LTC Nurses: What skills do you use the most?

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    I am a psych nurse of 5 years looking to move into the medical arena. I am looking into positions in geri psych and LTC to get some more medical experience. Ideally, I'd like to get experience with IVs and physical assessments. What kind of skills do you use most in your LTC unit? I am currently looking at a subacute/rehab facility
    Joe V likes this.
  2. 8 Comments so far...

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    Every LTC facility is different. I was never allowed to start and IV or draw blood from a picc line. Also we didnt get IVs that often, but when did, it was several to hang. We basically did admissions, med pass, assessments troubled area and weekly skin assessments.
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    PRN psych meds and pain assessments, 'cause most of the patients I had in subacute and rehab were constantly begging for their percs or vicodins early or they were so delirious/demented they needed to have every intervention in place for safety of themselves and others, including meds.
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    I have yet to start an IV in my LTC experience; however I have
    had a couple of residents receiving IV fluids. I place Foleys ALL
    the time because I work night shift. Lots of dressings but mostly
    decubitus ulcers, not surgical wounds. Physical assessments
    happen mostly once a week with skin assessments, and then
    when there is a problem. I've had to draw blood a couple of times
    but the lab usually comes and does it.

    You'll become an expert at giving meds. That is for certain.

    Also, G-Tubes. Lots of tube feedings, giving meds through
    G-Tube, assessing for placement... you'll even change the
    tube every few months, on some residents.
  6. 0
    subacute is lots of suctioning, g tube meds foleys and respirators
  7. 0
    Quote from ivyleaf
    I am a psych nurse of 5 years looking to move into the medical arena. I am looking into positions in geri psych and LTC to get some more medical experience. Ideally, I'd like to get experience with IVs and physical assessments. What kind of skills do you use most in your LTC unit? I am currently looking at a subacute/rehab facility
    Assessment skills: I use daily as not all the elderly are able to tell you what is wrong.We also have medicare residents who require daily head to toe assessments. Plus when you have to call a MD at 3 am ..better have all your info.
    Wound care: People are getting released early from the hospital with wounds both hospital aquired and surgical.
    IVs: Do to all the medicare guidelines most LTC choose to treat at facilty rather then send to hospital.
    Time management is a must Multitasking, Admits,Discharges, Behavior management,End of life, Medications,O2 therapy ( I think I could go on and on)

  8. 1
    A lot of wound care....Hip and knee surgeries and decubitus ulcers. IV's, PEG tubes, foleys, dementia patients, assessments.
    maddock26 likes this.
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    Quote from ivyleaf
    I am a psych nurse of 5 years looking to move into the medical arena. I am looking into positions in geri psych and LTC to get some more medical experience. Ideally, I'd like to get experience with IVs and physical assessments. What kind of skills do you use most in your LTC unit? I am currently looking at a subacute/rehab facility
    It depends on the facility. I have not started an IV as they usually admit with one in place, usually PICC. We are able to start peripheral lines prn for IV fluids. Not common. I have drawn labs in other facilities, but my present facility has phlebotemists come in. Wound vacs are common. We have a rehab unit; thats where most of the surgical sites and IV abx are. On the ICF side, behaviors, falls, safety interventions are par for the course, decubs, vascular ulcers, DM, UTI' (hopefully no urosepsis but it happens) My facility has CMA's so charge nurses don't pass meds, Nurses are given higher patient loads and do treatments and insulin assessments etc. The thing about LTC is you are the eyes and ears of the MD, assessment skills are invaluable, your patient gets the meds and treatments YOU recommend. No IV teams or wound nurses to fall back on. It is challenging, and so busy it will blow your hair back. Good Luck. I love it!
    Last edit by sam3n1 on Jul 17, '12
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    Depends on where you go. I did IV's once in awhile. it was a fluid bolus x 1 or vancomycin via picc line per pharmacy protocol. i did head to toe assessments on every resident in the medicare unit. I gave coumadins, and took my own inr labs, i gave low dose heparin sub-q, LTC is great for learning wound care! lots of wounds-stasis ulcers, pressure ulcers, surgical wound care, i took out staples and sutures daily on tka people. you will be well equipped to work with alzheimers since you are a pysch nurse.


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