Can anyone explain what an RN position at a long term care facility would require

[geritraum]

Hey there,

I've been thinking about starting at a SNF as a new grad, but I've heard a lot of different opinions on it. Can anyone explain what an RN position at a long term care facility would require in terms of skills/responsibilities as opposed to one in an acute care setting, s.a. new grad programs at hospitals?

[SitcomNurse, BSN, MSN, EdD, RN]

Sure!

Morning report on 30 people(average number), You will either do the meds for the day, all 30 people, or you will run the desk.

Meds have 2 hours to get completed, and it can be done.

But never think you are just doing meds, being the front line eyes for the nurse at the desk(if you are on days) eves or nights you are usually the only nurse.

GT set ups/ running time. ( calc by dietary)

If you run the desk:

Report, get from nights, and give to your CNAs.

Treatments and dressing changes.

MDS completion

Care plans(on computer - much easier)

IDT meetings

pre-screening all bumps bruises scratches and falls doe the MD ( so you know what to report)

Charting for medicare, medicaid,

Pick up all md orders,

run admissions and discharges

oversee the entire staff on the unit.

PICC lines, & their care

Tracheostomy care

and so much more.

Ther eis little difference between a med Surg Unit and a Geriatric Unit, those differences are pronounced..but of you too away the "ouliers" for each type of job, theya re the same

We run codes, We start IV's, we dischrge people to homes.

Now this all seems daunting, but if you have organizational skills...not the ones you think you have, but the ones people tell you that you have.... then it can all be done.

I have been doing it for 17 years, started in a Nursing Home, did evenings and nights, then days, then back to eves and nights, back to days. I think the only thing I missed was doing open heart massage.

Its not a slow job by any means, and we hav new grads here who could tell you the same thing. You stay busy and need all of your assessment skills.

good Luck.

[autumnmom]

or, you do all the meds and the desk job too because they do not have a desk nurse or the desk nurse answers the phone and gets lab reports and does some orders.

[geritraum]

Thank you so much for such a detailed answer! Now I have a much better idea. It does seem quite intimidating for an inexperienced new grad, but I guess it would really depend on what kind of training/preceptorship they would get.

I have a couple more questions:

How often do MDs come? Do they do rounds on patients? What other personnel is involved in patient care (RT/PT/OT/Social Work)? If not, what kind of support do nurses get?

I'm really interested in Geriatrics, but even on the general floor I see there's so much to do for elder patients, and can't imagine how 2 RNs would manage. But I guess it can be done!

[ImThatGuy, BSN, RN]

Around here the nursing home (LTC whatever it is) usually has RNs in admissions, DON and maybe ADON positions. Other than initial assessment or to cover a missing LPN they never touch patients. We rotated through an LTC a few days and this is what an ADON told me there. The rest is from what I gathered taking incident reports at LTCs. Around here LPNs give meds and work the desk while CNAs do everything else.

[Psychtrish39, BSN, RN]

RNs in LTC where I am located work as charge nurse ( the desk) or medication nurse 30 to 40 patients and sometimes you have a wound and treatment nurse either an RN or LPN. What I see in LTC here is that management RNs do not touch patients however the good ole charge nurse , medication nurse or wound and treatment nurse RNs do hands on care same as the LPNs we are paid more for our education and experience. However, I still learn from all my coworkers whether they are LPNs or RNs like myself... being a new grad it can be done and is all about time management and you will learn alot and nothing is ever the same two days in a row in LTC.

I was glad that I had a background in cardiac and psych before I did long term care as you see quite a bit of cardiac issues and psychiatric issues such as depression, dementia, and Alzheimers.

[prinsessa]

At the facility I work at there is no Med nurse/Desk nurse. It is just one nurse that does everything. We pass meds, hang IVs, answer phones, relay labs, send residents to the ER or home, write orders, call pharmacy, make appointments, make transportation for the appointments, incident reports, "easier" tx orders (we have a tx on days that does the rest). The RNs "work the cart" just like the LPNs do. The only difference is that RNs can start IVs and hang IV meds. If I am the only RN on the floor, I am responsible for all the IVs plus my work. If you are the only RN in the building you are responsible for all the IVs in the building. We can have anywhere from 15 to 30 residents with up to 10 of them (or more) being G-tubes.

[rainbowsandsunshine]

I am a RN in LTC... in my facility, the staff RN does basically the same thing as LVN's, but they are considered the supervising nurse. I work along side many LVN's, and my job duties do not differ from theirs significantly. However, because of my license, I am considered the charge nurse and higher on the chain of command. Sometimes, I will fill in for the RN supervisor position (building supervisor, state requires 8hr of RN in facility per day). While supervisor, I do chart audits, carry out discipline and basically put out little fires everywhere I go. In our facility, you must be RN to be DON, but you can have a LVN ADON.

Also, the RN's are paid higher than LVNs.