Can anyone share their experience on working in a nursing home?

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Specializes in Pediatric Critical Care.

I am a BSN student going into my second year in fall 2010 , I have completed my first year sucessfully and passed my first clinical. I have been hired at a local nursing home and I was just wondering what should I expect?

I have never really been in a nursing home or have had family in one so this is really new to me...

So any insight, exp, or advice would be super helpful!

Thanks :)

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Specializes in Pediatrics, Cardiology, Geriatrics.

I've worked in 2 nursing homes. One was a night shift job, so I was responsible for 60 residents on 2 different floors, with one CNA on each floor. It was quite an eye-opener! It was my first job when I was an LPN, and I learned time management skills very quickly! The other job was my second RN job, at a nursing home with a rehab unit, and I worked on the rehab unit during the day, was responsible for 48 post-surgical patients, and I could never find my one CNA. Very disturbing. That 48:1 sub-acute patient to nurse ratio was criminal in my mind!

I'm not trying to scare you, but many people feel that new grads shouldn't work in LTC. It's very easy to get behind in your med passes and treatments (Have you ever tried to pass meds and do accuchecks for 30 - 60 (sometimes up to 90!) residents in 2 hours? You are only allowed 2 hours per med pass by law (regardless of how many residents you have responsibility for!), and the state will visit and observe at least yearly, and they will not care that you are by yourself, or that it is impossible to really do that! Trust me, the facility will throw you under the bus when the state dings them for that.), and you are very open to lawsuits and license issues. Most nursing homes are for-profit, private corporations, and they are usually not at all interested in providing good care or safety for either the residents or the staff.

However, if you can get past the feeling that you could lose your license any day, and you can find creative ways to keep up, it can be so rewarding. The relationships you build with the residents can be exactly what you had in mind when you decided to become a nurse. You become their family, and they, in a way, become yours. You get the feeling you really are making a difference, in a way that you might never feel at the bedside in a hospital. You have to be ready to really advocate for your residents. Often, they have no family to visit or speak up for them. They need and deserve great nurses.

It's not for the faint of heart, and it can be emotionally draining when they pass away, but it can be the "best worst job" (a former classmate of mine used to call it that) you'll ever have! You just have to go into it with your eyes wide open. Good luck!

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Specializes in Pediatric Critical Care.

Thanks for your post! It means so much! :)

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Specializes in LTC.

I couldn't put it any better than AnaCatRN . Right on the money.

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Thanks for a honest review. I'm not yet in nursing school but I think I want to go into geriatric care which would likely involve working at a nursing home at some point. I know it's a difficult environment to work in but the patients need and deserve good care and people that want to work with them.

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I work in LTC and I'm responsible for 20 residents on day shift and 40 at night and have 3 CNA's. Its not even legal for a nurse in NY to take the keys for more then 40 residents at a time. Humm I guess I should stop thinking my job is so bad after reading anacats post. :bugeyes:

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Specializes in Pediatrics, Cardiology, Geriatrics.

I love working with the elderly. It is really hard working in a nursing home, but it's not impossible to handle. I'm just saying that unless you know what you're getting into and have a true passion for providing the quality care the residents deserve, it's not for everyone. I have worked with some nurses who took the job only for convenience or because that particular facility paid quite well. Burnout can happen fast, and yes, Kkalasa, the residents absolutely do deserve to be cared for by staff who want to be there for the right reasons. The elderly are far too often forgotten, and they deserve so much better. I've often found that the "mean" ones only act mean because they feel neglected or disrespected. Listen to what they have to say, and prove that you truly care, and they are surprisingly not mean, anymore! I've had the pleasure of knowing some amazingly feisty and fascinating people who have stories you wouldn't believe to share with others, only because of my work in nursing homes. If you're strong and truly caring, go for it!

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Specializes in Pediatrics, Cardiology, Geriatrics.
I work in LTC and I'm responsible for 20 residents on day shift and 40 at night and have 3 CNA's. Its not even legal for a nurse in NY to take the keys for more then 40 residents at a time. Humm I guess I should stop thinking my job is so bad after reading anacats post. :bugeyes:

In Illinois, we are not so lucky! If we had your setup, maybe we could keep more good nurses in LTC!

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I started off as a new grad LPN in LTC in 2005. I agree with what is being said here. You have to have great organization skills. After orientation I had 16-18 residents to pass meds on and do treatments on . Luckily we had resp. therapists to do the neb. treats. But we did have many trach patients to do trach care on. Also a 1/4 of my patients were gtubes.

It was quite an eye opener for me as a new grad and I did go home crying more than once. But I eventually got it down. You learn who to give meds to first, who to wait until last to do. Who will take most of your time and who you can get in and our with. At least with LTC you really get to know your residents - their likes, their dislikes, how they take their meds, when they are awake, etc. We also as LPNs had to do CNA assignments 1-2 times per week. I eventually moved to nights for school and it was a bit better -as long as the other nurse showed up. If not I had the whole 26 residents.

I am now a RN on a acute floor in a hospital and those 5 years in LTC were invaluable to me. I am very organized.

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Specializes in LTC.
I love working with the elderly. It is really hard working in a nursing home, but it's not impossible to handle. I'm just saying that unless you know what you're getting into and have a true passion for providing the quality care the residents deserve, it's not for everyone. I have worked with some nurses who took the job only for convenience or because that particular facility paid quite well. Burnout can happen fast, and yes, Kkalasa, the residents absolutely do deserve to be cared for by staff who want to be there for the right reasons. The elderly are far too often forgotten, and they deserve so much better. I've often found that the "mean" ones only act mean because they feel neglected or disrespected. Listen to what they have to say, and prove that you truly care, and they are surprisingly not mean, anymore! I've had the pleasure of knowing some amazingly feisty and fascinating people who have stories you wouldn't believe to share with others, only because of my work in nursing homes. If you're strong and truly caring, go for it!

When I started at my job there was this particular resident who was a pain in the tush. The first time I was assigned to her hall I was still shadowing and she was a real pain in the orifice.. I admit it. When I went off orientation I was assigned to that hall probably the 3rd or 4th night being on my own so I had an idea of what I was doing.

I took a different approach with her. I was completely honest with her about everything she was getting. I explained to her that we are only allowed to give her what the med book says.. and she was fine.. Whenever I have that resident and go into her room at the start of my medpass (I do her meds first lol) Her face lights up and she says "oh good you are my nurse tonight!!" Sometimes kindness and honesty.. goes a very very long way. She still is a pain in the tush that will never change lol..

To the OP-

I have been at my facility for 2 1/2 months per diem. It is my first nursing job and it is the perfect pace for me. I am learning time management and organization. When I had orientation the nurse educator said to us the residents are awesome. She was very very right. Some are very nice, some are not so nice, some yell, some cry, some like to talk to you, some like to talk to themselves (seriously).. and I love each and every one of them like the are my own grandparents.

The med pass is the biggest annoyance of my job. Yes theres a 2 hour time frame. No you aren't going to get it done in 2 hours. The only one I get done on time is the HS med pass. I like to give meds safely and correctly.

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What position were you hired for?

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Specializes in Pediatric Critical Care.
I started off as a new grad LPN in LTC in 2005. I agree with what is being said here. You have to have great organization skills. After orientation I had 16-18 residents to pass meds on and do treatments on . Luckily we had resp. therapists to do the neb. treats. But we did have many trach patients to do trach care on. Also a 1/4 of my patients were gtubes.

It was quite an eye opener for me as a new grad and I did go home crying more than once. But I eventually got it down. You learn who to give meds to first, who to wait until last to do. Who will take most of your time and who you can get in and our with. At least with LTC you really get to know your residents - their likes, their dislikes, how they take their meds, when they are awake, etc. We also as LPNs had to do CNA assignments 1-2 times per week. I eventually moved to nights for school and it was a bit better -as long as the other nurse showed up. If not I had the whole 26 residents.

I am now a RN on a acute floor in a hospital and those 5 years in LTC were invaluable to me. I am very organized.

These posts are all really helpful! :)

Thanks again

-- To Kcochrane--- I am hoping to go into an acute floor as soon as I graduate, so hopefully my experience with LTC comes in handy to me aswell

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