Help ASAP! LTC orientation drama.


So, I've been orienting at a long term care/ rehab for 9 days all together (over the course of 3 weeks). 8 of these days have been on the subacute floor and 1 on the long term floor. I'm a brand new RN with no previous experience- nothing! not a CNA or anything, which I told them during the interview.

Within the last week, the staff coordinator apparently moved from full time to prn because she got a new job. I haven't been orienting this whole past week (not going into work) because she didn't call me back after trying to get in touch with her countless times! She basically forgot about me.

So I finally call the receptionist, who directs me to the regular scheduler who asks me if I just want to start working already, which I politely replied that I was not so she gives me one more day on the long term floor.

So the coordinator finally calls me yesterday and says to just talk with the DON about my orientation status, which sounds just odd. During the interview, I specifically asked how long I would get to orient because I'm starting from scratch. The assistant director told me 6 weeks, which I thought was very reasonable. Now, it sounds like they just want to push me onto the floor.

To top it all off, I started orienting with a knowledgeable 16 year LPN. But after a few days, they told me I couldn't orient with him for absolutely no reason--- this LPN even asked the supervisor about it and she gave no clear answer. They put me with an LPN who got her license about 5 months ago (we both graduated at the same time but she got her license and started working about 4 months before me)

I guess i get the whole routine of working there but there's things like wound vacs, trachs, that I dont have any clinical experience with. The paperwork is probably the most confusing part! I also never had to deal with 14 patients at once--which can be overwhelming depending on their needs!

So, what do I say to the DON? Am I being unreasonable for wanting more orientation when I was promised 6 weeks? and wanting to orient with an experienced nurse who can answer my questions?


33 Posts

Specializes in ER, Med-Surg/Telemetry. Has 3 years experience.

Yikes. I'm sorry this is happening to you! I would insist on more orientation. It's your license, reputation and ultimately your career as a nurse that you are putting on the line. If you begin caring for patients without the confidence and the experience, you will likely make mistakes that could harm you in the end. It's not fair for them to just throw you to the wolves like that.

Specializes in Med Surg, ICU, Infection, Home Health, and LTC. Has 35 years experience.

I have watched hospitals and nursing home say they would orient a new person "x" number of weeks or days but have not in 30 years ever seen the promised time turn into reality for anyone. Most places are so desperate for a warm body with a license that they orient the person for a week or two and then they have a call off or someone quit unexpectedly or the census goes up and then all of a sudden you are on a cart with 14 patients.

It is bad enough when you are a seasoned nurse and only orienting to a new place or people but are comfortable with your skills. My biggest concern is that if they are this unprofessional now and things are this confusing then maybe I'd turn tail and run. Try to at least set limits as to what you will let them do to you.

Being overwhelmed can lead to fast burn out and frequent turnover,


7 Posts

In the past week of just waiting and not working, I've seriously considered quitting just because of how unprofessional they are being. But wouldn't it look really bad to other employers to quit so soon? How would I explain this to another employer without seeming like I'm the problem?

Without proper training, I'm really scared to make a mistake in the long run. I never imagined being trained by a nurse who has been a nurse for 4 months. She seems like she knows what she's doing for the most part but can't answer the more critical thinking questions I have or questions about what a certain med does.

They also have paper charting and only two computers at the desk (and if the MD and NP are at the desk- which they often are, you can forget about those computers). I got a tiny slap on the wrist for being on my phone while trying to look something up about a med(really tiny- just a "don't use your phone")! How do they expect me to learn? I'll never get anything done if I have to lug a med book around all day. I'm already slow enough trying to make sure everyone gets the right pills.

TheCommuter, BSN, RN

226 Articles; 27,608 Posts

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 17 years experience.

In the area where I reside, new grads receive anywhere from three to five days in LTC before being cut loose to work the cart on their own. I have not seen a promise of six weeks of new grad orientation come to fruition in LTC because the majority of facilities do not have the budget for lengthy training times.


700 Posts

Specializes in Med-Surg. Has 1 years experience.

"Orientation" seems to be a loose term in LTC. I was promised 4 weeks, but ended up with 3 days of being with a preceptor before being on my own. The rest was only considered "orientation" because I was expected to still be asking questions, slow, ect...

LTC orientation is notoriously short and brutal. Since they promised you six weeks, try your best to stick to your guns and hold them to their word. Do not be surprised if it doesn't happen though. 3-5 days is average in my area, even for a brand spankin new grad.


208 Posts

I got 8 days as a new grad RN. 5 on the rehab/ subacute floor and 3 on LTC. I have 25 patients in LTC and its brutal. Lots of dementia, a few dressing changes, etc. Rehab is almost easier, since I have around 20-21, but I have a LOT of 2-3 times per shift blood sugars and insulin. I am about 6 weeks in and struggling!


186 Posts

Specializes in Emergency Department, ICU. Has 7 years experience.
I got a tiny slap on the wrist for being on my phone while trying to look something up about a med(really tiny- just a "don't use your phone")! How do they expect me to learn? I'll never get anything done if I have to lug a med book around all day. I'm already slow enough trying to make sure everyone gets the right pills.

You need a good med book! I highly recommend Tarascon Pocket Pharmacopoeia 2013 Classic For Nurses (Tarascon Pocket Pharmacopoeia: Classic Shirt-Pocket Edition): 9781449674090: Medicine & Health Science Books @ It is informative and small enough to fit in a scrub pocket. It lists nursing indications and typical dosages of the most commonly ordered/frequently administered acute care meds.