New Grad to LTC on 3-11 shift- help!

On days you start with report, count your narcs, and start your am med pass. You will probably have gluco checks and insulin to give. After the med pass I always did my assessments, notified Drs, and faxed drs. I would do my treatments. Before the noon pass I would take a break and come back and start my noon pass. After the pass I would check to see if I had any labs, or Dr. visits that needed my attention. Day shift is a good shift for new grads because there are more seasoned nurses there to help you get organized and help lead you in the right direction. Second shift and noc shift are a little harder because there are less staff.

This is about how my day starts, too, and this is a great timeline to follow. I start meds as soon as I see people getting up because there is ALWAYS something/someone interrupting. If you have 7am, 8am and 9am meds, as I do, I start them all as soon as possible. Don't wait until 7am to start giving your 7am meds. I was a new grad and my first job was in LTC 2p-10p. (and I am still at the same job) been there for almost 4 years. I am planning to start the LPN-RN in the next few months thru the Univ. of Phoenix.

It will take you awhile to get into a routine (took me about a month, with only 3 days orientation.) Try to relax and take your time. You definately won't get all your meds passed in 2-3 hours. You'll feel like you've gotten nothing done, and angry residents and families will always whine and complain that you didn't get their meds on time, mom's bed isn't made, so-and-so needs to be changed, so-and-so wants a pain pill, so-and-so just fell, now you have to do neuro checks and fill out an incident report, etc., etc. Make sure you take your breaks and if you can't at least take 20 minutes to eat something, and always carry a water bottle for you on your cart. If I don't do that, many days my shift will be over and I will just realize my mouth is so dry, I haven't taken a drink in 8 hours (or more). Congrats on your first job, you'll do great!

My words of advice after being a nurse for 27 years and having worked every shift...PRIORITIZE. There are evenings where you won't get everything done. Don't beat yourself up about it. That's why there are 3 shifts. Be prepared to be flexible as well. If you have it in your mind that your schedule of things to do is set in concrete, you'll make yourself crazy. Years ago, I had a nurse tell me I HAD to do things in a certain order: Meds, then treatments, then assessments, then notes. Seems it worked for her and she thought it would work for everyone. Sure..on an OLD TIME nursing home floor with no sick people. For me I combined the med pass with some assessments, wrote notes when I could, did assessments while doing my treatments. The point is, you will figure out a system that works for you and the kind of patients you have. Good luck with your new career in long term care. It is never dull and this part of the industry needs all the new nurses we can get!

kmarie724
i'm a new nurse in ltc and still orientating, i have been wondering what am i going to do when i get on my own, because during orientation you get a different nurse each time and they all have different routines. your comment for new ltc nurses was so helpful and organized, once i get on my own i will definitely use your comment as my guide.

thank you
fissile

Wow! Great post. Also have an opportunity to work as a new grad RN in LTC...just passed NCLEX. This thread helps alot.

Glad I could help. I used some of the tips I gotfrom each of the nurses I oriented with and developed my own routine that works for me. I've noticed that I get more and more efficient with my time everytime I work.

Jellocorp.

How are things going with your position. Do you have any helpful tips for new grads starting LTC. I will be starting next Wednesday orienting on the floor. I am starting corporate orientation tomorrow. Any help would be appreciated. Wish you will well on your new position.

Thank you all experienced nurses for all the great tips. I am a new grad and just started in a LTC facility. It is my second week and I am OVERWHELMED!
usually we have an LPN to do all the med pass, but today there was a short of staff, and I was exposed the the RUSH!!!!!
It is really scary. It's like trying to do a million things at once because while I'm am checking their blood sugar, my preceptor and I try to do treatments at the same time, and talk to the residents. OMG
I cannot predict the future if I am left in charge of the floor without an LPN.

I feel good on some days of orienting, and some days I don't feel as confident. I am 24 and have been told I look 18. That makes it harder for me to be "in charge." I may have did some slight engraving in my own head of how people will view me differently just because I am young.

My preceptor is great. The place is great, but on some days, there are those experienced nurses who question me:
Is this your first job?
Why didn't you start in a hospital?, etc
It just bothers me and makes me feel less confident.

I just swallow my fear and try to answer them with a smile.
I feel better when I read about other new grads in a LTC facility.
I don't feel as alone.

For now, all I can do is try to absorb anything and everything. There is so much documentation to do! But my biggest problem is CONFIDENCE!

Ok, I'm babbling.
BUT THANK YOU ALL FOR THIS POST.
IT REALLY HELPS!!!!

I'm a new grad nurse and I have been contemplating on whether or not I should work at LTC for my first nursing job. I have been offered a job at a skilled facility in santa rosa, Ca. Has anyone worked at parkview gardens in santa rosa california? How is the working environment? are the staff supportive? I have until monday to make my final decision, if I go for it then I will have to relocate since I am currently in NV. I'm still not hearing from any of the hospitals here in Las Vegas..should I wait until they start opening new grad positions or should I take the opportunity at santa rosa? is the workload at LTC really that unbearable? Does it get better in time? How long did it take for you to develop your routine and get comfortable? I was told that I would have 1 week of classroom instruction and 2-3 weeks on the floor then I'll be on my own, and I will be responsible for 25-35 patients max. I will also be rotating in other units such as rehab, since there are 3 units in the facility. There will be 1 nurse per unit with 4 CNAS and I will be working the afternoon shift. I know that the DON there is supportive. What do you think?? please give me some advice. thanks!