nursing home- nights 7p-7a. What to expect?

Specialties Geriatric

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Hi! I have just accepted a full-time nights position at a nursing home/rehabilitation center. It is 7p-7a and I am a new grad. This will be my very first job as a RN and I've never worked night shift before anywhere. I was told that the nurse to patient ratio would be about 1:30. Is this normal? I guess I just feel like that is a lot of people to handle as a new grad. Also, as this is a nursing home, what kind of skills do you think I will learn and what do you think a typical night would be like? I am super nervous as this is my first job. Orientation starts in 3 weeks, so what should I be doing to prepare (besides the paperwork/physical..stuff like that). I thought maybe go over some gero stuff from school. Any thoughts?

Thanks, Avia

30 is waaay to many. 15 max. I don't want to scare you ,but I have a boatload of experience and could not handle 30 residents.

Review your job description . Most likely you will be responsible for the med passes. Maybe dressing changes.

Of course you will be assessing for any changes in the residents condition. That requires knowing the code status, how to obtain doctors orders STAT, and if you have any standing orders to implement.

Then you will have the CNA's to handle. They will test a newbie to the max.

Good luck, I couldn't do it.

I guess there also might be an LPN on staff as well as 2 STNAs...but they did say that it was rare to only have one RN in the whole facility. So I wouldn't be entirely on my own...

I am an LPN doing NOC shift with 47 residents and 2 CNA's. I am the only charge nurse, it's hard and scary but you can do it. Good luck and try to sleep all day. :)

Wow- hats off to you. I cannot do night shift. Please take care of yourself and get your much needed sleep.

I'm an LPN on night shift and I always have 47-50 residents. I am also the charge nurse for the entire building (198 residents). I have 2-3 aides depending on scheduling. I do a morning med pass, change out all GT supplies. Treatments. Charting. And get paperwork ready for doctor appointments, as well as manage the problems on the other floors. I also handle all scheduling conflicts such as call offs, no shows, etc. It makes for one busy night!

I'm an LPN on night shift and I always have 47-50 residents. I am also the charge nurse for the entire building (198 residents). I have 2-3 aides depending on scheduling. I do a morning med pass change out all GT supplies. Treatments. Charting. And get paperwork ready for doctor appointments, as well as manage the problems on the other floors. I also handle all scheduling conflicts such as call offs, no shows, etc. It makes for one busy night![/quote']

47-50 patients! Wow. That's an astronomical amount of responsibilities. I've done clinicals at a nursing home and I see the nurses with their hands full with 15 patients.

You must be super woman :)

Specializes in Gerontology, Med surg, Home Health.

Are they long term residents or short term patients? My long term floors have one nurse overnight...we try really hard not to give out any meds at night since people need to sleep. My short term unit which is currently half long term, has 46 beds with 2 nurses on 11-7. It's mostly PRN pain meds, blood glucose checks at 6am and dealing with any emergencies.

Yes 1:30 is very normal in LTC/SNF. It's going to be tough. Hopefully you have a good orientation.

Oh and remember if they are LTC they are not acute like in a hospital. That is where they live, their home. If it's SNF patients are not as stable as LTC but are stable enough to be out if the hospital.

It does have skilled nursing, but it also for long term care patients. I guess what I am most worried about is night shift...I almost feel like I only took this job because it was the only place that offered me one. Do a lot of new grads start out on night shift at LTC facilities? I I just hope that I made the right choice!

Not sure if you are an LPN or RN, but yes a lot of new grads start out in LTC on night shift. I would say more LPN's than RN's for sure start out in LTC. LTC is not for everyone and not everyone can do it. I have worked with more than 1 new grad RN who didn't come back after a few days. I havn't experienced this with LPN's yet but I'm sure it happens too. I started out in LTC as a new grad LPN 3 years ago and it was not easy. I struggled but didn't give up and I have survived for 3 years. Now that I'm an RN I will start my new med/surg postion next week. I am so excited to leave LTC, but I really have learned a lot there.

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