Any tips for new nurses in LTC?

LTCRN4LIFE · Apr 7, 2006

As Suebird pointed out, it is rather difficult to know what kind of help you are looking for. And by the term LTC, is it an Assisted Living, Extended Care, the old-fashioned nursing home, Alzheimer's unit, or perhaps with developentally disabled clients, etc.
Please don't flame me, :sofahider as this is simply my very humble opinion, and I do realize there are many (bless their hearts) nurses who truly love LTC. But, my best tip would be to spend a week shadowing another nurse - even if you had to volunteer to work in the facility - to get an idea of just how chaotic, totally nuts and fragmented care can be for nurses there.:chair:
Naturally it depends on the facility, the management, your position there, and overall how really supportive are the other staff towards each other. How well they work together.
When you are passing meds, doing complex treatments - often on outrageous amounts of folks, dealing with doctor's calls and faxes, trying to chart, trying to find and motivate certain staff members who don't give a hoot, attempting to give tours to family members, find wanderers, while tracking down the beeping I.V. - not to mention having to track down that most unpleasant odor, having to run marathons to make it to the phone before it stops ringing (we never had ward clerks) , filling out yet another incident report, signing the scores of papers only the nurse can sign, doing CBG's, tube feedings, helping to feed those that can't do it for themselves, nebulizer treatments, arranging for labs, x-rays and other procedures, spending time trying to find your patient to give meds to, cause none of the residents wear name tags, and half can't tell you their name. OY! Shall I go on?? And depending on what type facility you're dealing with foley or suprapubic catheters clogging, I.V's needing to be restarted, impactions, ostomies, and the inevitable fall, usually just before you are getting ready to go home for the night. Oh, and leaving the best for last - those loony family members that no amount to placating can calm down - the ones who insist on standing in the middle of the hallway, pointing fingers and accusing staff of taken Mom's penny collection or such. You know, the one mom hid under her bed.LOL
Although not usually as physically demanding as CNA's duties, nurses still put in backbreaking, overwhelming, chaotic shifts, which are the rule rather than the exception. I've sat and cried in pure frustration because no matter how late I stayed it was never enough. And Admin probably would have had us working 24 hours staight if they could have found a way around the law.
As you can see, my negative response to your question about 'any tips for new nurses in LTC' would be to run for the hills, particularly if you are a staff nurse or RCM (no glory, and all the blame). But luckily, we are all different with different areas that appeal to us, so......
Good luck! Maybe you'll be one of those nurses who loves LTC. They are really .

You've painted a very real picture LOL! and I LOVE every minute of it....I certainly can add to it having worked both LTC and SNF...and prefer the SNF....there is the patient who has just become acute and needs to be transported to the hospital NOW!! but the policies are the Doc is called first and even though you say it is an emergency your call doesnt get returned fast enough and you are torn between making a decision that you surely will get yelled at for or calling the ambulance and transporting the pt anyway.....your assessment skills must be top notch as there is no Doc on staff 24/7....the revolving door of admissions....3 in....2 out....2 in....1 out...everyday...and the paperwork that goes along with Medicare! OMG!!

but....your right....you need a supportive management and a team effort and keep moving till ya find it....look on the geographical location forums and asked those nurses for advice on places.....I would definetely look for non profit facilities...they tend to have higher staff to patient ratios....check your state Vets Homes.

mickeypat · Apr 14, 2006

One huge suggestion I have, and that will go a long way with your staff, is to say "Thank You" to those you worked with on the shift, and give that person a smile when you say it. It does mean alot! You can usually get someone out of a crabby mood when you give them a smile. :icon_hug: