Help! Acute care exp in long term care a nightmare - page 2

Primary exp is in acute care 5 yrs LVN. I am wanting to change to long term care and have gone to a couple different facilities through an agency. You get little of any orientation, expected to know... Read More

  1. by   ebony2
    So Sad and so true ingelein...we need avoice and to be heard about LTC expectations. I have gound no easy way.organization and having an initial plan for the day is helpful but even with all of that you never know when you get on the unit what interruptions are going to come your way. I fifnd after many years it's all about taking the ball and running with it always hoping one problem is solved before the next one starts. Factors that will also crimp our style are those patients who just hate taking their meds, never-ending skin issues you need o stop and assess and the telephone. Oh there is alo a rule to never interupt the nurse giving her meds and if you or anyone can solve that one.........please let me know
  2. by   Calgon-take.me.away
    Greeetings from the world of agency nursing. I have been an agency nurse, strictly long term care for almost nine years now. And would not trade it for the world. As for getting thru the night, first and foremost find out who you are working with. Get the CNA's names, the other nurses on the floor and write them down. It makes the unfamiliar seem more familiar. Get a patient roster, crush, wholes, tubes, accuchecks, and start there. Take a break if you are feeling overwhelmed. We as agency nurses, have typically 25-30 unfamiliar residents, all documentation, summaries, daily and problem charting, in addition to charting on all your g-tubes, diabetic flow sheets (breathe) and treatments that you have to HUNT for supplies for. You have great facilities that welcome your help and others that you have to put up with the attitude that why should I help you, you are making so much more money then I am,,,so why should I help you.
    Go in with a smile, a warm greeting, introduce yourself and dive in.
  3. by   Simplepleasures
    Quote from ns lpn
    If your voted union reps do their jobs then the issues that come to the negotiating table should reflect the major issues the staff want addressed. This being said I find alot of staff take the MONEY over the other issues when it comes down to one or the other.

    All this said being unionized does not solve all the problems with LTC esp. not the staff/client ratio.
    Didnt the California Nurses Union, get state mandated patient/staff ratios?Why not demand your union to lobby for this?Why not get all the nurses in your facility that are unhappy with the union together en mass and complain about what thay see wrong in the union?If your union is not doing their job , why keep them, get another one , research unions that have a better record, report your union to the NLRB, dont just give up! My opinion is that we need a NATION WIDE union, not these weak little ineffectual ones that have now turned off the nurses they are supposed to be serving.
  4. by   Kashia
    A little late but thank you all for your input.
  5. by   linzz
    Ingelein: I agree with what you are saying. LTC's, a lot of them need a real wake up call. I fantasize about a black day where all LTC nurses nationwide withdraw their services,although we all know who would suffer even more than they already do. I only pray that the baby boomers will start rattling some cages. Sometimes it is so depressing knowing that there is just no way to provide good care in a system that just doesn't even come close to making it possible.
  6. by   swimmom
    Quote from Kashia
    Primary exp is in acute care 5 yrs LVN. I am wanting to change to long term care and have gone to a couple different facilities through an agency. You get little of any orientation, expected to know everything, but the most overwheming part is passing meds on time ( ???) to patients and treatments when you do not know them or reconize them. I have felt absolutely overwhelmed each time! Are their any tips on how to do this, a special routine like in acute care?
    Thank you
    I have not worked in a LTC or rehab facility yet in which it was possible to pass your medications at the correct time. As everyone else has said, you have to get to know your patients. I always give the meds that very much have to be on time when they are due and work around the other meds. Obviously, if it is your first time at a facility and you are working through agency, you will not know who gets those meds with important timing. Definately ask during report. I have worked some agency, and have found that facilities that typically use agency are prepared for this and don't have impossible situations for med passes. It is still hard to make it on time, but usually the important stuff in which exact timing matters is in a place that the agency people can easily find it. And there will be people who say so and so usually gives me my meds at this time or complains that no one gave them their meds when it is not even time for them yet. I just always apologize and tell them I will remember next time.

    Good Luck:spin:

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