New Grad 5 days orientation

[vulupure]

Hello,

I need some word of advice. I am being offered a position in a nursing home. The orientation is only five days, and then I would be on my own. I am scared that I might not be able to grasp all of the new information being thrown at me in this time frame. Is this a normal amount of time for orientation? Or am I right to be scared? By the way I am a new grad, so no experience here.

Thank You!

P.s. If anyone has any tips on how to "survive" in a nursing home please share!

[vulupure]

That's all I ever got, in both LTC and then when I moved to acute.

orientation is to learn how a site/ unit operates. The paperwork and routine, where supplies are kept. It is not meant to teach you how to be a nurse. You know your own weaknesses😆, let your buddy nurse know lEtsand work on them

Thank You for your response. I dont need to be taught how to be a nurse, however this particular facility has 310 beds. It is quiet large, and I am assuming they have many different policies in place that in my opinion might be challenging to grasp in less than a week. Also, I have not had more than 4 patients under my care at a time, and I am scared I might get a lot of patients and will run out of time to provide them with necessary care as I have read that many LTC facilities give 20-50 patients per nurse.

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[vulupure]

At my facility, we can use the "phone a friend option." You know, I can call the DON or ADON if I am not sure about something as well as we do have a manual with some checklists should something come up. Like the first time I had a fall, there was a list of what I should do and what follow-ups would need to be done.

I hope this facility will have something like this in place I really dont want to feel and look like a deer in the headlights.

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[vulupure]

That is about what I had in the nursing home I work.

At first you feel slow and feel like you will never pick up speed or learn it all. One thing that really helped me was taking the list of residents and marking when they receive their meds and if any are in the Narc drawer. I revised it to fit my needs. I work 1400-2200. I have a column that is unmarked but it is anything I need to do between 1400 and 1600. Vitals, Skilled nursing assessments, meds, Glucose tests, etc. Then I have a column for 1600 where under that I have the marked who receives 1600 meds and if one is a Narc, there is an N in that column. Then a Supper column, a 1900 column and a 2100 column. Down the left side are the resident's names. I double check the meds with the MAR (we are still on paper). If I depend totally on the MAR, I tend to miss some meds due to the way our paper Mars are created.

I also include how the resident receives their meds. With applesauce or pudding and crushed with applesauce or pudding. Any others are whole with a drink.

I hope this gives you some ideas.

Thank you so much! This is very helpful. When do you make the list? Do you come earlier before your shift to see who needs what?

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[quiltynurse56, LPN, LVN]

Are you orienting on all units or just one? Are you hired for one unit or all units? That makes a difference. How many residents in each unit? Will you be doing the med passes or do they have medication techs who pass the meds?

I have 30 residents and it has worked out well. I would say if you are orienting to each unit, you will need several days orienting on each unit.

Thank You for your response. I dont need to be taught how to be a nurse, however this particular facility has 310 beds. It is quiet large, and I am assuming they have many different policies in place that in my opinion might be challenging to grasp in less than a week. Also, I have not had more than 4 patients under my care at a time, and I am scared I might get a lot of patients and will run out of time to provide them with necessary care as I have read that many LTC facilities give 20-50 patients per nurse.

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[quiltynurse56, LPN, LVN]

I have a prototype on my computer, print it out before going to work and filling in when I get there. I have a mail box at the facility where I keep my papers and such so I keep extras there.

[vulupure]

Are you orienting on all units or just one? Are you hired for one unit or all units? That makes a difference. How many residents in each unit? Will you be doing the med passes or do they have medication techs who pass the meds?

I have 30 residents and it has worked out well. I would say if you are orienting to each unit, you will need several days orienting on each unit.

From what I was told thus far, they expect me to be able to float to all of the units. As far as orientation, I was not told yet which units they would cover, only that it would last for 5 days.

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[dream'n, BSN, RN]

I started as a brand new nurse many years ago in LTC. What I remember being the most difficult was time management, learning my medications, and being confident in my decisions.

You can do this! Just remember that the beginning is so hard for all new grads. There will be moments you'll be nervous, times that you'll cry, and days you'll feel defeated and want to quit. Sometimes it'll seem like the medication pass will never end.

But...as time goes on you'll pick up speed and confidence. You will grow as a nurse so much in the first year though it is hard, no matter where you work. Understand the work will seem overwhelming at first and that you'll probably work some longer hours at first. Be kind and patient with yourself, don't take inappropriate shortcuts, ask questions as often as you need, and do your very best.

[vulupure]

I started as a brand new nurse many years ago in LTC. What I remember being the most difficult was time management, learning my medications, and being confident in my decisions.

You can do this! Just remember that the beginning is so hard for all new grads. There will be moments you'll be nervous, times that you'll cry, and days you'll feel defeated and want to quit. Sometimes it'll seem like the medication pass will never end.

But...as time goes on you'll pick up speed and confidence. You will grow as a nurse so much in the first year though it is hard, no matter where you work. Understand the work will seem overwhelming at first and that you'll probably work some longer hours at first. Be kind and patient with yourself, don't take inappropriate shortcuts, ask questions as often as you need, and do your very best.

Thank you so much for your kind words. This made me feel much more confident, I will keep your advice in the back of my head during this chapter of my life.

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[wanderlustnurse88, RN]

I find one of the biggest challenge is how the residents get their meds. Who gets them crushed, who gets them whole on pudding, who needs them one at a time etc. If you are going to be floating, maybe come in a bit early to talk with the previous shift to get a cheat sheet of how they take their meds. It does change, but it's good to get a basic idea.

[SWM2009]

If you asked for more time for orientation, would you get it? My facility gives 3 weeks of orientation, usually 1 week on day shift and then 2 weeks on the specific shift one is hired for. 5 days is not long enough but seems to be the standard for most facilities.

As others have stated before me, you will need to know how each resident takes their medications - crushed or whole, 1 pill at a time, thin or thickened liquids. If you are floating, I second the idea from flutist to come in early and have some extra time to get that information from the nurses. Many nurses at my facility willingly share their cheat sheets with new hires so you might get lucky.

Also, if you have not done so already, use the Allnurses search function to search for information and advice about working in LTC. There is a ton of helpful information there.

[vulupure]

If you asked for more time for orientation, would you get it? My facility gives 3 weeks of orientation, usually 1 week on day shift and then 2 weeks on the specific shift one is hired for. 5 days is not long enough but seems to be the standard for most facilities.

As others have stated before me, you will need to know how each resident takes their medications - crushed or whole, 1 pill at a time, thin or thickened liquids. If you are floating, I second the idea from flutist to come in early and have some extra time to get that information from the nurses. Many nurses at my facility willingly share their cheat sheets with new hires so you might get lucky.

Also, if you have not done so already, use the Allnurses search function to search for information and advice about working in LTC. There is a ton of helpful information there.

Thank you very much for your response! I have been reviewing my Medsurg notes, in hopes that it will give me more confidence for when I start. But I know that each facility has their own most commonly used meds and lab values. I also view youtube videos to refresh skills and just to feel in a zone.

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[NurseSpeedy, ADN, LPN, RN]

Five days seems really short for a new grad but unfortunately, as others have said, it seems to be the norm. I worked for an ALF that hired new grads after I had over 12 years of nursing experience. I got three days orientation and I thought that was fair because I had a strong acute care background and it would just be a transition to a different setting. Then I got to see all the new grads when they were hired and a lot of them I trained. They also got only three days and to be honest I don't think it was a fair arrangement for them or the residents.

Now, your situation is different in that since it's a nursing home you will also be providing skilled care. Your facility has a lot of beds but since a nurse must pass the residents meds and not a med tech, along with skilled nursing care (that most ALFs are not licensed for), you will not be assigned to all of the patients as the only nurse on duty. There will be other nurses, most likely experienced, that you can go to for guidance. If you are at the end of your orientation and you do not feel that you can manage the ratio safely, then I would suggest asking for more time. You worked hard for your license and you don't want to lose it because you put yourself in an unsafe situation (plus you don't want to endanger a resident either). If they don't understand then maybe this isn't the right place to work.

I understand that finding employment as a new grad can be hard in some areas, but there are employers that will work with you so that you feel comfortable with your assignment and they feel comfortable that their residents are safely cared for, you just have to look harder for these opportunities and may need to relocate if necessary.