LTC is Crazy.

NamasteNurse, BSN, RN · Jan 27, 2011

I had to laugh when I saw your post, you hit the nail on the head, IT'S CRAZY! I felt just like you when I started last April and most days I still think it's crazy, but I love it and it's do-able.

Once you learn the floor, (hopefully you will be able to stay on the same floor most of the time?) the med and treatment carts, and the residents, you will get faster. You'll find a routine like which residents have to have their meds first, who are the finger sticks, who you can give meds to at dinner, who goes to bed first and so on. You'll know which things have to get done fast and which can wait.

There are some days I leave late, as you stated, I get behind because of some problem and yes, I stay late to chart, but most nights I'm out by 11:30-12 midnight on the 3-11:15 shift.

It can be unsafe but hopefully you have great aides. The BEST thing you can do for yourself is get on the aides good side. While you are orienting, watch and learn. Offer to help the aides here and there, like help pass trays, put someone on the toilet real quick, ANSWER CALL BELLS, set a good example of teamwork. Then when YOU need help they will be right there for you.

Remember you will be the leader and no one wants to follow a leader who is mean, lazy or who doesn't set standards.

The doctors, supervisors, unit managers etc can be royal pains. You will have days where you get 'in trouble' get scolded, and just plain mess up. You will have the most amazing days where you feel you did a great job. The residents appreciate you so much, they will become like family because remember that to them YOU ARE family! Cherish their smiles and hugs.

One great thing is you will never be bored! The shift goes crazy fast and when you get in your car you will feel like you just got off a ride at the amusement park. It's crazy but some people love it. See how it goes. Oh and get great shoes! :)

Mudder · Jan 27, 2011

I agree with making friends with the CNA/CMA because they do help you out a lot when it comes to patient care.
Well I am working on a rough draft for my own census sheet, since the facility doesn't provide one.

As a unit mngr for a LTC facility I have a working "To Do" sheet for my patients (er, residents). It has a place to list each pt and needs, i.e. blood sugars, IVs, BMs, treatments etc. If you'd like, email me and I'll email it to you so you can use it as a rough draft and adapt it to what works best for you. Organization and helpful CNAs is the only way to survive LTC.

Good luck! :nurse:

INLPN93 · Jan 27, 2011

Speaking from many years' experience (26 years now as a nurse, 14 of which was in various LTCs), I say RUN to another position while you can. There is WAY TOO MUCH hinging on your license. It will suck all your energy and no matter what you do, you will ALWAYS end up leaving late(despite the cheat sheets that are supposed to "save time"). I got out of LTC 7 years ago and am so glad I did. Too many times I was doing CNA work as well as mine due to a shortage of staff. Best of luck to you.

Couldn't agree more with this post.

LTC is out of control.

I have been at it for 18 years, and I am counting down to my RN because I simply can't take it anymore!

It isn't the residents or the work, its the job.

Every year it gets more and more ridiculous what is expected of a nurse, and the documentation is over the top. If the DON/nurse manager can't figure out a solution to an issue, lets make a sheet for you to fill out! I document the same thing on a resident over and over. Now, we document in several places and then on the computer too.

UUgggg!! GGrrrr!!!

It is insane.

I wish I could give you positive advice, but I am simply at a point where I see none to give.

There are good CNAs out there, and they do help by keeping people off the floor and residents happy & comfortable. I will say that. It is give & take with them, help them with things when you can and they will do the same.

But, as far as the nursing aspect it is like you say working over to get done is becoming the way it is.

I use a report sheet for my 'cheat sheet', I keep it with me making notes on residents as I go.

VS, PRNs, pulse O2 for resp txs, and the such.

Being organized and having what you need on that sheet is helpful in reducing stress and saves time.

Once you know the residents and meds, that will help too. Planning a routine for what you need to get done will keep you on track for the most part too.

It helps you organize and remember what's going on with your residents.

This job is do-able, but don't expect to leave on time. Enjoy the days you do though.

It happens.

cokito · Jan 27, 2011

Hi Mudder,

I an a new grad and I will start (in a week) working in a flex position in LTC, in the sub acute rehab unit with 20 patients. I am very nervous about this new job. Could you be kind and email me the "to do list" you have made too? It would be a life saver for me. I am new in this site, so I am not familiar in how send you an email. Thanks in advanced.

mRpeNa · Jan 27, 2011

As a unit mngr for a LTC facility I have a working "To Do" sheet for my patients (er, residents). It has a place to list each pt and needs, i.e. blood sugars, IVs, BMs, treatments etc. If you'd like, email me and I'll email it to you so you can use it as a rough draft and adapt it to what works best for you. Organization and helpful CNAs is the only way to survive LTC.
Good luck!

could you send me one too! please~

Mudder · Jan 28, 2011

Sure Ladies,

My sheet is on my pc at work but I'll get it tomorrow and send it to each of you that's requested. It's short, simple and to the point. Feel free to adapt it for your needs.

Keep watching this post for me to let you know when I have it ready :)

cokito · Jan 28, 2011

Mudder,

I don't know you personally but you are the best. It is so nice of you of helping without knowing any of us. Thanks again. :bow: :bow:

Mudder · Jan 28, 2011

Cokito,

No prob, we're all in this together :nurse: least we can do is lend a helping hand when we can

shookee · Jan 29, 2011

Cokito,
No prob, we're all in this together least we can do is lend a helping hand when we can

Mudder do you mind sending me one as well?

Mudder · Jan 29, 2011

Hey Ladies (and any gentlemen that may have posted)

I have my worksheet I will email to anyone that wants/needs it. Just email me because I will need to attach it as a word doc. to send to you. Feel free to add/delete and move stuff around to suit your needs. Each pages will hold 8 pts info, of course you could shrink it and copy to make it hold 18 but I'm old and need the big print )

Let me know who wants one!

LoveMyBugs, BSN, CNA, RN · Jan 30, 2011

Mudder, please send one to me too, I am starting my orientation in a 100 bed SNF on Tuesday. I shadowed a nurse for part of the shift on Friday and left feeling very overwhemled.

Hoosiernurse, ADN, RN · Feb 8, 2011

No we don't have a patient census sheet. I was thinking about creating my own, because I really need to organize myself. I have a small child at home, so I can't afford nor do I want to stay several hours after my shift is done. Thanks for the advice.

Oh Holy COW! I can't imagine doing this kind of work without a census sheet. I went from two and a half years in critical care to LTC in my hometown and I really like it! Much less stress not having to deal with doctors much (I'm a night charge nurse) or a lot of family questions. But I would never be able to stay on track if I didn't have my sheets. Our facility has five wings with different populations on each, and I have sheets for each one. Whichever wing they put me on, I pull out my sheet and update it. If it's a wing I haven't been on for awhile, I get with the nurse who is on it currently and get some cheat notes. Write it all down and mark down your blood sugars, Med A/B vitals that have to be gotten, breathing treatments...whatever. Check them off as you do them. You'll get a system down.

Cara:yeah: