New Grad RN's in nursing homes

Specialties Geriatric

Published

This seems to be a new trend since the hospitals are not hiring us! I was hired as a charge nurse.... what about you guys? Tell me your experiences as a new grad R.N. in a nursing home!:nurse:

How's the first few days gone for you? I sent my email address so if you have any questions feel free to email me!

Specializes in psych, ltc, case management.

I'm in a similar situation! New graduate, starting my first job as an RN at a LTC/rehab place on august 30th. Compared to what other LTC RNs have posted, it sounds like my job is a good place. They told me my ratio will be 15:1 (though i dont think i believe them), with 3 CNAs and one other nurse who is also taking care of 15 pts. The orientation is 4-6 weeks. I am thankfully NOT in a charge position! I feel like I have no idea what to expect. Ive read a lot of negative stuff about working in LTC and how hard and overwhelmed i will be. However, like every other new grad, I am lucky to even have a job. I couldnt turn it down without any other prospects! I'm really nervous though..

I start on August 23rd, so far they have given me IV certification and I have an orientation to attend tomorrow. Ill let you all know how it pans out!

Specializes in LTC.
I'm in a similar situation! New graduate, starting my first job as an RN at a LTC/rehab place on august 30th. Compared to what other LTC RNs have posted, it sounds like my job is a good place. They told me my ratio will be 15:1 (though i dont think i believe them), with 3 CNAs and one other nurse who is also taking care of 15 pts. The orientation is 4-6 weeks. I am thankfully NOT in a charge position! I feel like I have no idea what to expect. Ive read a lot of negative stuff about working in LTC and how hard and overwhelmed i will be. However, like every other new grad, I am lucky to even have a job. I couldnt turn it down without any other prospects! I'm really nervous though..

WOW!!! 4-6 WEEKS ORIENTATION!!!! you're blessed!!! i had 3 days, we have 2 floors but its section out by 4 departments. so i had 1 day each on 3 floors, and last night was my first night on a floor with 1 day of traing!...i was scared, nervous, but excited! we dont have a med aid so we do all our meds pass, and i felt like i was doing those meds alll day!....i really need some advise on how to get organized!...

Its impossible to be completely organized. I run into this problem all the time. The Pt ratio is too high!

Specializes in Geriatrics, Home Health.

Demand a good orientation. I got 2 days of watching videos, than 3 days on the floor before I was on my own. I lasted 6 weeks, and it was Hell.

Specializes in ED, acute care, home health, hospice.

I started at a rehab/LTC facility a few weeks ago. There are 3 different halls, usually with about 30 residents each. I got 7 days of orientation, a few on each hall since I will be floating. I had my first two days on my own last weekend, and thankfully have had 3 days off to recover. I have several patients with G-tubes, often have pts receiving IV antibiotics. I know I am new and slower, trying to be sure I am giving the right med at the right time, etc. I have gotten lunches most days, but have yet to have a break or so much as sit down for five minutes. I haven't been able to get all my treatments done, just meds, BS, insulins, feedings and IV's hung. I know I will get there in time but it has been extremely difficult and emotionally draining. Like one of the other posters said, when you are able to talk with your patients and their families and get to know them, and know they trust and appreciate you is when it is truly rewarding. Obviously there is not much time for socializing.

The long term care hall is a bit easier because (sadly) there are not many families there to see the residents, so I am not being distracted with questions from the family. I know I will just have to give it some time, and try not to feel so frustrated that I am not able to get everything done. I feel guilty passing drsg changes off to the nurse who is relieving me, but this is (hopefully) just temporary until I have a routine down.

It is hard when you have 30ish residents and only 2-3 aides. We have both LPNs and RNs working in our facility, but they are pretty much one in the same. Both can be med nurses, but of course only RNs can be charge. Staffing is not ideal, but it is much better than the LTC facility I did clinicals in.

Some days I feel completely incompetent, like I accomplished nothing and nothing went right, I know it will get better...eventually. I also know that I will move onto another area of nursing at some point, but for now, the residents deserve me to be the best and safest nurse I can be. I know the experience will help me in whichever specialty I end up in.

Specializes in Gerontology, Med surg, Home Health.

I hired a brand new grad 6 weeks ago. We gave her a longer than normal orientation. She is wonderful! Never comes late, gets all her work done on time, writes excellent nurse's notes....a good fit for her and for us.:yeah:

Specializes in Foot care.

This may be entirely a fish of a different color (I know I have that wrong) but I just took a job in a rest home. I was feeling desperate after having my license for a year, and very few interviews. I interviewed on a Thursday and was hired that day; started the following Monday, observing the LPN on duty. The job is essentially med pass and documentation, and the residents are somewhat independent. Mostly these are mentally ill people whose illness is under control. It's really like poor man's assisted living, and some residents are probably just poor and unable to live entirely independently.

The rest home has two "units." For each unit I observed one day, and on the next day, I did the med pass while being observed. I also answered the ever ringing phone and responded to all sorts of other interruptions. One unit has 20 female residents, the other 36 male. There are lots of narcotics and psychotropics, also finger stick blood sugars and insulin on sliding scale. All documentation is on paper. Tomorrow I do the smaller unit on my own. I'm a basket case tonight, barely able to speak without crying.

There's no way to know ahead of time who should be done first. The people who have been there for years have all the information about who gets what, when, in their heads. I spent every spare minute and hours before and after shift scouring the med records and jotting down who has meds due and at what time during my shift, so at least I know who to start with.

I don't know how the people who do it got to the point where they are today. Primarily this is a job done by LPNs, though some are not LPNs and instead a designated "responsible person" (RP) who has had training in medication administration. (The one woman RP I trained with is worth many times her weight in gold, she DOES the job.) But it is a hellish job to do. I'm not sure what satisfaction can be derived from it. The pressure is immense. There is always too much to do and too little time. The first two days I ate my lunch sandwich standing in an alcove off the main office where we keep ice in a cooler to provide cold water for the residents to take their meds with.

This is not the rewarding profession I thought I was getting into and now I feel like nursing school was the biggest mistake I made in my entire life. I'm not young but I am ready and willing to work hard and long, but this is just nuts.

I was told there will be opportunities more in keeping with my RN in time. I was happy to take a job "below my license" as long as it offered patient contact, but I'm not sure I can do it. I don't think anyone should. There's no learning going on, it's just grind, grind, grind.

Thanks for reading.

Specializes in ED, acute care, home health, hospice.

I know, it is difficult. I have days where I feel like I didn't accomplish anything and I can't wrap my brain around how these nurses I work with have done this for two years and how they are so efficient. I know I will get there some day, and there are days where there is no personal satisfaction. When residents are yelling at me for pain meds, telling me how to do my job, what orders the doctor should be prescribing, etc. However, it is when residents and their family members share their life stories with me or put their blind trust in me to care for them - are the days that getting up at 4 am and working two hours past my shift are truly worth it.

I know that my entire career will not be spent in LTC, but I know that the experience I am gaining now is invaluable.

Best of luck to you. My advice, hang in there. Talk to your supervisor, ask for pointers, always be safe and be patient with yourself.

Specializes in Acute Care. ER. Aged Care/LTC. Psyche.

I was a new grad when I started working in LTC. I was excited and nervous. I came from a country with no nursing homes and the equipments are not the same. And some drug names. So it was kinda difficult for me. Add to the burden is the fact that some movies portray nursing home patients as being rude, needy, mean, always yelling.

It wasn't bad as first because the residents are friendly and we had only 18 patients then(it's been a year). But lately the census went up to 23, and the latest additions are pretty much dependent, some with major disabilities. Before we have no resident with "psychotic" tendencies, now we have 3. And really our days would have been easier if we are not constantly running after them when they try to harm the other residents or try to escape.

It takes me almost 3 hours to pass my meds. Which isn't really bad. But what really makes me tired is the constant call lights. There are days that I can't even eat my lunch.

It's exhausting - Yes.

It's stressful - Yes.

It's physically demanding - Yes.

But its all worth it every time you see the residents smile, when you see the pain vanishing, if you hear them say thank you, and if you feel that they treat you as a family.

Hi i am a new grad RN too. got an offer at a nursing home for am 7- 3 pm shift . just wondering, they offer a 6 week orientation but they are offering me a much lower salary for the first 3 months (including the orientation) is this normal?

thanks

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