started new job at a SNF/LTC

  1. WEll today I started my new job at a SNF/LTC facility. Wow I have alot to learn after being in home health 11 years! I wanted to thank all of you who have been so kind to me while I tried to find a good job. Hopefully this is it........

    Tomarrow I am passing meds. Is that hard to do for 20 people? Seems daunting......

    renerian
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  2. 13 Comments

  3. by   quackers
    Pass meds is daunting. Go slow at first and gradually you will speed up with practice. The facility I work in I pass meds for at least 24 to 36 residents. At first I could not get done with my treatments and I spoke with the ADON about it and all she said was "Give it time and you will get everything done you need to." She was right. I am not a novice in nursing as I have been in nursing for 32 years. The LTC environment is great and I love it. It is hard work and can be very tiring. You will do a good job. God bless.
  4. by   renerian
    Thanks for responding quackers. I don't think the job was for me. I resigned. I was to orient and the DON walked out, left only agency staff there so they said I could not orient with them. Then they said I would need to orient with an STNA which is not going to help me but to boot they said I needed to drop my pay to STNA wage since I would be with an STNA. I told them that was unacceptable. They have an interim DON, an LPN supervising The RNs, and agency help. Needless to say they are a mess. Don't need that in a job. have you ever heard of an LPN supervising the RNs? I have not and I don't think the state would think that was appropriate either.

    renerian
  5. by   nursedawn67
    I pass meds for usually about 26 res, occas 50
  6. by   BadBird
    I hope you found a job that you will be happy in, I do not have any LTC experience so I can't offer any advice, just sending you good thoughts.
  7. by   robinrdrn
    Gee, I'm feeling spoiled again, I pass for 18 residents at my max! Usually, it's more like 15 and have one to two CNAs on my set. Then again, our DON has been with us for 6 years. That is unusual in LTC. I've worked in places where the DON and nearly the entire management staff has walked out at once. Needless to say, that place ain't in business anymore. I am thankful I'm back with a large chain facility with many years in LTC. I am also thankful that I have an administrator that respects the nursing staff.
  8. by   CapeCodMermaid
    There are some facilities which allow LPN's to be supervisors over RN's...I'm pretty sure the regs of the state of Massachusetts would have a problem with that. But your story of no orientation is all too common in LTC. I was the nurse manager of a subacute unit for 3 years. My entire orientation consisted of using the telephone. My new job of 6 weeks is that of the SDC in a different LTC. Not only did I get NO orientation, I had to DO the orientation for 2 new workers on my second day in the building
  9. by   Youda
    Congratulations, renarian! I'm so glad to hear that you found something you might enjoy!

    I've seen LPNs "supervising" RNs before, too. Usually it's because all the RNs had the good sense to quit and there isn't an RN to orient the new RN. I don't think, in those situations, that the LPN is to supervising the NURSING, but orient to the policies and procedures, charting methods, the residents, etc. Still, you'd think that the facility could find an RN at corporate headquarters or another facility for a few days . . .

    How did your first day go ????
  10. by   ShortFuse_LPN
    LPNs supervising Rns?? Is this place nuts or what? LPNs really aren't even supposed to supervise other LPNs as far as I understand. In the LTC facility where I work, I am usually the charge nurse on eves, but if the med nurse (LPN) calls in and is replaced with an RN, I am moved to med pass. And we pass to 75 residents!! And do tx!
  11. by   lisamcrn
    At a former employeer we had an lpn supervisor. This was a 340 bed ltc/snf facilty. This gal was chosen because she knew her business way more than the most rns on staff....but she did just recently obtain her rn. Regardless, she was able to supervise because the on call person was an rn. Legal or not?? I don't know, but this seems to be the norm for ltc around here of the 3 I have worked in.
  12. by   lisamcrn
    My first ltc orientation lasted 3 days and I had 38 residents with 2 cnas a 1 bath aide. This was a new grad a year after school ended before I decided to go make that education work for me. After about 3 weeks I would pass those pills within 2 hours. But, another facility with 10 alzheimers in one area and 2-3 tube feeders and about 10 other residents, maybe 5 all together a, ox3 would take forever---usually 3 hours. It all depends, but I hope you find something that works out better for you.
  13. by   sassynurse78
    Where we work we have had several LPN's as charge over RN's. Not to start the great 'ole RN vs. LPN stuff, but as an LPN, I have trained several RN's that have more opportunities then most LPN's. So they have had more job options which usually means less time in LTC. LTC is a whole diffrent type of nursing, where you are often there by yourself with no one in charge. I once had a nurse (I am calling all RN's & LPN's nurses cause thats what we r) freak 'cause she had to start her own IV. Where she came from there was an IV nurse that done that! Being in charge is all about knowledge and experience not the little letters next to your name. I have worked with great RN's that could run the show and I have worked with great LPN's that could to. But I do think I heard once that legally the LPN cannot be in charge of an RN's pt. care, but they couyld still be in charge as far as the floor goes.
  14. by   ChainedChaosRN
    I'm a DON of a 160 bed skilled LTC facility. I have several LPN supervisors. The ability to lead, motivate, and have organizational skills for a unit usually is not taught in nurses training. A lot of it is personality, character and critical thinking skills. I'm a believer that the ability to lead is inherited and fine tuned through out life by education and experience. True leaders shine through and has absolutely nothing to do with the letters behind someones name. I would personally prefer to use RN's because of the scope of practice, but the best person for the job (supervising) wins out.
    Just for the record there is a federal tag that states an RN must be present 8 consecutive hours 7 days per week.
    Hope this gives you a management perspective

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