Working in LTC

[jl2013]

I graduated with my RN in may 2012 and received my license in June. I started a job in LTC/SNF in December. I work pool on the 11-7 shift and care for 60 patients a night. Med pass takes me from 4 am until 6. I normally have no time for a break and end up staying at least a half an hour late. I feel bad for the patients because when I do morning med pass, a lot of then want to get up to use the bathroom or be changed and I just dot have time to do it, so all I can do is put the call light on for the cna's, who at that time ate doing their morning rounds so they are usually busy with other patients. Even on a good night, when nothing comes up i feel like there is just too much, with all the Medicare charting, MDS's, the chart checks, treatments, lab and appointment paperwork, making sure the patients who triggered for not having bowel movements get there suppositories in the am, and the med pass being so heavy. The facility is unhappy when you don't take a lunch or you stay past your shift, but they won't give any more staff to relieve the load, even though it has been suggested to them by supervisors. I really like being busy and always having something to do, but there is just too much. Are all LTC facilities like this? I really enjoy the elderly population, but I am not sure that its worth it to continue on there. At this point I am only staying for the experience on my résumé. I want to cry every time I walk out of there. Any advice would be appreciated, I just hate feeling like this and hating going to work, but without experience it's not that easy to just find another job. Is this really worth my sanity?

[SinikRN101]

Yeah that's pretty typical. But luckily for me, I was an LVN and had an RN supervisor to help cover emergencies. The RN supervisor usually worked the other station because it had a rehab side also.

[joanna73, BSN, RN]

It depends on the facility, but LTC is definitely a busy place. As you become more experienced and used to the residents routines and their behaviours, you will be more efficient. I work LTC, and I've noticed that my prioritization skills have greatly improved from year one- three. Just hang in there. However, some facilities are poorly run, and that is a different matter.

[BrandonLPN, LPN]

I think part of the reason new grads feel so overwhelmed by LTC is because nursing school focuses so heavily on hospitals and acute care. When years of nursing school prepare you for high acuity care of 4 or 5 patients, adjusting to having thirty-plus LTC residents is a shock.

Many new grads come into nursing homes ready to do head to toe assessments on all 30 residents. Not only is this not possible, it's not even necessary. We don't do full assessments on every resident every day. We do focused assessments as needed. Yes, some nights Mary-Lou in room 103 needs a nurse to assess her abdominal pain and nausea. And to call the doctor for some telephone orders. But, most nights, all she needs is some pills, a diaper change and a hot supper.

And there's nothing wrong with that.

I think too many good new nurses are scared away from LTC too soon. And that's a shame.