For those of you that are or have done a clinical on a Geriatric unit

Daytonite, BSN, RN · May 25, 2008

i am not a student. i started my rn career in long term care and have worked off an on in nursing homes over the years. the one thing that separates geriatric long term care from acute hospital care is that it has a regular routine. these little old people get upset if their routine gets interrupted. because of the huge amount of work and tasks that the nurses in these facilities have to accomplish, routines are the way they do it. so, going in as students, you are interrupting routines. find out how to fit into the routine as best as you can. you are going to get your first taste of how the real world doesn't always practice what the textbook says.

breakfast happens at the same time and place for each resident every morning. showers, bed baths are very seldom done, are given per a scheduled day(s) for each resident. in most homes, the residents are placed up in chairs of some sort after breakfast for their morning care (mouth care, grooming and dressing). they are then taken to various activities or therapies depending on what is scheduled for them. the aides will go from room to room straightening up the rooms and giving the scheduled showers. the linens on the beds are usually only changed on the day the patient is showered. the patient's clothes are either washed by the facility or their family so there are some kind of rules for how the personal laundry is handled. incontinent patients should be checked at least every couple of hours and changed. vital signs are usually only required to be done once a week. weight is only required to be done once a month unless there is another order by the doctor.

my recommendation is that you ask what the regular routine is of the patient is that you get assigned to. also ask what the routine is of the facility for meal times and any other major activities that are going on while you are there like scheduled medications/treatments. keep in mind that unlike an acute hospital a nursing home is considered the patient's home and you are the visitor. it is a great place to learn all about assisting people accomplish their adls. and that is about as basic in nursing as one can get.

momandstudent · May 25, 2008

I just finished my older adult clinical and just as Daytonite said, I would ask what type of routine they use. We assisted with everything that we possibly could. Ambulating, toileting, bathing, medication (oral and injections), charting, wound care and feeding. I know the anxiety that you are feeling. I worked in a LTC care facility for 5 years then became a stay-at-home mom for 10 before going back to school. I was so nervous the first day but as clinicals went on, I became very independent (toileting, feeding, vitals, and anything else that I could do without the need of the instructor). As time progresses, you will become accustomed to the routine and requirements and you will do fine.

nurz2be · May 26, 2008

Can you tell me what your typical day consisted of?
I am feeling great anxiety and I am hoping that perhaps if you tell me what a typical day consisted of I would have a sense of calming.
I would really appreciate to hear back from you.
Thank you:uhoh21:

We finished our LTC rotation a month ago. I will tell you my experience is that you are used to the routine by the 2nd or 3rd day. What is HARD to get used to is the way you see the elders treated. Not all are treated horribly, but you WILL see situations and it will take your breath away. The other HARD thing is seeing those who have no one come visit or have a visitor once a month. You REALLY have to ground yourself emotionally. So many people go in saying, "I won't get attached." It is EXTREMELY easy to get attached to these wonderful people. You will hear stories that make you laugh, make you cry, and make you wonder what life was like for them before they came.

I will share this story...I had taken my client, that is what we were to call them, to rehab inside the LTC. I sat down and watched her and a little man wheels in beside me and pats me on the hand. I just smiled and said, "Hello." (As you know many of the elder population in these places have less than perfect memories, so you don't always know if what you are told is true). Anyhow, He started talking to me about playing baseball with the Mets, Red Sox, Yankees and meeting and playing with Babe Ruth, Lou Gehrig and Hank Aaron. I smiled and listened to his stories for about an hour. My lady had finished so I excused myself from his company. The next day I passed a room and a man yelled at me. I went to his room and it was the baseball man. He had a photo album and he showed me the most precious pictures, him and Babe Ruth, Lou Gehrig, and Hank Aaron, LOL. I was SO taken away that someone who was famous was in a place like that. You just never know where people end up. I LOVE listening to all their stories, they are some of the most fascinating people. They were around when the depression was here, when Kennedy was President, when John Glenn stepped on the moon, before cars were on the road in the millions.

Don't be frightened of your time, be excited to be around such wonderful people. IT WILL change you!

GOOD LUCK