LTC newcomer

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Specializes in Progressive, Intermediate Care, and Stepdown.

I've recently graduated from college and now have accepted a job in a LTC facility. During nursing school, there was little focus on LTC and more on acute care. I've never worked as a nursing assistant nor have worked in LTC.

I was wondering what you all recommend I should learn or brush up on to become more competent in LTC. I'm looking for advice on what you would do now if you were in my position. Being, no formal/professional RN experience and knowing very little about LTC.

Thanks for your advice.

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I think knowing how to do a good assessment is key, I frequently do focused assessments, like respiratory and neuro.

But get to know your residents. Frequently, we nurses realize someone is sick when they start acting differently.

And time management!

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Specializes in retired LTC.

R E S P E C T your CNAs and listen to their recommendations and observations. Followup on those issues in a timely fashion and let the CNAs know. Esp if your assessment doesn't reflect the "criticalness" of the CNA's. They mean well and their job desc. requires them 'to observe & report'.

Lend them a hand when you can, like doing a task or 2, or assist with a boost-up when you see it needed. They'll appreciate it and that makes for better work relations!

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Specializes in retired LTC.

One other BIG BIG BIG thing I tell newbies - PLEASE be super cautious about your narcotic counts. Take NOTHING for granted and NO shortcuts. I know we all want to trust our peers and coworkers, but many staff have been hung up by their peers for incorrect counts. DON'T CHANCE IT!

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Specializes in LTC.

I was in a similar situation to you about 1 1/2 years ago. I finished my first year of my ADN program and became an LPN at a LTC facility. I had never worked as a CNA either. I agree with the other posters: listen to your CNAs they spend more time with the residents and know their routines better than you will. If they say something is not right they are probably right. Ask questions if you are unsure of something, even if you think it's a dumb question. And most of all relax...you will not be able to get everything done during your shift at first be ready to stay late to finish your charting. I have now received my RN and still work at a LTC facility and have become more comfortable in my role. Be ready to feel overwhelmed at first, but keep reminding yourself it will get better!

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I was in your position, quite recently! Started in Jan, never worked in LTC in any capacity and new to nursing after 14+ years in a completely unrelated career field. I was lucky to have 11 orientation shifts before I was on my own. I can't really think of any "studying" type stuff that I think would have helped. Familiarity with meds is important, but getting to know the residents is the biggest part. Once you know who they are and how they take their meds, you med pass will be much smoother (I can't say faster since mine isn't fast yet). Learn how you organize best to keep track of things, some of the other nurses highlight their report sheets, I find highlighter distracting. I make lists each shift of who has creams, powders, dressings, Foleys, GTubes, etc, right on my report sheet so I can keep track of getting stuff done. It will take a little time to find the system that works for you.

Despite what some of your fellow new-grads might say, LTC is not the end of the world, you might even enjoy it. Good luck.

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Specializes in LTC, Psych, M/S.

Does your facility have paper or electronic MARS? If paper - design yourself a flow sheet for who has what meds at what time and check things off as you go. Make sure to know your facility policy on what to do when someone falls, makes suicidal comments ( you will find out what I mean)how to chart bruises and y, what forms are needed to transfer a patient to the hospital. I know I got hung up on all those when I first started LTC.

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Get to know your residents well. Get to know their family members well too. Especially those that visit often will save you lots of head aches. The better you know the family and resident the better off you will be. I have been in LTC for 28 years count count the times the family put their trust in me because of those little extras you do for Grandma or Grandpa. I have even been ask to be Pall Barer at several funerals over the years for different residents. I think it all comes down to treating them like you would want your Grandparents treated or you Mom or Dad

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