Any experienced LTC nurses?

[Jesshayesatx, LPN, LVN]

Hello Everyone! I'm a brand new LVN I just got my licensed issued on 9/2! Does anyone work as an LVN/LPN at a LTC? I just got a job offer at what I think is a really nice facility. I'm not sure what to expect we did more Tech/CNA tasks when we did my LTC clinical experience in school. If so what does your normal day to day look like? Do you have any suggestions on how I can stay organized with a large patient load? Thank you in advance!!

[Queen Tiye, RN]

Congratulations!  I’m not “experienced” but I can tell you what LVN things I did when I worked in LTC.  I assessed and dressed wounds with and without wound vacs, hung antibiotics, gave sub q/ IM injections. Head to toe and focused assessments, admissions/ discharges, a ridiculous amount of charting and follow up on witnessed/ unwitnessed falls, addressing psychosocial needs/ validation and redirection of residents with psych diagnoses, elimination hygiene, giving a ton of pills (all of them), trying my best to follow up on their effect in a timely manner, watching for critical labs and acute changes in residents and notifying the provider in a timely fashion.  Suggest procedures, following up on results in a timely fashion and notifying provider.  Caring for feeding tubes/ feeding boo residents/ feeding PO residents who are total care, convincing difficult psych patients to accept their meds (in Spanish).  Charting on infection response to antibiotics on several residents, and trying to accurately chart all this stuff.  I only had three days of training and not one moment of it was spent on how to treat the patient in the clinical setting, so I had to do a lot of my own studying to make sure I wasn’t jeopardizing my license.  When I couldn’t do everything, I chose to do what is required by law over what was required by company policy.  Meaning, I made sure I always covered my bases a “reasonable and prudent” nurse according to the BON.  If I couldn’t chart on antibiotics, I would try to catch it next shift.  Best wishes.

[Queen Tiye, RN]

Oh!  Remember the acronym PIE — problem, intervention, evaluation.  So important.  If you chart or report a problem make sure you follow up in the chart.  For example, if Ms. Jones’ BP is 215/98 and it’s charted, you must follow up — it’s our responsibility yo f/u whether it’s charted or not.  So, the Problem is the dangerously high BP.  Intervention — does she have PRN hydrolizine?  The Intervention would be to give that PRN med, have her lay down, ask yourself what could be causing the BP spike, assess how she looks and is behaving.  The Evaluation is to check back in 30-1hr, recheck BP, notify provider, document.  

[Jesshayesatx, LPN, LVN]

Thank you so much that Information is very helpful! I’m so excited to get started but just so nervous as well. We used  APIE constantly in my nursing program so I’m very familiar with that. 

[NRSKarenRN, BSN, RN]

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