koko2002 1,699 Views
Joined: Nov 12, '10;
Posts: 33 (6% Liked)
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I think Tankweti's statements are true. As a new RN going into a LTC, I wouldn't emphasize educational level. My first job was at a LTC. After two months, they had me as charge over the whole facility. I also had my own unit of 25+ patients to handle. I think it did irk some experienced LPNs that I was charge. But most of them would be very helpful. One in particular was a bit hard on me at times. I remained humble and shifted my questions to other LPNs. I also let them know that I respected their experience. --On rare occasions, I was acutely aware that I had learned things in school that an LPN colleague hadn't, but for the most part, I learned TONS from them --All in all, as a new grad or even a new nurse, I'd rather have an experienced LPN on my team than (I can't believe I am saying this) another new grad. --When the stuff hits the fan, experience can really be helpful. --I guess it is important to have a balance on the team....experienced nurses with the newbies. I should also mention that I work with experienced RNs and LPNs now along with new grads. I learn from ALL of them. I like a well-balanced team. I am not a charge anymore. In my charge, I like experience. ...hm...I guess most of us would. --So if you are going in as an inexperienced charge, it might be easy to understand that some folks won't be as jazzed about it. ---But accept it and show them that you will bring your best to the team. Draw on their strengths and appreciate them. You will learn a lot.
oops...just realized you are LPN...I focused on previous poster.
I think you will be fine and learn a lot, just like me. I have found most folks want to help. Some folks are too busy to help. Very rarely, there will be some that just don't want to or just feel irritable...maybe they are burned out. If you find someone is cranky, give them the benefit of the doubt... nursing is stressful. Change your approach, and/or choose another person to help you...
I am now in acute care. I miss many aspects of LTC. I am in acute care as I am trying to "round out" my experience.
I learned about managing dying patients in LTC....pain, anxiety, breathing, emotional support... If you ever have a patient that is in the dying process and is in anyway uncomfortable (and you can't help it), draw on the other nurses on your team and the provider to find ways to make them more comfortable. I did not learn about managing the dying process in school. Things you might see prescribed --dilaudid, morphine, lorazepam, atropine, oxygen (NC/face mask), suctioning... Remember you can call on pastoral support....and sometimes if hospice is on the case --on hospice... In LTC, you are the one present --and you often must advocate for the patient to the provider. They may not have adequate pain control, etc., ordered. You must advocate for it.
It is normal and understandable to be nervous. I used to work in Subacute, am in ER now. The most important thing I learned working in SNF is time managment. You will be taking care of many patients. I took care of 26 subacute, more like acute , really! And I covered nurses in LTC, too. Boy! Too many patients to assess, too many meds to pass, too many phone calls from patients' family, pharmacy calls and doctors' orders to take care of. So very important to really prioritize your tasks. Go and see medically complicated patients first like diabetics and on vents. Get organized. I made a list of all my patients---diagnosis, diet, precautions, fingersticks for blood sugar, lab specimens to collect...etc etc. What I enjoyed most there was I get to know the patients since they stayed there for a long time, hence LTC. Good luck!
Hi: I graduated in May 2010 with a BSN and 3.5 GPA and was unable to find anything until I took a job at a local nursing home. I have now been there a little past 3 months. Unfortunately, in medical environments in general, there is alot of backbiting. I was a medical transcriber for 25 years and saw the same thing in that environment. What you must recognize is that nursing homes, and indeed all of medicine in this country, operates under a capitalist model. It is all about the money. Being precepted for 5 days when going onto a rehab floor is grossly insufficient (I got 3 weeks of precepting for a LTC floor) but there is not much you can do about it. The job market in general, even for nurses, is so tight right now that you have to take what you can get and suck it up. Point is that they want you to get out there working and start being productive from day one. Alot of nurses and even aides will expect you to automatically know stuff that you do not know. What you (and all of us) learned in nursing school is basically not helpful in the real world. We learn to do things the right way and by the book. In real life, it is not that way. People find ways to cut corners to save time. In general, you will find that the expected workload is more than can be realistically expected from a person. But again, that is the capitalist environment we are in. As far as nurse's attitudes towards you, it all depends on who you get as coworkers. Some of my coworkers have been very good with me, but they cannot provide much help because they also have 20 patients to look after, medicate, do treatments for, do copious documentation on, pick up MD orders, etc. And we are not computerized so alot of things must be done in triplicate and by hand. It all has to be finished by the end of your shift, with no going over time. Then there are other coworkers who do not want to help me or give advice and make it very clear that they dont want to. They will finish their work and sit at the nurses station texting and will not offer to help another nurse, even though it is unofficial facility policy that they do so. I have also run into "education discrimination". Many nurses at LTC facilities are LPN's, with an occasional RN. Most of those RN's are 2 year grads. I am the only BSN in the place, including supervisors and the DON. I wanted this title placed on my badge, as I felt I worked hard to get it. But I obviously pushed some people's buttons by doing so. However, nothing stops them from going back to school to do it themselves. Jealousy is a factor in these situations and you should be prepared for it. You should also prepare to be mandated to stay if people call in. I realize that some states have prohibited this practice but it continues nonetheless. The bottom line is that you should be nice, but not a doormat. Do not let people bully you or intimidate you. Be assertive and professional and keep your residents concerns first and put all that other petty stuff at the back of your mind. Keep focused on your residents and it will be easier for you.
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