Orientation length?

kat7ap · Apr 26, 2009

I was hired fresh out of school at a LTCF and was supposed to have 3 days orientation but it really turned into about 2 because of staffing needs and the state was inspecting the building when I was being oriented. I would say 3 days is normal, if you get more than that consider yourself lucky!

Starr1966 · Apr 26, 2009

i think that 3 days orientation is rediculous. that is how many i had at the ltcf i work at now. not nearly enough time. another ltcf gave 1 week orientation. that was when i was fresh out of school. a little better, but i felt not enough. i worked there only 2 months, i didn't feel that i knew enough and didn't feel comfortable being responsible for 38+ residents fresh out of school. the best place i worked at as far as orientation was a smaller town hospital and they give their nurses a one month orientation. it was wonderful and i felt more comfortable. after the first few days i was given my own patients, but still was in orientation and assigned to another nurse if i had questions or concerns.

:offtopic: i miss working there. i love hospital work, moreso than ltc. but it was an hours drive one way to work, that got old, especially in the winter :sstrs:. lol. the advantage to working in ltc is that you really get to know your residents because you're with them daily. where i work now is only 3 miles from home and thats great, but i still miss the hospital.

sorry to have rambled on, i have a tendency to do that :banghead: .

wanda/ne

:prdnrs:

AshiPanda · Apr 26, 2009

I was told I'd get two weeks. Well, after four days, they threw me out on my own. My first two days on my own were kinda rough... my med passes took forever and I never got around to my treatments (dressing changes and such) and I was there til an hour and a half after my shift was supposed to end. But today (the third day on my own), my day went great...got everything done EARLY. You'll be ok, have no fear...things'll be rough in the beginning either way... following someone around and doing it on your own are totally different ^^;

NC Girl BSN · Apr 26, 2009

I got three days. On the fourth day, they put me on a hall that I had never worked on. My first two weeks took me forever. I would leave 1-2 hours past my shift. But after that I got the hang of it and did well. With a few short cuts of course.

dulcemorena · Aug 17, 2009

at one facility I know they give around 5 weeks orientation. You cant even get used to the routine of a place after 3 days, let alone feel comfortable enough to pass meds on your own. A couple weeks sounds better and might guarantee that a new nurse wont feel overwhelmed and walk out

princezzzz · Aug 18, 2009

i got 6 days orientation... i felt like it wasnt enough.. bec i was just following a nurse, and they dont even let me try tp pass meds.. its completely different if your just observing from hands on.

nways, my 1st day on my own was nerve wracking.. it took me forver in giving meds... sigh!

i dont know... hate it! lol.:banghead:

2bNurse4life4ever · Aug 22, 2009

i got 6 days orientation... i felt like it wasnt enough.. bec i was just following a nurse, and they dont even let me try tp pass meds.. its completely different if your just observing from hands on.
nways, my 1st day on my own was nerve wracking.. it took me forver in giving meds... sigh!
i dont know... hate it! lol.:banghead:

omg.. how do u feel now? im starting on my own after 3 more weeks of orientation... the nurse thats orienting me always wants to leave on time.. and since shes so worried about her speed, she doesnt give me chance to pull meds.. and to top it all im a RN new grad going into LTC and sometimes i feel that the LPNs dont like that.. im scared and a nervous, I want to make everyone happy and want to learn everything there is to learn!! ughh!!! how are you doing in terms of speed now? i dont like how the meds dont have both names on them, sometimes it takes forever to look for the meds because both names arnt there.. and all the stock meds are mixed up! ughh , the lpn thats training me doesnt even do her three checks.. she has her meds memorized!!!! she just goes in and gives the meds to the patient without even checking them, sometimes she doesnt even compare them to the MAR and says its because she has them down .. and thats why shes faster.. and i dont want to take any chances.. i will do all my checks.. but im freaking out.. and im not even good at delegation.. i dont know how to delegate the aids.. let alone what they need to do, ect its driving me crazy!

NC Girl BSN · Aug 22, 2009

omg.. how do u feel now? im starting on my own after 3 more weeks of orientation... the nurse thats orienting me always wants to leave on time.. and since shes so worried about her speed, she doesnt give me chance to pull meds.. and to top it all im a RN new grad going into LTC and sometimes i feel that the LPNs dont like that.. im scared and a nervous, I want to make everyone happy and want to learn everything there is to learn!! ughh!!! how are you doing in terms of speed now? i dont like how the meds dont have both names on them, sometimes it takes forever to look for the meds because both names arnt there.. and all the stock meds are mixed up! ughh , the lpn thats training me doesnt even do her three checks.. she has her meds memorized!!!! she just goes in and gives the meds to the patient without even checking them, sometimes she doesnt even compare them to the MAR and says its because she has them down .. and thats why shes faster.. and i dont want to take any chances.. i will do all my checks.. but im freaking out.. and im not even good at delegation.. i dont know how to delegate the aids.. let alone what they need to do, ect its driving me crazy!

I worked in LTC for almost 2 yrs. I know its freaking you out now about the meds but if you get a permenant hall, you will learn your residents and TRUST ME you will learn their meds by heart. There is nothing wrong with that. You will soon find out that it will be a great assest to your speed. What I would do was have the MAR open and just go into the drawer and pull all the meds by memory. Then I would briefly glance at the MAR to make sure nothing changed. Then walk in and give them their meds. At my facility, most of the patients didn't even have name bands. Once you knew the patient, it was not an issue. LTC is mostly repetition. The residents take the same meds every day for the most part. Sometimes they added new meds or reduces the dosage on Cumadin or BP meds. Its so predictable in LTC. Sometimes a patient would fall or get really sick or die but it didn't happen everyday.

Everything is hard right now because you are new. It WILL get better I promise. As far as delegating to CNA's. Just make sure as your passing meds, that your residents are being changed and not neglected. Make sure you communicate when you want your vital signs so that your not sitting around waiting for them when you get ready to chart. Another thing that I stressed was for them to let me know when they leave the hall. This helped alot. Once you learn your job then the delegation part will fall into place.

2bNurse4life4ever · Aug 23, 2009

I worked in LTC for almost 2 yrs. I know its freaking you out now about the meds but if you get a permenant hall, you will learn your residents and TRUST ME you will learn their meds by heart. There is nothing wrong with that. You will soon find out that it will be a great assest to your speed. What I would do was have the MAR open and just go into the drawer and pull all the meds by memory. Then I would briefly glance at the MAR to make sure nothing changed. Then walk in and give them their meds. At my facility, most of the patients didn't even have name bands. Once you knew the patient, it was not an issue. LTC is mostly repetition. The residents take the same meds every day for the most part. Sometimes they added new meds or reduces the dosage on Cumadin or BP meds. Its so predictable in LTC. Sometimes a patient would fall or get really sick or die but it didn't happen everyday.
Everything is hard right now because you are new. It WILL get better I promise. As far as delegating to CNA's. Just make sure as your passing meds, that your residents are being changed and not neglected. Make sure you communicate when you want your vital signs so that your not sitting around waiting for them when you get ready to chart. Another thing that I stressed was for them to let me know when they leave the hall. This helped alot. Once you learn your job then the delegation part will fall into place.

thank you so much for your reply.. it was exactly what i needed to hear and right to the point , it made me feel much better.. how long did it take for u to adjust to the routine in passing meds? Thank God , i too, have a permenent wing that i will working on.. i will be doing 3-11s mon-thurs 32 hours per week. LTC was not my number one choice to work in, but the economy is in the dumps right now. there are no job openings where i live for new grads in the hospitals.. so i choose the LTC route.. my DON said that within 6 months if i get the hang of things she wants to train me to supervise.. did u have that experience?

as far as delegating to the aids.. so far ive worked one week in the morning, and the lpn i worked with really didnt delegate anything... it was 3pm and some of her patients vitals were still not done..and she was ready to chart.. her shift was 7-3 ..the lpn told me that whenever u have parameter meds dont trust the aids for the vitals. because the aids make up the vitals..?! i was shocked to hear that.. but thank you for your advice .. i really need to hear advice like this.. because i dont know how to communicate professionally and nor do i know whats in my scope of practice that i can delegate.. i mean yes i know most things from nursing school..buts its totally different in the real world.. i never really delegated anything in nursing school..although our instructor was pushing delegation the last semester.. it was hard to do since we were students..

im always afraid that what if i miss something or dont see a subtle change in my patient that i needed to report.. or what if i make some real bad mistake.. after all its my license on the line.. ughh.. it scares me to think this way.. did u have to fill out A&Is at your nursing home/ ? the sheet that u fill out if there is a new bruise or skin tear on a patient that is unexplained. i really dont get when those are filled.. my patient's arm was really itchy and the nurse put some hydrocortisone cream on it..and the arm had a rash.. she didnt have to fill out an A and I for that because she said it was a natural occurence, so it didnt need one,.and then other things that i found that are different from a hospital are that if there is something wrong with the patient or something happens on ur shift.. u have to notify the family? i dont think we did that in the hospital.. if the patient's oxygen sats drop and they need oxygen or they had a terrible night ect.. the family needs to know.. so that adds to more work.. and on top of it .. doing treatments and charting.. there is a pain assessment but the lpn thats training me didnt ask each resident about his or her pain scale and filled that out with mostly zeros for pain scale.. .. i mean it does look like lots of repetition and i hope, i too, can soon say that this is not that bad.. but so far i feel overwhelmed.

sasha2lady · Sep 4, 2009

Hmmm....my boss just hired a new nurse....today would be her 2nd and LAST day to orient on day shift...which isnt even the shift she will be working! I asked the boss why shes only giving her 2 days and no orientation to 2nd shift ....she said "well..its busier and theres more to do and see on days" ..umm...what?????????? Not to mention ...one of the slowest nurses was the one to attempt to train this new one. She will be on her own next week when I take my vacation days. I hate to think of how bad thats going to be..glad I wont be around for it.....but I'll get a taste of it eventually.