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Hello everyone; I'm a newly licensed vocational nurse with zero experience, I just recently got hired on in a long term care facility. During my first day of orientation I was very excited for this new journey but as I started speaking to some employees they commented certain things like " why do you wanna work here it sucks" or "you don't want to risk your license working here". I was a little discouraged but I decided I had to start somewhere so I disregarded all the negative remarks. After two days of watching old orientation videos which were so blurry I was introduced to an LVN and placed on the floor to shadow her. To say the least she was very short and just passed med's as I watched her. The second day I was on my own to start passing meds on the floor and to top it off I had to send a resident to the ER bc she was not responsive, I was a mess! It's been two wks since then and have not had any training on paperwork bc I do have to do the all Dr orders, appointments, referrals, and some days adding treatments to that before PM nurses comes in. I've done them just by looking through charts, it's been very frustrating bc no one there is willing to teach. I've spoken to the DON in regards to paperwork training but she just tells me what I want to hear but does nothing. Since I started two ADON's have quit in less than a month. I don't know what to do, to stick it through or start looking else where. Are all Long term care facilities like this???? Plz someone give me some hope.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

Not all long term care facilities are like this. However, in my personal experience, many of them do operate in the manner you have described.

I only received one day of training at my first LTC position as an LVN. Though I was promised three days, the nurse assigned to train me called in sick on the last two days. Therefore, since I was there at the facility, I was given the keys to the medication cart and told to work.

Nonetheless, I remained in LTC/nursing homes for six years. Unless you have better options, I would stick it out. To me, having a job is better than unemployment.

Also, the 'my license is at risk' chant is exaggerated. The vast majority of actions taken against peoples' nursing licensure is due to intemperate alcohol/drug use, theft, narcotic diversion, impaired practice, and other issues related to addiction. Rarely, if ever, do nurses lose their licenses for sloppy practice at a nursing home.


Has 10 years experience.

Wow. I was lucky. At my job i started in Aug i had two weeks of orientation. First week was just on how to do paperwork. 2nd week was med pass, treatments, etc. Then again prior to being hired they lost 5 nurses in one day so they did a complete overhaul of the nursing dept and training was more indepth. When i was on my own i felt extremely comfortable. It is a shame some facilities don't realize that a more thorough orientation may lead to a more stable staff.

downsouthlaff, LPN

Specializes in Nursing Home. Has 9 years experience.

I've been an LPN in LTC for 2 and a half years. Very common. I had 1 day of training at my current facility in which I have been employed for 2 years now. I can honestly say that, I didn't really learn anything until I was on my own. It's hard at first but as the weeks go by you get better at time management.

One thing about being an LTC Nurse, that many struggle with, is delegation. LTC is staffed with more CNAs than typically any other healthcare environment. V/S, Personal care, etc., don't be afraid to delegate this. LTC is not an environment in which the nurse can do it all like say med surg, ICU. For the most part geriatric residents are stable. You are there to do the things that require nursing licensure, let the CNAs handle the basic day to day nursing care. If you try to do total care as a nursing home nurse, you'll burn out so quickly. I've seen it happen many times.

There's a lot to do, but don't give up. Things will get better, if you go home every day and plan to do certain things better the next day. It will take time but you will get it. I love LTC. Some like the adrenaline rush, some like like pregnant women, some like the ICU. Me, I love my stable little elderly people in LTC. Some call it boring and routine, but I guess I love boring and routine haha. Good luck to you !