I'm sure you've all seen this before..

My name is Dave, I've been an LVN for 3 months. In my first three months of work I worked on a Med/Surg floor. Although it was great experience, the pay and hours were terrible (I was lucky if I'd get 30 hours per pay period).

I got a job offer this morning from a nursing/rehab company who had seen my resume on an online job service. They want me to start in two days, and I told them I would give them my answer tomorrow.

Here's the thing. What should I expect? I did rotations in LTC's in nursing school, but I never actually saw any "nursing", just the charge nurse filling out paperwork. (I hope that doesn't sound rude-- I was in my first semester and wasn't sure who was a nurse vs aide in the nursing home).

What can I expect?

Do you think my Med/surg experience will help out?

Are you able to keep current on skills? (IV's, Foley's, injections, etc).

Any information is welcomed. Please POST away! :-D

Hi Dave,

Before you take the job, Call them back and ask them

1.What their patient to nurse Ratio is? Its pretty typical to have 30 or less.

2. What is the acuity of the patients.

3. Also ask them if there will be a shift supervisor that will so all the admission work. Because if you have to do it, it will take up all your time.

4. Ask them what were the results of their last state survey. 2-3 are okay. But if its near 10 or in the teens, they have problems.

5.Ask them how long do they train

6. Ask them what their pressure ulcer and fall percentages are because if they are above 5% them someone is not doing their job.

If its a rehab nursing home, you will have a lot of hip replacements, you may have to dabble in IV. Catherizations, dressing changes, Lots of pills to pass. Its hard work and it pretty standard and the same everyday.

Here is my typical work Schedule:

Come to work

Get report

Count the NARCs

Stock your cart with juice and get your insulins

Start on the cart 3:30-4pm

Pass meds for couple hours

Eat dinner at 6pm

Come back do do treatments

Get back on the cart at 7:30 and pass till 9:30

9:30 Paperwork

11pm report

Good Luck!

Awesome! TheCommuter I love how you wrote that out! I am the same way, I always carry my trust notebook with me and lay out all my procedures throughout the day. Does your facility have medication aides?

Why is it that there is such a high turnover for LTC? Is that why pay in LTC facilities is higher than hospitals? The pay I am getting for this job is almost $4.00 more-- and it's closer to home!

Thanks again, and if there is anything else you think I should know-- just tell me

If it is a skilled facility you will do IV's but still not like you will do in a hospital. They say you lose your skills in the nursing home. I don't necessarily believe this, but I do say if you don't have clinical skills the nursing home is not the place where you would pick them up.

My sister works in a LTC facility as a treatment nurse, and she seems to enjoy it. Working in Med/Surg for the past few months has given me lots of skills, so the only thing is that I don't want to 'lose' them. The pay for this job is wonderful, and the schedule will still allow me to continue my education toward becoming an RN.

I'm going through Excelsior-- any of you working in LTC's go through there? Have any trouble with the CPNE?

Thanks again!

I am not sure about losing your skills working LTC. I currently work in a 44 bed nursing home and althought I have not been there long, I am finding out that I do have to use the med surg skills I learned in Nursing school. I am constantly assesing different patients which challenges me to go back and think about different disease processes. There are many different skills that I use now that I never did in the hospital. Yes dealing with the families is hard, but you just have to remember that alot of families either feel guilty that they've left their family in a nursing home or they understand that the nurse is a little out numbered and they are frustrated that THEIR family member is getting the care they need. I will say this. I work my butt off harder in the nursing home then I ever did in the hospital!!!!!!

In LTC, the residents are usually only seen by their doctor every two months. The nurse has to be able to spot subtle changes that indicate something is wrong and notify the doctor accordingly.

I worked in a facility where administration actually backed the staff, but this is the exception, I'm afraid.

also you will be settleling fueds w/cnas, searching for hearing aids etc, filling out fall &/or incident reports,adding to careplans re both, writing summaries,& medicare charting, dressing skin tears etc. if i could just do "nursing" i would save about 2 hrs ea shift,& i would use some of that time to read res histories, careplans etc.

Also, LTC tends to pay more because you will shoulder more reponsibility yourself. You may have an RN in the building, but she may be all the way on the other side where you'll rarely see her. There are not a whole bunch of other nurses around.