Im a New RN---LTC my first job

[tiedwithblackribbon]

Just passed my NCLEX in March and finally got a job working part time at a LTC facility. I've been reading in horror on these threads that so many new RN's and LPN's are getting short orientations and working as charge within a month. Any advice for me if this also happens to myself?

What skills should I brush up on?

RN's---what is your typical day shift like?

[CapeCodMermaid, RN]

At my very first nursing job....I was working in a hospital. I showed up for work after my 2 day orientation and was told by the supervisor that I was going to be the charge nurse that evening. "But," I protested, "This is my first day working!" She said, "You're the one with the RN after your name." It's not just LTC that wants people to step up.

There are good places and bad places to work. Charge after a month of working doesn't seem like a big deal. How long is the orientation? How many residents will you have? How many CNAs? Does management listen to the staff nurses? Does the place smell? The answers to those questions will help you choose a 'good' place to work. Good luck with your first job!

[mdp66lna]

Ive been working at an LTC facility for 2.5 yrs. im a LNA/med tech and train new hires. I would suggest when touring a potential employer, look and see how well the CNA/LNA's are working together and are they smiling, and do they introduce themselves. A great staff will make or break your day. As a lead LNA, I make sure im the buffer between the charge nurse and any problems that may arise, that can be handled by me. Our facility is strictly for people with dementia, and at times it can get really crazy! I've seen all the paperwork you have to do just when theres a fall. No nurse wants to have to make that call to the family. When doing the med pass, you cant have residents or family members bombarding you with questions. Thats why a great group of CNA/LNA's are so important. We had a new LPN start just recently and she was orientated 2days on each side. East is begining to middle stages and west is middle to end of life. She told our RCD that she wasnt ready. So yesterday I worked alongside her, answering questions and redirecting residents. All she had to do was read the med sheets, prepare the meds and then I delivered them to the residents. Its nice when the higher ups listen. They know it will cut the turnover rate, because new hires are overwhelmed. I cant say enough about the people I work for,and work with. Their amazing caring people who take their jobs seriously and have fun while doing it. Yes, and if the place smells good and its clean, your on the right path. :)

[neutrophil]

Know that you have the theory and that you have to pick up on the day to day work. That all of the nurses were new at one time. They know what you are going through. They expect you to stand up to the challenges and let you suffer so you will learn because being a nurse is not easy. So go and give it your best shot. Don't be afraid. It is not easy, not anyone can be a nurse. You will just be fine if you keep plugging away. Good luck, you will find a sense of satisfaction after you have gone through the grind.

[NC29mom, ASN, LPN, RN]

you'll do fine! i have worked in a nursing home going on 5 years, and i love it! started as a lpn and received about 4 weeks of training, but my don is really good about giving adequate training to new grads. just wondering, what is your job position going to be?? most nursing homes use the rn's for mds, new admits, or adon positions. you usually don't see a lot of rn's "pushing meds" in the nursing home. where i work, we have 4 rn's and 2 lpn's, which is very unusual (especially around here where med techs are becoming more and more common).

i hate that nursing homes have such a stigma attached, there are some really good ones out there.

i hope all goes well for you, let us know. and best of luck!! you made it through nursing school, so you can make it through anything!!!!

[txspadequeenRN, BSN, RN]

We are talking ltc right.....all nurses are charge nurses including the lvn/pns.....ur lucky if u get more than 3 days orientation in ltc ...most the time they just throw u out there......good luck

[NC29mom, ASN, LPN, RN]

i think they might call the lpn's charge nurse's, but there has to be a rn in the building so many hours a day. at night, when maybe there isn't a rn in the building, the lpn has to have a way to get in touch with one if needed.

[color=#00bfff]where i work, we do refer to the nurse working the hall the "charge nurse", but we have 4 halls with 2 nurses, so there are 2 charge nurses. they know there is a rn in the building if they need one.

[color=#00bfff]and, not all nursing homes just throw you out there. there are some really good ones that provide great orientation for their nurses. if you don't feel comfortable with the orientation process, speak with your don. after all, it's your license!

[C2Allen11]

That's a tough job but the ones that I know that went that direction really have a passion for it and have had good things to say.

[Finallydidit]

I am an 3-11 LPN charge nurse at a LTC facility, on the 7-3 and the 3-11 shift we have 1 RN supervisor and 2 LPN charge nurses and (usually) 4 CNAs per unit covering 60 residents. The RNs role is to do admissions, discharges, take off orders, labs, check MARs, etc. (basically alot of paperwork) and to asist the LPNs/CNAs if we start getting behind due to unforeseen emergencies or behaviors. For example if someone has to be sent out. While I am taking care of the Res. the RN is getting the paperwork, calling the ambulance, hospital, and family. Also if something seems a little off, or I am not quite sure of something, I have my RN come and evaluate, and we as a team decide what needs to be done. Or say if I have a skin tear, and need to do an inncident report, she if not busy herself, will either do the report, or go do treatments, or get a U/A, or blood draws etc. while I do the report. She is a great asset, and it sets my mind at ease knowing that she is there.

Now on the flip side of that on day shift, recently hired a new grad RN first job as a nurse, no prior medical exp at all. The issues that have been vented to me are the "patient care skills" are lacking and if the day shift charge gets behind, the "new" RN doesn't know how to "help" out.

So what I would advise you is to take every opportunity to do patient care that you can, Not that the LPN doesn't want or know how to do it, I say this because in LTC RNs don't get to do much of it until they are needed.

If a Res. needs a foley, DO IT..., When staff and new admits need TB test, GIVE THEM, Know how to change an 02 tank, GIVE the IM injections, DO the blood Draws, START the IVs.. These are things that don't happen everyday, and you want to skills to be sharp so when you are needed you will not be like a deer in headlights.

Good luck to you, you will do fine

[AXIDRN]

I am in the same boat as you, graduated in Dec and started working in a LTC a few months back. The place i work is good, its not the best from what i hear but definately not the worse. I am just getting used to having the 25+ patient load that differs from any clinicals i had in school. My orientation was about 4 weeks on and off and to be perfectly honest my first weeks i didn;t learn anything and felt more like i was picking up the extra paperwork that the nurses there didn't have the time to do. I am still learning alot but feel like I am not learning as much as i would in the hospital. I am hoping this will prepare me for something in the future. I am in NM and there is an oversaturation of GN's and the pickings for us are not great at all.

[BackfromRetirement]

I agree with FinallydidIt. Insert the foleys, do the UA"s, do the treatments, draw the blood. I do part of the clean and dry round with the CNA's. It puts a face on a chart. It shows you to what extent a pt can communicate effectively. It shows you just how much a pt can move about in bed. I answer call lights at times and yes, i do bedpans. There is a wealth of knowledge that can be noted by doing these.

[prinsessa]

At the facility I work at the RNs do the same exact job as the LPNs. The only difference is that the LPNs aren't supposed to insert IVs or flush PICC lines. That doesn't mean that they don't do that. As a RN I pass meds all day. Not exactly what I expected when I graduated from nursing school. Even though I haven't been there a month yet I really like some of the residents. I enjoy talking to them when I actually have the time to talk. I just feel like I am not doing everything I could be doing as a RN.