start ?

    Thank you <3
  7. 1
    Some LTC facilities are only nursing homes for stable long-term patients, others are a mix of long term and short term rehabilitation patients. Sometimes the rehab rooms are clustered together, sometimes they're not. On my assignment, most of the patients will not be discharged to home, but a few are recovering from different things and will go back home when they're able (according to insurance).

    Here's a quick rundown of my shift (3-11)
    I come in and check my treatment book and see what treatments I'm doing on my shift, who gets a shower (because I have to do a body audit/skin assessment on shower day), and other stuff like that.

    Then I have to check and see who needs milk of mag because it's been a while since they've gone- that goes on my med list.

    I've got 4-6pm med pass and 8-10pm med pass, so I usually get started on the first med pass right after report and narc count. Then it's first med pass, sit for five minutes and call home to say goodnight to my kids, then second med pass and treatment pass I combine together. I try to be finished with that by 10:30pm because then I've got to finish my charting before my shift ends at 11:30pm. We chart on anyone with a current issue- recent fall, on antibiotics, on any kind of watch (behavior, UTI, etc).

    The dr. usually isn't on site during much of my shift. For an emergency I can always call my supervisor and/or MD if necessary. For non-emergencies, there's a "MD board" where we leave notes about which residents they should see on the next day. Pharmacy comes and delivers, but there are people available by phone if we've got questions.

    I think that the organizational skills and time management I'm getting in LTC will serve me well no matter where I go. No, I'm not dealing with anything as acute as a med-surg assignment, but it works for me. Some day I'll manage to pee more than once a shift!

    Good luck with whatever you decide.
    milfordmom likes this.
  8. 0
    Quote from HARLEYDNS
    Nurse Guy Bri,
    You seem to be on this site frequently. I would like to ask your opinion about taking the DON position. I am new to long term care and am going for my 3rd interview tomorrow for the DON position. I have no idea what kind of money to expect or to ask for. I have been an RN for over 20 years. Also I have to do a competency verification training test can you give me any ideas what that will be like. i anticipate about a 50 hour week. Oh, I should tell you it is a 60 bed facility. Aprox 20 of those are skilled rehab, the other are long term care. It is a large non-profit organization. There are 2 RCM's (resident care managers) one on each of the two units. Can you give me any advice as to things to say or ask at this 3rd interview. This one is the panel interview and the regional nurse consultant with be on a conference phone for the interview. Thanks in advance for any assistance you can give me.
    Harley
    I have been a DON in LTC for over 25 years. I have watched the profession change and grow. And yes it is a profession. Check out NADONA/LTC website they have tons of info. I would hope in your interview they ask about infection control and quality improvement. They will also want to know what you know about staffing minimums and other state regs You can find these on the internet by going to your states website Go to ___(state).gov then look up long term care There will be good weeks and bad weeks and you will wear a variety of hats. The goal is to develop your team in order to delegate as much as you need to still know your residents. I suggest deciding now what special things you have to offer and what your philosphy is
  9. 0
    Thank you for sharing, JBMmommy:

    As a task oriented, process management type of person who recently applied to nursing school (this is a complete career transition from IT / fighting hackers), hearing your story gives me greater hope I can fit into the field.

    Thank you.


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