LTC Charge Nurse for New Grad?

algebra_demystified · Nov 18, 2008

I'm a new RN, and had a job similar to what you're being offered. Some days are great, some aren't. Passing meds is a big job in a facility like that.

I'm thankful now that they hired me on as a temp because I didn't feel so bad giving my two weeks notice after only a month on the job. It wasn't for me. I felt there was way too much to keep track of and patient care suffered on my watch.

My orientation wasn't bad, the nurses who trained me were good at their jobs, etc. Still, I only had a week of orientation, and I didn't soak up enough to be effective in the position. Another new nurse in the facility said she thought I'd be fine in a couple of months. Well, I don't like the idea of hanging in there for a couple of months dangling my license out there.

I got a job in a hospital in an acute setting and am very much looking forward to my new responsibilities and the long orientation that comes with it.

TheCommuter, BSN, RN · Nov 18, 2008

40 residents is a normal patient load in nursing homes and skilled nursing facilities, which are known for generally short orientations and immediate staffing needs. You've got to remember that, although many nursing home patients these days require heavy care such as complicated wound treatments and tracheostomy care, they still are not as acute as what you'd find in a hospital.

I first received my LVN license in early 2006. My first nursing job out of school was at a small LTCF as a charge nurse over 30 residents. Although it's challenging, it is also workable if your time management skills are superb. Good luck to you!

girls1 · Nov 18, 2008

Thanks for the replies. I will be back.

Melinurse · Nov 18, 2008

I am working at 2 LTC facilities as a new grad. Got 4 days orientation and am in cahrge of 20 pts if I am doing floor nursing or 40-50 pts if I am acting supervisor. As a supervisor I have 2 LPNs who are wonderful and 4 - 5 CNAs. We get more rehab type pts so they do go home usually in 12 weeks or less. We get a few trachs which I'd never cared for before and lots of feeding tubes and J-tubes/G-Tubes, etc on our long-term wing. I work mostly in the rehab. Like the Commuter said , these pts are for the most part a bit more stable/less acute than those in the hospital.

girls1 · Nov 19, 2008

I'm a new RN, and had a job similar to what you're being offered. Some days are great, some aren't. Passing meds is a big job in a facility like that.
I'm thankful now that they hired me on as a temp because I didn't feel so bad giving my two weeks notice after only a month on the job. It wasn't for me. I felt there was way too much to keep track of and patient care suffered on my watch.
My orientation wasn't bad, the nurses who trained me were good at their jobs, etc. Still, I only had a week of orientation, and I didn't soak up enough to be effective in the position. Another new nurse in the facility said she thought I'd be fine in a couple of months. Well, I don't like the idea of hanging in there for a couple of months dangling my license out there.

Thank you for sharing your story. I think they give shorter orientations to temps and agency nurses so that might have been the case with you. This home claims to give you at least a month of orientation and more if you need it.

I just feel like 40 patients would be a lot for me to be responsible for period; especially if they have trachs, and feeding tubes.

I got a job in a hospital in an acute setting and am very much looking forward to my new responsibilities and the long orientation that comes with it.

girls1 · Nov 19, 2008

40 residents is a normal patient load in nursing homes and skilled nursing facilities, which are known for generally short orientations and immediate staffing needs. You've got to remember that, although many nursing home patients these days require heavy care such as complicated wound treatments and tracheostomy care, they still are not as acute as what you'd find in a hospital.
I first received my LVN license in early 2006. My first nursing job out of school was at a small LTCF as a charge nurse over 30 residents. Although it's challenging, it is also workable if your time management skills are superb. Good luck to you!

I think I'll give it a try. I am confident in myself but I never really thought about the number of patients I might get in different settings. The more patients you have, the more likely something will go wrong and get you into trouble.

Of course this is something to worry about in any setting. I'm just not used to being so accountable for others (aside from my children).

I keep thinking abouth the millions of scenarios that could take place during my shift and how I will be the one to blame for all of it. I just need to be brave period I guess.

girls1 · Nov 19, 2008

I am working at 2 LTC facilities as a new grad. Got 4 days orientation and am in cahrge of 20 pts if I am doing floor nursing or 40-50 pts if I am acting supervisor. As a supervisor I have 2 LPNs who are wonderful and 4 - 5 CNAs. We get more rehab type pts so they do go home usually in 12 weeks or less. We get a few trachs which I'd never cared for before and lots of feeding tubes and J-tubes/G-Tubes, etc on our long-term wing. I work mostly in the rehab. Like the Commuter said , these pts are for the most part a bit more stable/less acute than those in the hospital.

Four days of orientation sounds crazy to me. Wow! I guess rehab itself isn't too bad. They have a rehab floor too, but she doesn't want to place me on that floor.

I think I will give it a try and see how it goes. The Director of Nursing is wonderful. She seems so supportive and nurturing. The Nurse Manager for my would-be floor is also alright. The CNA's were not happy to see me though.

Edited to add:

Are you happy you chose a nursing home? Do you feel you are learning and growing as a nurse?

Melinurse · Nov 19, 2008

Four days of orientation sounds crazy to me. Wow! I guess rehab itself isn't too bad. They have a rehab floor too, but she doesn't want to place me on that floor.
I think I will give it a try and see how it goes. The Director of Nursing is wonderful. She seems so supportive and nurturing. The Nurse Manager for my would-be floor is also alright. The CNA's were not happy to see me though.
Edited to add:
Are you happy you chose a nursing home? Do you feel you are learning and growing as a nurse?

I am very happy with the nursing home actually. Four days was not too bad though. However, I should add I felt and still feel confident because I have such an amazing team. Two of the CNAs worked with me at the hospital and I had worked with both of the LPNs several years before and I know they know their stuff. The DON said I could have a couple more days if I needed it but I feel ok. I do still learn. I came from working acute care on a med-surg floor where I worked as a LPN for almost 5 years and then oriented as a GN for 6 weeks. But, in the nursing home I am getting more experiences with trachs, vents, TPN, alot of wound care/wound vacs. And the challenges of dealing with some who have Alzheimer's which can sometimes really bring out your creativity. So, yes I do feel like there is growth as a nurse, it's just different types of growth.

girls1 · Nov 20, 2008

That sounds great Melinurse. It seems you were prepared for this type of position.

I decided not to accept the job offer. Thank you everyone for your comments and help.

Melinurse · Nov 20, 2008

girls1, good luck in whatever feild you decide. Nursing is a wonderful profession and there are certainly many different areas to be explored. I wish you the best. :smokin: