Help! RN working first time in LTC

You probably need to ask specifics about the position. As a RN in my LTC, we have our own patients load. I had 12 patients of my own for which I passed meds, did treatments, et assessments. Plus whatever basic care that they needed assistance with. One thing that I have learned is that even the smallest people can be very heavy if they are unable to help you turn themselves. I always try to have someone help me with turning/repositioning if it is someone who is unable to help. But I have read on here that at some places, the RN is the supervisor and do paperwork, deal with short staffing issues, do the admissions, ect. and the LPN does the meds/treatments, ect. I guess it depends on how your facility is set up. At mine, we have someone oncall for all staffing issues so that I do not have to deal with call-ins but I do have a patient load. Also, I am ultimately responsible for not only my patients but supervisor for the whole building, which is a 150 bed facility. So if there is an IV somewhere else et no IV cert. LPN on that floor, then I have to take care of that IV. And if there is a Hospice patient somewhere, I will have to also go et assess them once per shift because our facility policy is that the RN document on them Qshift. And if an admission comes in the LPN can do all of the admission paperwork (meds, tx sheets, Code Status, ect) but I have to do the fall risk assessment, the admission assessment, skin assessment, et the alarms/siderails assessment. Sounds like a lot but you do get the hang of it all. And I love it!!

Hi QT RN,

Recently, the LTC facility I work at did away with unit managers/charge nurses and divided the 44 res up between the nurses. However, prior to that the nurse manager was responsible for all the charting, incident reports, and rounding with the MD once a week. This wasnt a bad gig, but by having that extra nurse to take pts now each nurse has 22 and does the charting and incident reports for their res. The ADON or DON round with the MD. Good luck!

I'm a LPN and when I work 3-11 I am responsible for 40 residents with the help of 2-3 CNA's. I do all the treatments, pass all the meds, do all the charting, the accuchecks, help with turning, skin assessments when they get ready for bed and whatever else may come up. I get out of work around 1:00am. Good Luck and if you decide to work days it gets even harder. My motto for nursing is "Do your best and bless the rest" because we are only one person doing an awful lot of stuff for an awful lot of people.

If you don't get a formal orientation from the DON, ADON, or staff developer, or someone else, you will have to rely on your LPN to clue you in. Suggest a meeting with your "crew" where you let them know your expectations, etc. and that you will be relying upon them to keep you properly informed and that you expect everyone to work as a team. If you get thrown in without an orient., you might want to start by learning your residents, start with the MAR, then quick read each chart, etc. Split the assignment with your LPN. That is probably how it is done anyway. She does half the residents med passes and tx, etc. You do the other half. And help each other. Good luck.

If the nurses I work with thought they had to turn a resident, they'd freak out lest they break a nail.

At our facility, the charge nurse (RN or LPN) is responsible for 28-29 residents and have 2 CNAs per wing (on days we have a bath team of 2 CNAs also) - Our census has been running about 60 so on average the resident to nurse ratio is about 30:1, but there are 2.5 CNAs on PM shift (the fifth girl floats). Our charge nurses pass the meds, do assessments, treatments, family / MD contacts after hours (otherwise on day shift the RN supervisor does the contacts). Pt care, turning, etc is the responsibility of the CNAs, unless there isn't a partner nearby, then they might ask the nurse to assist them. It's ultimately the charge nurse's responsibility to ensure proper care is being provided to all residents - but that does not mean SHE (I say she because we don't have any guy nurses) has to do it all.
Our activities on PM shift generally include some sort of afternoon event, supper, then everybody is getting ready for bed and after people are in bed, the CNAs are doing rounds on the first residents in bed.
I worked the PM shift for a total of 5 years, first as a CNA, then as an LPN while I was going to school. The most frustrating thing of the shift? SUNDOWNERS! It gets really bad when the weather gets nice and they all want to go outside!
God Bless in your new spot!