Hello all! I love this site and just wanted to share my 4 months experience of working as a brand new nurse in a LTC/SNF. I started off my first month with one week of orientation on the "long term care halls" where I had close to 60 patients. I was really overwhelmed and could not for the life of me get everything done on time. But let me mention this as I know not all facilities have them. I do have med aides and a treatment nurse, so that, im sure makes a world of a difference.
After about a month and half I got moved to the rehab/skilled hall where I have up to 22 patients. Here I have done many many skills like insert IVs, IV meds, insert foleys, ostomy changes, Peg tubers, IM injections galore, Resp tx, PICC care and removal, among numerous other things! I have had to call codes, perform CPR, assess sudden changes in pts and of course call docs and input orders. I have loved it and think it was a great start to my nursing career. In the beginning I heard it all from, nobody will hire you to you will lose your skills...this is not true at all! It took some time to find my mojo but I have and enjoy going to work. I will say you have to be determined and strong enough to be able to stay. In the short 4 months I have seen many come and go.
I wanted to share because I know alot of new grads are in the position of needing a job but unsure of where to go and hear the negatives of starting in SNF/LTC so here is a little positive. Yes I know having the med aides and tx nurse is a HUGE factor in my positive experience, but I am always on the move and hardly sit as there is always something needing to be done.
I will admit that I am getting bored at times because it can be repetitive but for now I am okay with it as i go through my RN-BSN program and plus have my baby
I will eventually leave after the birth but for now it works.
Oct 21, '13
When I worked SNF in a LTC setting, we did everything the hospital did but hang blood. Our nurse/pt ratio was 2-3 times that of a med/surg unit. We did all of it without the luxury of a rounding MD everyday.
I remember it as my favorite nursing job. I'm sure the passage of time has softened the more miserable days, but it remains the yardstick I've measured every job I've ever had against.
Last edit by imintrouble on Oct 21, '13
Oct 21, '13
I am happy to hear this! I am not a new nurse; but new-ish to LTC/SNF. The ratios you have honestly amaze me, since it basically sounds like MED-SURG! You should be very proud of yourself!!! I also realize MANY people think we "lose our skills" in LTC/SNF, and/or that it's easy.....after all, don't the cute little residents sleep and play Bingo all day?
I am a VERY hard worker and I can tell you, I KNOW I could not handle 22 residents with the acuity you describe...wow! Where I am now, we have VERY few "SNF", and in seven months, I have only had to deal with ONE PICC Line, and have not had one resident with a peripheral, nor do we have trachs, but we (nurses) do give all the respiratory treatments. We also have a treatment nurse and CMAs also. Unfortunately, we have a high turnover and WAYYY too much drama with many of our aides.
Anyway, all this to say.....when I'm dealing with 40:1 LTC, I can BARELY make it, nor can any of the other excellent nurses I work with. If they had IVs, lots of IMs, lots of ostomies, etc....I don't know how we could do that with our ratios.
What still amazes me in this type of nursing is the constant FAMILY drama we have to deal with......oh. my. goodness...!!! Take up an hour of my valuable time to complain, but you live 10 minutes away and haven't visited in over a YEAR.....
Then you threaten to call our administrator tomorrow---PLEASE call her, because I have been nice to you and lost an HOUR of precious time dealing with patient care...!!!
Last edit by nervousnurse on Oct 21, '13
: Reason: paragraph indention/ wrong wording :-)