LTC interview update

[mharrah]

Earlier, I posted that I was going to an interview for LTC. Well, I had that interview today.

They asked a few questions that I hope I answered well. They asked "If Mr. Smith falls on his head, what would you do?" I said I would immediately go assess Mr. Smith. I would contact the doctor and fill out an incident report and any other paperwork required by their policy. They said "if this happened at 3am, would you still call the doctor?" I said that, yes, I would call the doctor and added that the doctor would probably want to know. Now, I don't know if this is the right answer, because my experience is not LTC. My experience is hospital, and you would definitely call the on call doctor when working at the hospital. Mr. Smith would also need to go to the ER probably to have a head CT and some other testing done, but I did not think to say that during the interview. So give me your own feedback about Mr. Smith, please.

They said that some nights, I would be the only RN in the building, and this is a 130 bed facility. But there are LPN's there, and I wouldn't be alone til orientation is over. Is that normal to be only RN? That sounds scary.

How do you give report at LTC since there are so many patients? Forgot to ask that question.

They said they would need me most in the transitional care unit. They said turnover is big there. Should I be concerned about that?

When I worked in the hospital, I got down to an unhealthy weight, because I did not have time to eat during my 12 hr shift. Would this be a problem in LTC as well?

I would love to hear your opinion about working at a hospital vs. working in LTC. Would like to hear your pros and cons. Thanks.

[Sparrowhawk]

If there are LPNs it sounds normal for one RN per shift. And yeah it would make sense to at least call the on call doctor for a head injury and to ship them out it's what I would do, then notify the PCP in the am...but it's what your Facility policy is to

[changeofpaceRN]

My last LTC facility had a standing order for neuro checks if the pt had a head injury. I would always call for an injury like that no matter what the hour.. a minor skin tear can wait until the AM. I call to save my butt even if that means getting yelled at. I don't take it personal and I know they get paid waaaaaaaaaay more than I do so they can answer the phone.

Oh and yes, you should have time to take your break and eat. Some nights are worse than others but you should at least get SOMETHING. Some nights I was able to have 1-2 hrs of down time and other nights I have 20 in the whole shift in LTC... find time to eat!

[RNBearColumbus, BSN]

So give me your own feedback about Mr. Smith, please.

You gave a great answer. :)

They said that some nights, I would be the only RN in the building, and this is a 130 bed facility. But there are LPN's there, and I wouldn't be alone til orientation is over. Is that normal to be only RN? That sounds scary.

Yes, it's normal, especially since they have LPNs on staff. You'll probably each have your own patient load, but depending on the scope of LPN practice in your area, you'll be expected to cover IVs and any other task limited to RN practice.

How do you give report at LTC since there are so many patients? Forgot to ask that question.

You will only need to give / get report on the patients on your unit, not all 130.

They said they would need me most in the transitional care unit. They said turnover is big there. Should I be concerned about that?

Patient turnover? or Staff turnover? High patient turnover makes the job more interesting (and demanding) imo. High staff tuen over can make it a real pain.

Good luck! LTC nursing can be very rewarding and challenging. It's not the cake walk that some people make it out to be.

[mondkmondk]

Sounds good! We have a 154 bed facility and generally on evening shift, I'm the only RN there too, with a slew of LPN's on the other stations. I have my own wing to be in charge of and give report on, about 39 residents. But I have floated to the other wings to do central line IVPB's, draw blood, start IV's, or anything else an LPN needed me to do.

Blessings, Michelle

[kcochrane]

I just came from a 500 bed LTC facility where there was 2 RNs on at night. Maybe 3 if they were lucky. We had several respiratory floors and some really sick residents. So I think 1 for 130 beds is not bad. A big turnover is not that unexpected in LTC. Many find it just isn't for them. How you dealt with falls is pretty much our policy. They don't always call the doctor - just depends on the fall and/or injuries.

Good luck!