Brand new LTC LPN

Published

Specializes in Pediatrics, Geriatrics, LTC.

Hi all,

I am a newly minted LPN and got a job! in a LTC facility. I've been a CNA at another LTC for a year so know some of the ropes. But, as an LPN any suggestions on what I should study up on in order to be better prepared at my new job? Dementia and wound care I assume, but what are the common meds? What else can you suggest? Thanks in advance!

New in NY

Up Vote Up Vote ×

Welcome to LTC neighbor. I'm in upstate NY and was a LPN in LTC for about 5 years before I got my RN. Wonderful experience!

I would study up on hypo and hypergycemia since many of your residents will be diabetic.

Bowel meds are big, like colace, ducalox supp, lactalose, etc. I also had a lot of residents on iron, B12 shots, and/or Epoetin sq. Ceftrioxone seems to also be the abx of choice. We used a lot of Aricept and Namenda for Alzheimers.

Also read up on peg tube feeding and how to admin meds via a peg tube.

Hope that helps. Let us know how it goes.

Up Vote Up Vote ×
Specializes in Home Health, PDN, LTC, subacute.

Everything the OP suggested plus I bought a forehead thermometer which was great for dementia/combative residents. Saved me a lot of grief. I used to jot down any unfamiliar meds and look them up when I had time.

Also I would ask other nurses to observe/perform procedures on their patients if it was unfamiliar to me such as an ileostomy bag change or central line dressing change.

You'll do great! Best of luck!

Up Vote Up Vote ×
Specializes in Acute rehab, LTC, Community Health.

Congratulations on your new job! I also work as an LPN in LTC and am finishing my RN. I have realized it is very good to be aware of what is in your scope of practice, because in LTC this is often not well defined. Just make sure to protect your license and if you question something or do not feel comfortable doing something, you reserve the right to say so and request that someone else do it. It is tough starting out. I have been working for about 8 months and I am already feeling much more confident. Best of luck to you!

Up Vote Up Vote ×
Specializes in LTC.

Lotsa narcs....I would study up on my analgesic meds.

Up Vote Up Vote ×

Look at Miralax as well. My docs are in love with that stuff.

Diltiazem, metoprolol, lisinopril, lasix and HCTZ, digoxin.

And congratulations!

I am in NYS and your limitations as an LPN in LTC are:

You will be very restricted as to anything relating to IVs, more so than in a hospital, by law.

You cannot pronounce death. Law.

You cannot sign off of any falls without an RN counter-signing. Law.

You can do admission assessments but, again, an RN must counter-sign.

Some facilities will not allow an LPN to determine if a PRN should be given. Mine does.

In NY you are far more limited than, say Texas. But there's still plenty to keep you busy and employed.

And welcome!

Up Vote Up Vote ×
Specializes in LTC.

Congratulations on your new job.

I've been in LTC for about 2 months. I work 3-11 shift. You will learn more in your first month of work than the whole LPN program.

Review med administration(because that will be a majority of your shift), wound care, insulin and blood glucose, G-tube feedings and med administration,

Meds that I commonly see are Xanax, Percocet, Ambien, Ativan, Colace, Sennokot, Coumadin, Lopressor, Sinemet, Coreg, Glucophage, Lasix, Digoxin, Vasotec, Cardizem, Iron, OsCal, Synthroid, Neurontin, Aricept and Remeron

Up Vote Up Vote ×
Specializes in Pediatrics, Geriatrics, LTC.

Thank you so much for your replies. I am excited beyond words! I will drag out my med cards! Scope of practice is a good thing to remember as well! I will be working the 3-11 shift as charge and med nurse! (yikes) but will have 30 days of paid training on the day shift with a preceptor then another week on my floor. If I or they feel I need more they will keep me with someone till I'm ready. Thanks again!

Up Vote Up Vote ×
Specializes in Pediatrics, Geriatrics, LTC.

PS I don't mind more responses! Keep the ideas flowing I need them all!

Up Vote Up Vote ×
Specializes in LTC, Memory loss, PDN.

HIPAA, Pt. rights, signs of infection (UTI, pneumonia) / dehydration in the older adult. You already mentioned wound care. Remember, the first question is not how to treat the wound, but what caused it.

Up Vote Up Vote ×

Learn defensive charting - how to phrase things in such a way that they are honest but State won't ding you. And ding they will. Ask your preceptor.

Up Vote Up Vote ×
Specializes in Pediatrics, Geriatrics, LTC.

oh yeah, we just went through a state week inspection and I heard the inspectors really digging into the LPN's on their charting. I am going to have to learn computerized charting too...these are great suggestions and I am taking notes! thanks soooo much!

Up Vote Up Vote ×
+ Join the Discussion