I finally feel like I "belong" - transition from psych to ltc

[pinkiepieRN]

I started my job at a long term care/rehab facility 3 months ago. I spent 8 weeks on orientation and finally started flying on my own. It's been rocky, but I feel like things are clicking now and I mostly enjoy my shift. Switching from having worked 12's to 8's has been difficult but it helps me stay in a routine. The growing pains were hard for sure but my preceptor was great and my unit manager says that there are no stupid questions. The unit managers help serve trays in the dining room and I've seen the director on weekends sometimes!

Most of the docs are great too. I'm used to being afraid to call the doc about something small like needing an order for Tylenol or a U/A but a majority of the docs are pretty friendly. I even got my favorite doc to write me a letter of recommendation for grad school. He's really laid back and even jokes around most of the time. I once asked him something while he was writing an order and he said, "dolcebellaluna, you are a psych nurse. Don't you know that men can only think with one side of their brain at any given time?"

I'll admit that I had no idea what to expect from the residents. I may have had the idea of working with little old ladies in my head. I was pleasantly surprised by the acuity and variety of the population. We have everything from walky-talky residents in their 40's to little old ladies. My patient load is usually 16, which is better most of the time than it sounds. I have 1 GNA who takes care of ADLs and I'm grateful for their help. I'm still a bit overwhelmed by the 15 or so medications that some of the residents take, but it's getting better.

I worked in psych for 2.5 years and I think I did lose some of my "skills". Thankfully, these came back more quickly than I thought they would. I deal with g-tubes on a regular basis, have had a resident with a trach and do some simple wound care. My therapeutic communication has been helpful and I find myself picking up on subtle behaviors and being more sensitive to residents. I make sure to give PRNs for anxiety before a resident becomes a total nervous wreck. I'd say at least 50-60% of my residents are on at least 1 psych med, most commonly an antidepressant.

Working 4 on, 1 off, 4 on, 2 off makes me feel like I never get a break and I'm always at work. I'm going to use a couple personal days at the end of the month to regroup and recharge. Hubby and I are probably going to stay in town but we're going to do fun things. I'm excited!