Any tips for long term care?

BSNMommyof4 · Sep 10, 2010

I graduated in 09 and it was a year on the 8th that I received my license. I left the hospital with max 8 patients at night to do LTC and I went to a place that had one nurse for 42 residents. I was mortified but the other nurses were complaining too so it made me even more concerned. I am starting a new position at a different facility where the most I'll have is 16. I have been told that it's mostly prioritizing. We'll see but I'll be looking at your post to see what other advice LTC nurses can offer because I need all the help I can get. I wish you well and am hoping that you get some good feedback.

NamasteNurse, BSN, RN · Sep 13, 2010

When I started my LTC job I had 42 YES 42 residents all to myself! I was one week out of orientation and responsible for it all. Now we have two nurses and it's sooooo much easier! 24 isn't bad at all.

First of all you have your aides, depend on them like crazy--they are your lifeline. Be oh so nice to them but also be in charge and they will do anything for you. Offer to help them whenever you can.

After you get report, go to the rooms of people who have a problem and see how they are doing, if they need anything. Tell the aides who those residents are and what they need, water, help etc. Delegate vitals to aides where you can and have them write them down. (for your notes later)

Start your first med pass asap. Do all vitals as you go and write them down on your resident roster, you may need them later for certain meds like lopressor.

Try not to listen to horror stories, or at least dont let them get you down--this job is do-able and can be very rewarding. Try to give some time to like every other resident and then the next day time to the others, this way you are checking in personally at least every other day.

Learn the meds you give out. Many will be the same day after day. Know the side effects and watch for that. Do your insulins ON TIME. Others can be within a 2 hour window-an hour before or an hour after the given time.

Know your med cart. Check all 'stock' meds before you leave the med room- milk of mag, colace, tylenol, vitamins etc and make sure you have enough. Check your syringes and supplies for finger sticks. If you don't have a lot of treatments you can do them as you go, but you will probably need an extra run.

Go to the bathroom before you start!!!

Bring food! Healthy food! take a break and eat and drink!

Go back out and do your second med pass. It's usually shorter. Write down anything unusual as you go so you can put it in your notes and give it to the next nurse at report.

Write your progress notes and do all your other work as soon as you can. Don't worry, you will get used to this fast paced job. I thought I was going to bored in LTC---HA!

mikeicurn, ASN, RN · Sep 16, 2010

I am in week two of my orientation at a LTC, it was a little overwhelming, but I am pretty sure I will be OK. I work 7p-7a with 56 residents. I have 2 med aides till 2300, so I only have a 2400 and 0600 med pass. The 2400 is only a few residents, so I really just have the 0600 med pass to worry about and the 0645 chem sticks. Our aides do most of the vitals, so that helps a ton. I am getting my routine down, and am getting faster every shift. It is all about organization. I made up a little check off sheet of all the things I have to do, check crash cart, q shift charting, etc... and check them off as I go, so I don't forget anything.

I was really nervous the first night or two, but am much more confident now. Hang in there, you will do great.

God Bless.

mRpeNa · Sep 22, 2010

i started working in LTC and terrified, i only got 3 days of orientation and feel like i could have used at least 3 wks or more!.... i am learning on the job and feel like i dont give good patient care because of it!

thank you for the advice!

Heart 2 serve · Oct 10, 2011

So how have your experience been? Still working in LTC? I feel exactly how you feel and and researching on what can be of great advice for a situation as such.

i started working in LTC and terrified, i only got 3 days of orientation and feel like i could have used at least 3 wks or more!.... i am learning on the job and feel like i dont give good patient care because of it!
thank you for the advice!

WanderingSagehen · Oct 18, 2012

I am just completing my 2nd month of LTC. Totally overwhelming for about 3 weeks. I no longer break out in sweats, even when told we are short 3 CNA's. I have learned all the resident's names, about 46 of them, but even harder was all the names of the staff, i.e., CNA's, RNA's, PT's, OT's, admin, activities director etc. I think the employee names where harder than learning the residents. Now am working on diagnoses. Its one thing to know the diagnosis of a patient but then the additional important one, is the reason/incident that brought them to being admitted to the facility- thats what the State will want to know, from what I have heard. I love it, its a crazy busy environment. I have never been bored or had time go by slowly. It is a 9 hour race against the clock to give as much care as I can and put out the "fires" as they arise, which is usually at the same time. I never expected LTC to be this exciting. Great experience but I may not need the experience as I think I might just stay! Was really hard to be the boss of CNA's whom I didn't even know their name. Its all good now and I bribe/reward with pizza but we never have time to eat it!