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Discussion

LTC Tips/Advice

Next Thursday I start my first nursing job after graduating in May. It's at a very small (9 bed med-surg, 11 bed LTC and 6 bed ER) rural hospital in upstate NY. I was supposed to spend 2 weeks on the LTC wing learning the ropes and then switch to the med-surg to begin my full orientation. However, the LTC night nurse has taken bereavement leave and won't be back for a month. I'm going to spend 2 days orientating and then covering for her until she returns. It's a pretty small load compared to a lot of the LTC ratios I've read about, but I'm still pretty anxious. It's going to be me and 3 CNAs from 11pm to 11am (with 3 other RNs just down the hall if I need help.)

Does anyone have any advice or tips on surviving the 4 weeks without making a total fool of myself? I feel like I have no idea what I am doing.

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    Try to relax, you will be fine! 3 CNAs is an amazing ratio for only 11 beds.

    Trust your CNAs if they have worked there for a long time. They probably know a lot more than you think, and they will appreciate that you ask for their input.

    If you have any questions, and of course you will have many, ask all those RNs down the hall! It sounds like you will have lots of resources.

    When you start off, just know the most basic stuff like where the crash cart is, how to use the phones, and how to use the med cart/ med room.

    Also find out if you have a pharmacy resource you can call with questions, like in the morning daytime hours of your shift. I find that pharmacy is always a huge help for those times when you are unsure about medications dosages/interactions. You will be needed for nighttime and morning med passes, both routines and prns. When you orient for those two days, ask for a list of the most commonly used meds, and then brush up on those. These will likely be pain meds, anti hypertensives, diuretics, antipsychotics, hypnotics, antidepressants, mood stabilizers, antianxiety meds and anticoagulants to name some of the more common categories. But don't sweat it. I bet everyone is thankful to have you so readily available to work! Good luck!

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    Wow! You and three CNA's for 11 beds? That's an amazingly high staffing ratio for LTC, especially for an overnight shift. To put this in perspective for you I work in an 80+ bed facility with 2 nurses and 3 CNA's for the entire building and that is considered pretty decent staffing for LTC. There are plenty of good threads in the LTC forum that can provide you with tips. I suggest browsing there first. If you have any specific questions after looking around there feel free to ask, I am sure you will get plenty of helpful advice.

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