LVN Charge nurse with no LTC Exp is it worth it?

Nurses General Nursing

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Hi everyone, I recently went in for an interview at a well known facility where they serve LTC residents. I'm assuming I did well on the interview because I was hired on the spot. They offered me a charge nurse position even though I mentioned I did not have any experience working in LTC let alone being a charge nurse. I've worked mostly in outpatient clinics. This is a wonderful company with generous benefits package but that means nothing compared to the safety and care of my patients. I believe in my self but at the same time I do not wanna make a fatal mistake on the job. Am I putting my self in a bad situation? What does a charge nurse commonly do?

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Specializes in Psych (25 years), Medical (15 years).

Wow, Life22feb. Your guess is as good as mine.

You might want to play it safe and believe that if something is too good to be true, it probably is.

Or, you might seize this opportunity to professionally grow by leaps and bounds!

Whatever you decide, good luck to you!

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Specializes in Transitional Nursing.

I can really only comment on what LTC is like in my experience, as I've not been a charge nurse.

We have 60 pts with 5 CNAs and two LPNs on 3-11, (6 cnas on days). Here's the dirty truth

The only meds that get given on time are meds given twice a shift (4x day meds, etc), antibiotics, coumadin and insulins. Everything else gets given when we get to that patient, and it gets given all at one time. Some 9pm meds are given at 5 pm and some 5pms are given at 9pm, it's horrible and it's not fair, but quite honestly that it the only way they'll get any meds at all.

Many times skin checks consist of what the CNA reports, without so much as an eyeball on the patient from the nurse.

Family members who throw fits and ask for unreasonable requests will usually be accommodated or they'll try - by making new in services which consist of nothing but a piece of paper for staff to sign saying they will adhere to whatever new policy that's been created to appease the family. Rarely are conversations ever had with staff to help them understand what the perceived problem is or how to actually fix it. When I see these lovely "in services" I do try to educate my staff and fix the problem, but often we aren't given the tools to do so.

Because these folks are stable, when things go south it's not hard to miss because we don't get to assess them half of the time until they get their meds. If they don't get meds, they might not even get assessed. We depend on our CNAs to let us know what's going on. I pray to all that is holy on my way to work that specific CNAs are working that night - otherwise it's chaos.

For my facility anyways, the administration is only concerned with saving money and the budget. If they can justify something with documentation, they don't worry about whether or not the patient is getting what the patient needs.

Whatever the HCP wants, the HCP gets and it doesn't matter if it makes sense or if its in the best interest of the patient as long as its legal. Sometimes HCPs fail their loved ones, and somehow it's allowed.

I often think about climbing the ladder so I can make a difference, but then I get discouraged because its just one big circle of red tape.

It's also so rewarding, because these people are mostly so very sweet and deserving of the best care. Hugs and genuine thank yous from the heart can make my whole day. I love having autonomy working 2nd shift because I can bend a rule or skip a task that isn't important for the benefit of my patients.

I sleep at night because I know that I'm doing the best I can with what I have to work with and if I'm not there, someone else will be and maybe they won't give a hoot.

A good charge nurse or unit manager would really make a big difference, so if you're up for a challenge and you love people it could be right for you.

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Specializes in Emergency.

Welcome to LTC/SNF.

Just hold on, look to more experienced personnel for guidance (including CNAs who have been there a while) and realize that after 6 months of this you will be a seasoned vet. It will take a few weeks to get your own course of attack for each shift and your own way of trouble shooting issues. Hopefully your DNS supports you and you have great staff overall.

I was also hired as a spanking new nurse as charge RN. Fortunately the facility has rock-star CNAs who are on top of everything. Trying to get all treatments done in a timely manner is a rush and I never get to give each resident the attention they need/deserve for problems that arise. There are so many things I really love about working with this population and I am lucky, our DNS gives a hoot and has our backs against corporate. I know that I did my best all the time but really, something needs to change in this care setting but it isn't going to happen as long as profit is the driver.

So to sum up...do your best, if something doesn't seem right with a resident stop all you are doing to do a thorough assessment and pull your resources as needed...from calling the facility MD to sending the person to the ED. Use that nursing process and Maslow to the hilt.

Good luck.

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I was a charge nurse for a LTC facility as a brand new LPN, before I became an RN. I took care of 50 residents by myself, with the help of a med tech and 4-5 CNAs. Luckily, most of the people I worked with were wonderful...as a charge nurse, if you have an extra few minutes, help out your CNAs. It will pay off, trust me. But overall, it was hard. I did all of the treatments, charting residents in/out, ordering medications/lab draws, communicating with the doctor/wound team/pharmacy/residents family/etc, setting up appointments, skin assessments...I was also responsible for certain things that med techs are not able to do, such as lovenox shots and hanging IV antibiotics. Our med techs were certified to do insulin and handle narcotics, but some facilities don't allow that, you would have to check with yours. Also, the charting could be ridiculous. You would have to chart the same thing in like four different places. However, it really was all doable unless something unexpected happened...like a fall, death, hospital transfer, etc. It was SO rewarding too, though. You get to know them so well (over years, instead of days) and it becomes pretty easy to tell when someone isn't acting like their usual. LTC is a place where you really do feel like you can make a difference and I loved that. I hope you the best with whatever you decide! LTC can really make for a wonderful career!

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If you are curious/wondering I would ask to follow a charge on the same shift you would be working. If they don't want to allow that run.

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You can choose to accept the challenge and learn like others before you, or you can choose to take the next job offer. Realize that there will be a learning curve in any new area of nursing that you decide to try.

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Specializes in LTC and Pediatrics.

I have only worked as charge nurse in LTC. It is much like those who have replied before me have said. For me, it was either I was the only nurse on on that shift, or if the facility was big enough and we had two nurses, I an the charge nurse for the units I am assigned to. For the most part, it is like any other floor nurse, but you need to make sure that the med techs and CNAs complete their tasks as well. There are the labs, orders etc you must do.

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