New to this field! Have a question!

netglow, ASN, RN · Jun 10, 2011

Oh boy.

I'll let others advise you. You do really need to take the advice and information that will follow. Cheers!

gorgenurse · Jun 10, 2011

Thanks, I should add, each unit has approx. 40 patients, 1 or 2 cna's and a med aide in addition to 1 charge nurse.

Does this sound typical?

mazy · Jun 10, 2011

Sounds like your standard LTC nightmare. It's definitely a very different world from acute care. It's not uncommon to have a unit with 40 patients, 1 or 2 CNAs, a med tech and one charge nurse. As charge you would be responsible for the whole kit 'n kaboodle.

Amparo Pagan Titmus, MSN, RN · Jun 10, 2011

Are you asking for comparison to what you are currently doing or because you are curious as to what you might be getting yourself into?

In years past, when I was a student and once as an RN, I worked LTC. I had 30 residents and 1 CNA. It was an 8 hour shift and by the time I was done passing 9am meds it was past noon.

It is a completely different scenario than acute care and requires an individual that has a tremendous amount of patience and frankly passion for this type of nursing. Kudos to them.

gorgenurse · Jun 10, 2011

I am asking not to compare to acute care. I know it will be very different. I have 9 years of experience as an RN. I have worked in acute care settings where I was so busy I literally prayed that the patients I didn't have time to get to would stay stable until I got through the others. I have worked ER, urgent care, rural hospitals, med/surg and inpatient rehab, as well as agency. I am not worried about not being able to handle it. I am wanting to get a feel for what I might expect from those who do this on a daily basis.

I truly love working with the elderly, and look forward to being a different kind of busy. I look forward to not having to worry about the severe acuity of my patients.

But I also like to be somewhat prepared, I just want to get an idea of what I might expect.

Amparo Pagan Titmus, MSN, RN · Jun 10, 2011

"I truly love working with the elderly, and look forward to being a different kind of busy..."

Your comment speaks volumes. I suspect you will do well.

I will leave further commenting to those that work in this area.

NamasteNurse, BSN, RN · Jun 10, 2011

I am a charge nurse in LTC. I have 2 LPN med nurses on days and usually two on evening and one on overnights. Usually on a good day 4 aides, sometimes 3 and almost never, two. The LPN's do meds and treatments unless they can't get some one to cover, then I go on the med cart.

We have 40 residents with many complex issues. Most elderly will have some of these and most have multiple dx. Dementia, HTN, CAD, PVD, diabetes with amputations, CHF, COPD, depression, anxiety. Arthritis and all it's cousins. Lots of UTI's, rashes, eye and ear troubles. Chronic renal insufficiency. Stents, multiple heart problems. And about 10 meds per resident.

Charge nurse is responsible for orchestrating the unit 24/7. No you aren't there all the time but you are still responsible. Staff issues are yours, ordering meds and supplies, consults, and labs.

You will be working with the MD's, and you are the bridge between staff and administration. Make sure everyone, including yourself gets in-serviced. Know all the residents and deal with their families. Send them out when they go anywhere and receive them back. make all the arrangements. Assess, chart, all that. Do wound rounds and follow ups. Make sure everyone is doing their jobs and get in trouble when they don't.

Go to meetings, morning report, and be in charge of the dining room at times. Go look at residents and assess when CNA's and LPN's come and say somethings wrong. Listen to everyone's problems.

Pitch in when needed. Sometimes this means toileting, answering bells, and feeding. There's a ton and a half of paperwork.

Sit with residents when they are dying, call the families to tell them of change in condition, even a small skin tear. Comfort loved ones, call for a coffee cart when they come in to sit with their dying mother or father.

That's the basics, I know I missed a lot more! It's very rewarding, I hope you have a great place to work with wonderful people! Find yourself a mentor immediately. Be really nice to everyone from the housekeeper to the administrator. You never know who will step up to help you when the air conditioner burns out on a 100 degree day or jump start your car in the parking lot. Peace.

Brea LPN · Jun 11, 2011

I'm an LPN and I'm the charge nurse of my hall. I have 36 residents and two CNAs.

Amanda3RN · Jun 11, 2011

I know there are a lot of situations out there that are not so wonderful but there are facilities that are not as nightmarish :yeah:

We have 100 residents spread across 3 different units. We have 5 nurses (1 RN, 4 LPN) on the floor. 6 CNA's on our skilled unit. 2 on our rehab unit and 3 on our Alzheimer's unit. We have myself (ADON), a treatment nurse and a clinical services supervisor that assist with everyday activities

on the floor.

After 6pm on second shift our staff changes to 4 nurses on the floor, 1 med aid and 2 CNA's on the Alzheimer's unit. The other CNA's stay the same. Then we have the RN Nurse Manager.

On 3rd we have 2 nurses, 2 CNA's on the rehab unit, 3 CNA's on the skilled unit and 2 CNA's on the Alzheimer's unit.

There are always going to be days that staffing changes in an instant and we do not have on call so I may have to wear many different hats within the day. But LTC nursing truly is about loving what you do and for the most part if you try to be appreciative and good to your staff they work with you. :redbeathe

gorgenurse · Jun 12, 2011

Thank you all so much for your reply's. It really helps to hear about your experiences! I think I got the job, I will know for sure on Monday!

gentlegiver, ASN, LPN, RN · Jun 12, 2011

WOW! I'm spoiled where I work! We have 1 RN & 1 LPN on 1st & 2nd shift and a Treatment Nurse during the 1st shift, we also have scheduled 5 CNAs (and pray no one calls out) for 50 patients. The night shift has 1 LPN and 2 CNAs. Since there are only 2 or 3 dressing changes required on 2nd shift it's very do-able, most other treatments are neb, treatments or creams & powders. That being said, another CNA and someone at the desk to answer the phones, take orders & write them up, follow up on labs, answer family calls would be a blessing.