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How much orientation for LTC nurses?



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Sep 10, 2004 10:43 PM

How much orientation for LTC nurses?


For those of you in long term care, I have one question:
How much orientation did you receive as a new employee. Since I have completed my BSN(was an ADN until 8/04), I decided to try and work in LTC. I have 3-8 hour shifts scheduled for orientation, and then they want me to start to work. I will only be part time and work 4 hours one day a week. I met some of my patients for the first time tonight. Do you think that 3 shifts if enough orientation?
I don't mean to whine, but I want to know should I ask for more time,since I will only be there sporadically?


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10 Comments
No. 1
from JellyBean1
Old Sep 10, 2004, 11:06 PM

I felt the same when I first started in LTC. I got 3 shifts each one in different areas. Basically gave me a full overview of my facility but nothing too specific. It is daunting at first but remember to ask LOTS of questions. I think most places would (or should) say if you are still unsure ask for another orentation day. It's in there benefit as well as yours especially since you have just graduated. I know look after anywhere from 25-75 residents depending on the shift. You will soon feel more comfortable. Just don't do anything you have questions about. Everyone starts somewhere. I for one am still trying to feel confident about lots and I've been at this for 10 years. Hope that helps you.



Originally Posted by military girl
For those of you in long term care, I have one question:
How much orientation did you receive as a new employee. Since I have completed my BSN(was an ADN until 8/04), I decided to try and work in LTC. I have 3-8 hour shifts scheduled for orientation, and then they want me to start to work. I will only be part time and work 4 hours one day a week. I met some of my patients for the first time tonight. Do you think that 3 shifts if enough orientation?
I don't mean to whine, but I want to know should I ask for more time,since I will only be there sporadically?
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No. 2
from sixes
Old Sep 11, 2004, 06:21 AM

At our facility you get 1 day shift 2 evening shifts and 2 night shifts.
Evenings is the biggy as you have meds coming in and are responsible for the building
Nights is not bad although you have the building things are usually quiet (haha)
If you feel you require more orientation them what is offer ask for more all they can say is no
Rely on the staff the first couple of shifts they are a great resource the HCA's know the residents and seldom will they lead you astray then of course you must assess and implement.
Good luck
I love long term care in the past 18 months i have adanced from part time RN working mostly nights and evenings to my new position as full time charge nurse/unit manager
I love it
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No. 3
from renerian
Old Sep 11, 2004, 06:37 AM

Default glad you like it
I wanted to try it but I was rather concerned about skimpy orientations especially since I had never worked in LTC/SNF. I heard when I was interviewing 4 hours to three days. I just hear so many horror stories it personally scares the bejeebers out of me. I also heard if you get behind the facility gets mad if you work over.....

renerian
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No. 4
from mona b RN
Old Sep 12, 2004, 04:49 PM

Originally Posted by renerian
I wanted to try it but I was rather concerned about skimpy orientations especially since I had never worked in LTC/SNF. I heard when I was interviewing 4 hours to three days. I just hear so many horror stories it personally scares the bejeebers out of me. I also heard if you get behind the facility gets mad if you work over.....

renerian

I feel the same way. I start clinical at an LTC on Tues and I am a little nervous. I am afraid that I will not like it although I am really hoping I do. I read the horror stories and that is what really scares me.

mona
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No. 5
Old Sep 12, 2004, 10:00 PM

I have very individualized orientation. If you have worked long term care recently, I plan for two weeks. Some of that time is on the desk with the nurse manager, the rest on meds. If you are new to LTC then you get as long as it takes! Each person individually meets with me to address what they have/haven't gotten on orientation and we continue from there. Everyone is different, so each orientation is different. I would like my orientees to stay! A good orientation is a great retention tool!
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No. 6
from catlover1
Old Sep 13, 2004, 12:43 AM

Originally Posted by military girl
For those of you in long term care, I have one question:
How much orientation did you receive as a new employee. Since I have completed my BSN(was an ADN until 8/04), I decided to try and work in LTC. I have 3-8 hour shifts scheduled for orientation, and then they want me to start to work. I will only be part time and work 4 hours one day a week. I met some of my patients for the first time tonight. Do you think that 3 shifts if enough orientation?
I don't mean to whine, but I want to know should I ask for more time,since I will only be there sporadically?
This is definately not enough orientation. Many in LTC believe that since a nurse in general is trained to pass medications he/she can start immediately. As a LTC nurse for 20 years I have went to work and given and floor the day I started and I have also had 1 week of orientation. As a former Director of Nurses I have given some 3 days to 3 weeks for the basic and 2 months for extensive training. It should depend on the person's history of nursing and their comfort level. New graduates get sometimes a month or more training and orientation. If a nurse has never done long term care they should be treated as a new grad. If a LTC nurse goes to work in a hospital with no acute care experience they are often put through the new grad program. Remember if you are uncomfortable with your work load you can make mistakes and as nurses we are responsible for our own actions as well as the management. If we don't speak up we can't make changes and believe me LTC will continue this practice because many do orientation just like this.
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No. 7
from mlolsonny
Old Sep 13, 2004, 08:35 AM

At the LTCF where I work on-call, they give three-8 hours shifts if the nurse is training for two different shifts. I was on my own alone at noc, not even programmed into the glucometer... I was not impressed. Had a diabetic LOL vomiting and wanted to check her BS, had to walk to the ajoining hospital for a code. I told the DON basically to her her crap together and that I wouldn't work again until I was properly prepared.

Have worked there twice since they started a new computer charting system, still don't have a log-in or any training on how to use it. Have had to chart under another nurse's name. I questioned if that's even legal...

The LTCF where I'm full-time doesn't have a set number of days for orientation. The DON gives the person what need to be successful. That's part of why I love my job...
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No. 8
Old Sep 13, 2004, 09:35 AM

I definatly think it should be individualized. MOst nurses are shocked at the extent of paperwork and charting that needs to be done in LTC. Getting that down might take a few shifts. The med pass can be very overwhelming. There are so many regs for a med pass in LTC, multiple meds, GTubes, nebulizers to be given per resident, and even finding a resident can make a med pass hard to learn. A few days learning that helps. At least a week or so is what our nurses get. More if they are new to nursing.
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No. 9
Old Sep 16, 2004, 04:28 PM

Our new nurses have a day and a half to 2 days with the SDC watching the required videos. Then they hit the floor. They watch a med pass for a day....meds, treatments, paper work, the next day they are watched and the day after they are pretty much on their own....little wonder the turnover is so high.
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