Advice for new LTC RN

pinkiepinkPN · Dec 10, 2013

Recently after over 4 months of looking for a new RN grad position I was offered a charge nurse position at a LTC facility on the skilled unit. I was offered 3 weeks of orientation which I thought was great. I work the 11p - 7a shift. Turns out I received only 2 weeks of orientation/ training, but this is more than a lot of new RNs I know. Everyone I meet on night shift seems to be a new nurse. I haven't fully developed my nursing skills, and we have to do blood draws, trach care, ostomy care, IV Atb, etc. I feel very uncomfortable because when I work my shift and have to perform a skill I am not comfortable with, I have to ask 1 of the other 2 nurses who are new themselves. Of course I can call on-call nursing for help but I learn by first watching and then doing it myself. I feel like I may be risking license working here, but I do enjoy caring for the elderly. I am strongly thinking about applying for a RN residency program, but I would have to move two hours away since there are no nursing residencies in my area. I just don't think I'm prepared for the emergencies that might arise, and I don't have any nurses with a lot of experience working with me. Any advice would be greatly appreciated!! Thanks!![/quote']
If you feel you have not received adequate preparation you need to advocate for yourself and your patients and ask for more training, or at least request that the staffing be different, with a mix of new and more experienced nurses on a shift.

LaRN · Dec 10, 2013

The ideal solution is to request more training, but that may not be possible. The only other alternative I can think of is to watch nursing education and instruction videos for the nursing task that you need to learn. there are several on youtube, but try to make sure that it is a reliable source. medcom and some universities, and medical supply companies or supply brands are a few.

There's probably 200 instructional videos for each nursing skill. This has helped me tremendously.

Guest757854 · Dec 10, 2013

To LaRN ...... exactly which ones do you request if i may ask?

TNNurseCares · Dec 11, 2013

Thanks for the advice!!

KellyRN2013 · Dec 12, 2013

go to your DON and let them know you would like more training. they may be able to set you up with training modules or they may be able to have you come in on a different shift and observe or you can ask to stay a little bit after your shift and watch the 7-3 nurse do the first med pass and treatments at that time! speak up if you feel its affecting your licensure status because everyone needs help especially if your other coworkers are new as well. never be afraid to ask for more help or training. your facility should be able to provide this for you!!!

mturnerRN · Dec 14, 2013

Hi TNNurse,

I have been a geriatric nurse for over 26 years and really enjoy being around the elderly. It is both a challenging and rewarding field and the nursing profession needs more nurses like you to care for the aging population. I have also been in management-ADON, DON and I would never allow any of the new grad nurses that I hired to work the 11-7 shift until they had enough orientation and/or training and told me they felt comfortable enough to work independently. I would also made sure that they felt comfortable with their skills. There are numerous geriatric nursing books that are available, too, that will help you. I am in the process of getting my master's and I have learned even more about this population. It will take you at least a year to feel comfortable within your setting. Don't be afraid to ask for help. Your DON is responsible for assisting you. I'm not sure who does the scheduling, but it was poor planning on their part. If all else fails, call the doctor and explain to him/her what the situation is, be sure that you know which patients are DNR, in the event that something does happen to them. One more thing, your assessment skills are extremely important, in addition to documenting. Best of Luck!