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Specializes in Geriatric/LTC, Rehab, Home Hhealth.

I'm feel prompted to start this thread to share what I've learned about choosing whether or not to accept a job offer.

Looking for a job in LTC can be so stressful. Student loans and other financial obligations bear pressure. Questions like: will they call for an interview? Will it be a shift I can accept? Is the money going to be enough? ---they all compete with the worry: Can I do this? What if I make a mistake? Where's the coffee pot?

Take a breath - it will be ok. Yes, there are a lot of nursing homes that are nothing less than nightmares (and yes, for a short time I've worked in them). In retrospect, there were clues available before I even took the position.

These clues are what I'd like to share. Maybe some of the other "old timers" and add to the list!

When filling out the application (usually in their lobby): 1.Look at the facial expressions of the staff - If there is a spectrum of expression from happy all the way to suicidal or homicidal, where do most of them fit? Do they look confident or "beat down"? If you are able to see some of the interaction between staff at this time, it's even better...are they at ease or is a supervisor reaming out a staff member or what? 2.Usually, the last DHEC survey is in the lobby (either hanging on a hook or in a three ring binder) - try to peek at it if you can.

On your way to the "interview room": Usually this is the BEST time to get a feel for the facility. Are the residents lined up in the hallway with blank stares and food on their clothes? Do most of them look content or unhappy? Are any of them speaking to eachother or to the staff? Do they look well cared for or uncared for? Is there a strong odor of urine coming for any of them (if so, try to walk past them after the interview to see if they have been cared for)? Do they look well hydrated? Are they "slumped" or are they correctly positioned? If they don't look cared for, keep in mind that if you take the job, you'll be putting yourself in a position of turning a blind eye, being labeled by staff as a you-know-what or trying to do it all yourself.

During the interview: Are the DON and ADON established? My best experience was at a facility where the administrator, DON and ADON had worked there for years. There were no acts of blood letting. If your interviewer is spening a lot of time talking about changes that are being made, then something has been wrong there for a very long time and it may not be a best first experience for you. *there is never anything wrong with improvement, but I have found that in this situation, "changes" are usually a day late and a dollar short! It's ok to ask about things like time to orient - when I was a new nurse, my DON and ADON recognized the value of a good orientation---insist on nothing less. Management that is THAT shortsighted when it comes to orientation will cut all kinds of horrifying corners to save a couple of bucks. Ratios can be tricky...ask what the ratio is, but also what the level of care is...one nurse to 30 patients on day shift is common these days. BUT, are there eight bolus tube feeders, 7 fingersticks, and a persistent elopment risk? If/when an admission comes, is there support staff or are you on your own? Other things to pay close attention to is when the interviewer and/or DON or ADON brags about certain things in the facility....this is a big plus! They actually care and have turned that care into action! BBQs and yardsales are great indicators of a family atmosphere. At a "high dollar" facility, the administration actually served the residents their lunches every day for those who went to the main dining hall. That says a lot.

I hope my experiences help you to find a GOOD nursing home...they do exist. Good luck and congratulations on graduating!!!

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I hope my experiences help you to find a GOOD nursing home...they do exist. Good luck and congratulations on graduating!!!

Nursewendy2000,

Thank you for your post. I find it very helpful. I've worked as a CNA in long term care while in a Nursing Career Advancement program. I'm now a new grad LPN and will be starting my ADN bridge in March 08 and finishing December 08.

I really like working in LTC. My husband would prefer I work in a hospital but I want more routine on a daily basis and would like to come to know my patients/residents, which I think LTC would afford me the opportunity to do.

Also, people can not be hospitalized all the time and in LTC I feel that you really do have the opportunity to put more nursing skills to use. At any rate, I appreciate your insightful post.:balloons:

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Specializes in nursing home care.

Spot on! I tend to look for inspection reports befire even applying for jobs. I like honesty from management and staff. Smiles gain extra points!

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Specializes in Geriatric/LTC, Rehab, Home Hhealth.
Nursewendy2000,

Thank you for your post. I find it very helpful. I've worked as a CNA in long term care while in a Nursing Career Advancement program. I'm now a new grad LPN and will be starting my ADN bridge in March 08 and finishing December 08.

I really like working in LTC. My husband would prefer I work in a hospital but I want more routine on a daily basis and would like to come to know my patients/residents, which I think LTC would afford me the opportunity to do.

Also, people can not be hospitalized all the time and in LTC I feel that you really do have the opportunity to put more nursing skills to use. At any rate, I appreciate your insightful post.:balloons:

You are very welcome!!! I really hope it helps!

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Specializes in Med/Surg.
Spot on! I tend to look for inspection reports befire even applying for jobs. I like honesty from management and staff. Smiles gain extra points!

Where can you find the inspection reports for free?...Just Curious

I work in LTC and your info was very helpful ....Too bad I had to learn the hard way.

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Specializes in Geriatric/LTC, Rehab, Home Hhealth.
Where can you find the inspection reports for free?...Just Curious

I work in LTC and your info was very helpful ....Too bad I had to learn the hard way.

The last survey inspection is usually in the lobby. Years ago, I found a website that listed all kinds of data (for free) for local nursing care facilities...nurse/res ratios, survey info...I've tried to find the sight again, but I haven't had any luck. Like you, I found out the hard way :uhoh3: .

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I am not sure of the actually site but if you go to the Medicare web site you should be able to navigate thru that to get to the survey site. Please note thou surveys may be 6-8 months old.

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Hi! Just wanna know how much is the starting salary for new grads RN in LTC. I will be taking my NCLEX-RN exam this July. Thanks!

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