Advice for a New Grad in LTC

BerryHappy · Jan 15, 2009

Don't be surprised at how much you don't know!

Tay245, RN · Jan 15, 2009

I am in the same position as you. I wish I knew what to expect except that its a LOT of work. I spoke to my unit manager today and she was very honest with me, telling me what to expect. I am a little nervous but a lot excited. While I am sure I will have many questions I am ready to take on the challenge.

rnlately · Jan 15, 2009

Don't be surprised at how much you don't know!

co-signing on the above.

I was precepted for about a month and yet there are many things that I had to learn based on trial and error. Just remember to ask as many questions as you need to regardless of how much you think it will irritate your preceptor. Also try to develop your own routine and do what works for you in order to deliver the best care possible. I'm 2 yrs in and there are still things I ask questions about.

LesMonsterRN, ADN, RN · Jan 16, 2009

Good luck in your new position! You will be surprised at how much you learn this first year out.

Caffeine_IV · Jan 16, 2009

I enjoyed working in LTC. Read the resident's charts and history when you have time. It will help you get the total medical "picture" for them. Often times they have been here for 3+ years.

Keep a drug book on hand. The med passes are time consuming and you will come upon many drugs that you don't recognize.

jnrsmommy · Jan 16, 2009

Familiarize yourself w/ the P&P manual. Know who is a DNR and not (I keep a list of this on me at all times). Above all else, ask questions for anything you don't know or are unsure of. Ask others how they do their routine. You will learn how to adapt parts of what they do into your own, so that your shift will flow easier for you.

catlvr · Jan 19, 2009

Long term care isn't easy, despite what some hospital nurses may say. You will generally have about 20-40 patients, and just figuring out who is who is a challenge! Some things that have really helped me:

Be prepared to be flexible, but know what cannot be fudged (sugar checks, insulin).

Rely on the CNAs, and go out of your way to build a good relationship with them. This is something that I really failed at, and have been working hard to fix it. (I have little tolerance with anything that approaches rudeness to a patient, and it took me a while to accept that for some people, yelling at patients is not considered rude - that's just how they communicate.)

Do as much as you can to prevent falls, mostly for your patients' good health, but also because the paperwork is horrible.

If it is possible to safely group meds to streamline your med pass, do so! That frees up time for other nursing tasks.

A genuine smile really is understood by everyone, no matter what their mental status. Most people with dementia respond to a smile and will be more cooperative.

Remember that a resident's room is their home - compliment them on their decorations etc. Most of our ladies take pride in their rooms and like it to be acknowledged.

If you can give a resident a choice about something - do it! It gives them a little bit of control in an environment where they have so little control.

Accept that despite your best efforts, people will die. Often, your job is to keep them as comfortable and as happy as possible. Our floor of 29 patients has had 2 deaths and one patient on a vent in the last two weeks. Since I am "new", I really struggled with this.

Oh, and remember that you don't have to be like all of the other nurses - take the best of what they have to offer, and then be *yourself*. You may run across some nurses who are burnt out and you will likely see things that you don't like, but that doesn't mean that you have to pick up their attitude or judge them. Just be friendly and go about your business.

As a new nurses, resolve to remember how you feel now, and what is helpful to you. Then, when you have some experience under your belt and are training the new nurses, recall how it felt to be new and nervous.

Good luck to you!

e