About to start first job as a LPN...What should I expect???

Nurses LPN/LVN

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I finally got the call today to come for orientation at a LTC facility (LPN). REALLY EXCITED!!!!!!! Please share some of your first day on the job experiences........:D:D:D:D:D:D:D:D:D:D:D:D:D

Specializes in Geriatrics.

I want to know the same thing... Hopefully I will be getting a call from someone this week...I can't wait to see the posts so I can be better prepared...

Oh I like your screen name

Thanks! and.....Congratulations LiasMom_07!!!!!!! I would also like to prepare myself better.....

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

It all depends on the facility.

1. Expect a short orientation period that ranges from a couple of days to a week. Some new grads have been lucky enough to receive several weeks of orientation, but it seems that most receive a short orientation.

2. Expect to have 20+ residents who need medications, various treatments, finger stick blood sugar readings, assessments, and new physicians' orders. This means that you must manage your time very well.

3. Expect to deal with family members and visitors who are sometimes unreasonable, loud, or emotionally upset. Many of these people are seething with displaced anger, and the nurse is the most convenient person to take it out on.

4. Expect to spend plenty of time completing paperwork. The nursing home industry in America is very regulated, and your charting must follow Medicare and Medicaid guidelines in order for your facility to be paid properly. Also, LTC is a litigious area of nursing, so you will want to document adequately (but not chart excessively) to avoid getting wrapped up in a lawsuit.

5. Expect to become attached to some of the little old ladies and gentlemen. Some nurses can maintain professional distance while others cannot.

Specializes in LTC.

Couldn't have said it better myself!!! Ask lots of questions...and that goes for no matter how long you've been a nurse. Don't let anyone intimidate you

no matter how overwhelming it seems in the early days... Know that it will get easier in a few months.

1 Votes
Specializes in Med/Surg, LTC/Geriatric.

If you will have the same resident assignment for every shift, pay close attention to their medication needs during orientation.

You will get into a rhythem after a few shifts, but be sure to note the diabetics, those on QID narcotics, those who just have 0800 meds etc. This will really help you to prioritize your med pass.

I always start with those on QID narcotics. If you end up doing them last (around 9:30 or 10am, it really cuts into their next scheduled dose). While I'm doing those, I watch out for the diabetics coming down the hall. If they need an accucheck, I'll stop them and get it before they have any breakfast. For those who have only 0800 meds (none super urgent like narcotics or Sinemet), I can leave until later in the pass as I won't be messing with timings of other meds at 1200.

I have one fellow who only gets Digoxin at 0800 and then nothing until 1700. He's a very late sleeper, so I often give him is 0800 Digoxin at 1030 or later. We got the doctor to officially change the time to 1200 as he was always getting it after 1030.

Take note of what is usually needed on the med cart to save trips to supply. How many pudding cups/applesause for crushed meds. How much nutritional supplement drink (if applicable), enough acetaminophen and lactulose stock. Enough med cups, drinking cups, straws, water, juice, accucheck machine, strips/lancets etc.

If you get a resident roster, make notes on how residents take their meds. Crushed in pudding/applesauce. Whole in pudding. Whole with water only, juice only. Likes only during meals etc. You will definately memorize that after a few weeks, but a cheat sheet will really help the first few shifts.

Little things like that will really help your first few days to run more smoothly.

Best of luck and congratulations on getting a job!

:nurse:

Thanks a lot everyone! I have been provided with some GREAT information here! I will be sure to ask many question and prioritize as needed. I am soooo looking forward to starting! ThanX!!!!!

Shorter orientation seems to be the current trend around here. Four to Six shifts generally.

Having a cheat sheet with Pt names, how they take meds, med times, and which patients are diabetic, who needs treatments done, etc, really Helps me stay focussed and organized. Just be sure to shred this sheet at the end of the shift.

Be sure you are knowledgable about computer system/labs/charting prior to end of orientation. Best Wishes to you on your new Job!! Congrat's!

Thank you sooo much Leelee2. I think that a cheat sheet will be a great idea....

Expect time to fly by! majority of the time im busy with handing out meds or charting. i clock out for lunch and im still charting. and if you get an incident report, good luck! when i got my first incident report i stayed an extra 2 hrs after work, WITHOUT pay! its my first job as an lvn.. and all i can say its nothing like they teach you in school.

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