Is it just me or is everyone a little slow when they start out in LTC

Long Term Care Columnist / Guide · Jan 18, 2009

I'm considering getting a job in LTC. I tried it once before and didn't last very long because I just couldn't cope with the work load. I'm trying other avenues but they just don't pay as well as LTC. I'm mainly concerned about my speed. I'm not very fast like other nurses and a med pass for about 30 patients takes me more than 2 hours! ALFs give you a ridiculous number of patients like 60 or so. I'm confused. Am I likely to get better at an LTC with time and practice?

Absolutely! And it won't take long, you just have to be patient with yourself and ask others to be patient with you while you learn the process and develop your own routine.

I recently returned to LTC nursing after years in management, and you can bet I was slow at first, especially being older (50), overweight, and seriously out of shape. But after a couple of weeks, things began to flow better and I got faster. Now I manage 22-28 residents with two CNAs and a half-time CMA, and even with half of them being diabetic and needing FSBS/insulin twice per shift, I almost always get everything done on time including my own med passes......and no, I don't pre-pour. It WILL get better, I promise you---just give yourself time!

pagandeva2000, LPN · Jan 18, 2009

I have never worked LTC, but I have to assume that in time, once confidence is built and having a better handle on the routine, sure, you would become more expedient.

caliotter3 · Jan 18, 2009

It is not you. It took me about a year to start to feel comfortable in LTC. I started a little slower because I was making sure I didn't make a mistake. You can improve on your speed by doing things to make it more organized for yourself. Make sure the cart is in order and set up before you start. Make a list of who's who and what's what for yourself. Example: write down your BS and insulins, list those who need a BP first, etc. Start 15 minutes early. Don't worry. As time goes on, you will take less time.

Jules A, MSN · Jan 18, 2009

Anything new takes time to get the hang of it. Go for it!

kat7ap · Jan 19, 2009

I started out in LTC and I refuse to go back. After a short time you will pretty much memorize your residents meds and med times, treatments, and blood sugars and insulins. There is usually not a whole lot of change, thus it being LTC. So yes you will be slower at first as you are learning. I found that working in LTC, that sometimes your day would be just fine but heaven forbid something should happen like having a resident fall or receiving a new admission. Your whole day goes to hell after that and you end of staying 2 hours after your shift. This usually happened to me a couple times a week. God bless the nurses work in LTC.

systoly · Jan 20, 2009

...a little slow.. ? - I was a snail when I first started. I think this is true for any new job situation. I can usually improve my speed by about 50% after a few months, however, the newly gained time is always eaten up by more duties and assignments.

luvbug · Jan 22, 2009

I agree with the people who said Go for it. I think it takes time to become proficient at anything new. Med passes in LTC are difficult to master because each resident likes things a certain way, and no two will ever be the same. I would think that as a new kid on the block you would be given some time to adjust and maybe even work right along side of someone for a period of time before going solo. LTC can be very rewarding, too.

autumnleaf · Jan 24, 2009

It took me a good month of having the same patients to pick up speed I have 30 patients and it takes me 2 hours to do my first med pass and about 2 hours to do my 2nd. and let me tell you where im at that is pretty good time. I have seen nurses there still passing pills at 11:00 It helps to not look at the time this will cause you to get stressed and try to rush which causes med errors.

atlantagirl · Feb 9, 2009

Thank you all for your responses. I might just reconsider LTC afterall.

newLPN04 · Feb 9, 2009

You will be slow at first...it's something new..you will be extra cautious...you'll probably float around to different halls for a while...but then one day it will all fall into place...and don't forget, even nurses who have worked the same hall with the same residents for years have days that nothing seems to go right and you will probably finish before they do on those days. I'm not trying to sound negative...just want you to expect to be slow at first..and not be down on yourself because someone else is finished before you are. You will find your own routine and things will flow for you...unless that one little old lady sits on her call light all nite long.....Good Luck...Wishing you the best.

dotherightthing · Feb 26, 2009

Every one is a little or lot, slow. It's difficult. In LTC, nurses take a lot of shortcuts you wouldn't see in a hospital. Memorizing patient's medications and pulling them without the MAR, you do go faster but I don't ever want a patient's medication to depend on my memory, which is pretty good but that's a bad policy. I've seen nurses who pull medications the day before because they know which floor they're going to be on. Also a bad policy and one of the reasons why in LTC they get so many state tags.

In my first LTC job, I worked only weekends, passing lots of meds on almost 50 patients...5 months out, I was still slow. A lot depends on where you work and how much you work. You speed up more quickly working 5 days a week.