First RN job in a LTC facility.....help me

Published

Hello all! I graduated in May 2011 with my ADN. I passed the NCLEX in July. I just landed my first job. Its at a nursing home in my town. This facility contains a secure Alzheimer unit, rehabilitation unit, and the regular long term care. I have heard horrible things about starting out at a nursing home. I will be on the 2-10 shift. I will have one week of orientation which will be on the 6-2 shift. I am so nervous about being on my own sooo quickly. I am also nervous that I will never be able to land a nursing job in a hospital after this. I plan on keeping this job for 8 months to a 1 1/2 years. My husband is military and we will be moving sometime in that time frame. Im rambling!! Sorry! I would just like some advice. What to expect? How will this effect my career in the long run? I would also just like to hear everyones experiences in LTC facilities in general. THANKS

KarriRN:nurse:

Up Vote Up Vote ×

there's a nurse on my floor (surgical tele) that spent like 30 years in LTC and just made the switch last year to hospital. She seems to be doing fine with it. I'm also a new grad (yay c/o 2011 !) and I am starting out on this tele unit. I had 12 weeks of orientation which I just finished. A week sounds a wee bit short to me. I've never done LTC before or had clinicals there so I don't know if that is long enough. Maybe you can ask them for more time if a week doesn't cut it?

Up Vote Up Vote ×

...and the more we talk about how bad it is in a nursing home and that you are un-hire-able afterwards, the worse reputations the nursing homes get.

Nursing homes (contrary to popular belief) are great places to learn! By the time a person is elderly and entering a nursing home, they will many times have multiple diagnoses and be on multiple medications. You will get quite an education in both areas if you care to learn.

Up Vote Up Vote ×
Specializes in LTC, Psych, Hospice.
...and the more we talk about how bad it is in a nursing home and that you are un-hire-able afterwards, the worse reputations the nursing homes get.

Nursing homes (contrary to popular belief) are great places to learn! By the time a person is elderly and entering a nursing home, they will many times have multiple diagnoses and be on multiple medications. You will get quite an education in both areas if you care to learn.

:tku: I couldn't agree more. It seems like the people who talk about how bad the nursing home is are the ones who have never worked there.

Up Vote Up Vote ×

LTC is hard and a lot of work. I havent worked as a nurse in a hospital so I dont know if its just as crazy. I know at the hospitals in CA and RN cant have more that 5 patients in med surge, 2 in ICU, etc. LTC has no ratio, it only has a required 3.5 nursing hours per patient per day. This includes CNA's, nurses, and all the other nurses in the office who never look at a resident. So I work as a med nurse on day shift. I regularly have 31+ residents. And yes they are all on a lot of meds, and they take a long time to take their pills, sometime it takes some convincing. I dont always get my breaks, and I dont usually get a chance to pee either. One week isnt much, I had 2 weeks as a new nurse. And 4 days when I changed jobs. Its really overwhelming when you hit the floor by yourself. New nurses need more orietation than that. However, LTC can be very rewarding, we become very attached and love our residents. Its great experience because they arent always stable, you will learn great time managment, assessments, and learn to make tough calls. Its not going to determine the rest of your life as a nurse so dont fret.

Up Vote Up Vote ×

there's part of me that wants to say "oh I'm so sorry!" It's just that I've seen so many new grads and more experienced nurses thrown to the wolves. Some are promised a long orientation and get two days. Some are just thrown on the med cart the first day. The mgr or orienting nurse says that's the best way to learn. I wouln't have made it through the first day as a new grad, the ones who do, well I admire them. I hope you have an awesome experience, learn a lot and most of all, reach out to the other nurses on other units. They will be happy to help you figure out paperwork or provide back up when assessing a patient who may need to be sent out. CNA's know a great deal and can tell you a lot about the residents and their families. They are great for teaching you how to move fast and transfer patients into W/C, onto toilets, et al.

Up Vote Up Vote ×
Specializes in LTC, ICU, Cardiac,.

First off,,,congratulations on your new position!!! Give yourself an "Atta Girl"!!!

1...Will you be charge nurse and med nurse??? If both,,you will need to multi-task,,,BIG time,,, dr.s phone calls, new orders, labs,,faxes, dietary, assessments,,CNA assignments,,blood sugars et insulins,,treatments,,charting,,,in addition to the huge 2-10 med pass :uhoh3:

2...I guess if I had my druthers,,I would initially be a med nurse,,crash course in learning your meds,,more res. interaction,,get some hands on experiance with the CNAs,,some take the treatment cart with the HS pass,,good time to do skin checks,,et the aides are doing cares so it's a good time to grab 1 to help,,et take the couple minutes to help them finish up,,,trust me on this one,,,:nurse:

3....The nurses that have been there know the docs et office nurses,,they are familiar with the res. et their nuances et quirks

4..Don't beat yourself over the 1 hr before and after prescribed time,,,we're dealing with people,,first,,et things will happen to throw off your time,,,a fall, CP,,need to transfer,,,a CODE BROWN:eek:

DELAGATE!!!!

After 30 years,, I don't regret a day in LTC,,the good and the bad,,et in between I have worked in hospitals,,,certainly never held me up there,,

Good luck to you, hun,,please keep us posted,,,et don't forget,,you would not have gotten hired if they didn't think you could do it!!!:yeah:

I hope I helped a little:redbeathe

Hate to be a debbie downer, but that 1st ATTA GIRL!!! may be all ya get,,,enjoy your residents,,they are your reward,,,don't let the suits et 'bean counters' get ya down!!!

Up Vote Up Vote ×
Specializes in LTC, Disease Management, smoking Cessati.

LTC is not the piece of cake some think it is...you will use your skills, you will use critical thinking and you will gain valuable experience. I love it and have never regretted my time working with this population. Give yourself a break, go and know it is a challenge as any new job is, and that with time you will get organized and be able to handle all kinds of situations...

Good Luck

Ruthie

Up Vote Up Vote ×

First of all, Congrats on graduating, passing boards AND getting a job!!

I graduated in Dec. and couldn't land a job for 3 months. So I applied at LTC and took the first offer. It was horrible, except for the people I worked with. I was second shift and would often be there 12 hrs a day, 5 days a week. The place was understaffed, finding correct supplies was nearly impossible, and just plain dangerous. I stuck it out for a few months, but was miserable. I had about 2 days of orientation and was let loose. At times I was the only RN there and that freaked me out!

I have since gotten a job at a hospital and although it isn't what I may have wanted, it's what I needed as a new nurse. I have support. I have a TON of education and classes they provide and I am getting so much experience that I know will go with me forever! I have commited myself to atleast a year of med-surg then I will go and discover whatever is next.

I hope your place of employment is different. I hope you get the experience and support you will need as a new nurse. I just wanted to reply to your post because if I could have done it differently, I would have. I would recommend getting your med-surg experience first. I never thought I would enjoy the hospital, but I do. It's not my dream job, but it's exactly what I need for now.

Best of luck to you!!

Up Vote Up Vote ×

Thanks for all the replies. From what I understand I will be a med nurse. I guess I'll really know whats expected of me once I start orientation. I will definitely be asking for help. During nursing school I was a CNA at a LTC facility but it was much smaller then the one I have a job at. But I do have some idea of what to expect. But I'm still pretty terrified. At the moment it is absolutely impossible for me to get a hospital job. Ive applied at all in a 60 mile radius. The local one is going bankrupt(being sued,,,its so bad) and are only hiring internally. And the others are either only hiring internally as well or not taking new grads. There is a good chance my husband will be stationed in FL within the next year. The goal is to learn everything I can from LTC and then try to get a year of hospital under my belt when we move. My ultimate goal is to be a Family Practice NP so I figure I can learn a lil everywhere I go that will help me in the long run!

Up Vote Up Vote ×

I'm wondering how the job at the LTC facility is going, KarriRN. I'm a new grad who's interviewing for a position with LTC. Right now, I don't have a lot of confidence in my skills/time management and it's been a while since nursing school (at least a year) and I just wanted to see if LTC would be a good fit for a new grad like me--as in, would it be too stressful/busy/not enough training. I'm looking at a 7p-7a job. Any information from your experience or from others' would be much appreciated! :)

Up Vote Up Vote ×
I'm wondering how the job at the LTC facility is going, KarriRN. I'm a new grad who's interviewing for a position with LTC. Right now, I don't have a lot of confidence in my skills/time management and it's been a while since nursing school (at least a year) and I just wanted to see if LTC would be a good fit for a new grad like me--as in, would it be too stressful/busy/not enough training. I'm looking at a 7p-7a job. Any information from your experience or from others' would be much appreciated! :)

Well I've been in orientation since Friday. At first I was miserable. My preceptor that day didnt have time for me and I was being told different things about paperwork(which there is a lot of). I was stressed all weekend worried about Monday. Then I show up Monday....and it was wonderful. The preceptor I was with that day took her time explaining things to me and never made me feel stupid for asking questions. Since then I have had great preceptors and I have fallen in love with our secure Alzheimers unit! I'm actually going to ask the don tomorrow if that unit can be my normal unit once I'm out of orientation! The most difficult thing for me is all the paper work. Ive barely scratched the surface of it. I'm also going to ask the DON if I can have orientation on 2-10 (ive been on 6-2) because 2-10 sees more admits, which is something I havent done and that is the shift I will be on. Now that Ive started orientation I must say I am a little hurt by the bad rep LTC gets. I understand that their are certain skills I will not do very often in LTC compared to a hospital BUT it is challenging it is hard and it deserves more respect then it gets! I love it!!

KarriRN:nurse:

Up Vote Up Vote ×
+ Join the Discussion