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Discussion

Major shift in practice...

I became an RN (ADN) at age 52, did Med/surg then Adult ICU then found Occupational Health Nursing which I've excelled at for ~12 years. The problem is that I'm 69 and have had 8 really, positive interviews over the past 6 months, all for which I am eminently suitable (I have the experience/certs, etc.) but have not been hired. I have heard the words "we'd like someone who will stay with us for a long time." I also realize that hospital wage models will not hire a RN with 17 years experience (too much $) when one with 2-3 years will do. I suspect I'm being "priced out of the market."

I'm doing an ADN>BSN currently and very near the end. "Not" nursing for a long time (an employment gap of even 6 months) is bad. So I applied to an agency and was accepted as a flu clinic/wellness clinic (BP, BMI, Lipid profile, etc.) PRN nurse at about 70% of what I usually pull in. So I go in for orientation/training (which I could teach) finish that in two hours then get a question: "Would you consider being the nurse for a "small," nursing home? The home just happened to be a short drive from where I live--that's nice. Then I thought, "I know nothing about geriatrics/LTC (excepting that I am geriatric). My company had me do a LTC "exam." OMG, it was like taking the NCLEX again--it was difficult, but I achieved an 89, so I guess I did remember some of what I learned 19 years ago.

At any rate, I took the job. I really liked the "director" who is an LPN and liked all of the current "residents," and the CNA's seemed quite happy too. It is obvious that this small (19 bed) facility has had issues with state inspectors, so there is a lot of learning to do to come into 100% (if that is possible) compliance. It's not a "skilled nursing facility," it's more an "assisted living facility," but being responsible for 19 residents is scary.

Don't get me wrong, at my last job I was sole "practitioner" (agreed--RN's are not Practitioner) for a industrial site with over 700 employees. Cardiac incidents occurred about 2x a year, I do have a clue--but how well will this translate to elderly/frail elderly, I'm not quite sure. This house's acuity is very, very low, so I'm as concerned with compliance. I'll take each resident and learn meds/conditions in turn.

Any suggestions for a newbie to LTC? Top 5 tips? Any good books out there? It's likely that I'll be back here picking your experience.

What do you think about a 69 yo RN newly moving into geriatrics? I'm finishing a BSN and will try to find a decent but cheap ANP degree in adult/geriatric. Btw I intend to continue nursing until someone tells me "go home and retire." Dr. Leila Denmark is my role model, she was an active pediatrician until she retired at age 103. Google her, what a remarkable lady.

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Is it a skilled facility? What is the structure of the facility? How many nurses vs CNAs? Do you have 24/hr responsibility or is there a DON?

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