New Grad in LTC

crashcartqueen, BSN, RN · Aug 14, 2015

Unfortunately that is the way of life in most LTCs/SNFs. I was there myself a few months ago and it was rough. I decided it was not for me as I did not feel safe as a new grad being responsible for the well being of 26 patients with varying acuity and mental states with TONS of meds. Between the meds, treatments, charting, and supervisory responsibilities I knew it was a matter of time before my license would become in jeopardy.

Ultimately only you know if you will be able to step up to the plate or not. But please don't feel like you are stuck, there are so many different types of nursing. Some nurses are wonderful at the LTC environment and some cannot keep up. It does not mean you are a failure you just have not found your niche yet.

During orientation try to focus on the paperwork - especially if your facility still uses paper charting. I found that and all the procedures that go with it was the hardest for me to keep straight. Also once you get to know your residents and their recurring needs you will feel a little more comfortable. Best wishes!

strawberryluv, BSN, RN · Aug 30, 2015

I feel the same way. My first day, I felt so overwhelmed with learning how to do all the paperwork. I never even seen paper charting or worked with paper charting in nursing school. Long-term care is like a whole new language to me. I am scared if I forget to do one paper for a certain task which makes me liable or something. I am still not sure what to input in the computer for admission and my shift (3-11pm) is big with patients being admitted on that shift. I just feel like I don't know anything. I couldn't even correctly hook the CPAP onto the patient's machine. My preceptor is using me as a medication aide, she is punching the meds from the bingo card and telling me to give it to the patient and take vital signs. I don't know my patients and on my first day, almost took the blood sugar of the wrong patient. I even asked the nurse aide and he said that was the right patient to get the blood sugar. I am so scared I will make a med error because I read a medication order incorrectly or omit a step to a medication administration such as vital signs. I'm so scared of long-term care. I have 3 more shifts until I will be on my own, they said I can have one more day if I need it. I don't even know where the crash cart is or where the supplies are.

tsm007 · Aug 31, 2015

I feel the same way. My first day, I felt so overwhelmed with learning how to do all the paperwork. I never even seen paper charting or worked with paper charting in nursing school.

This is me and something that bothers me now a lot with my school. We did NO paper charting either and it's killing me. Then the nurses are impatient showing you this because I think they assume this is something you should have learned in school. I wish now that my school made me do more paper charting.

I am struggling too with LTC. I am doing 3rd shift now and finding it much easier than 1st shift to learn on, but I do not think I want to do LTC forever.

quiltynurse56, LPN, LVN · Sep 4, 2015

I was where you are a few months ago. I thought I would never get it down, but I did. Do I still have questions about what form to fill out at times? Yes, Have I made med errors? Yes I have. I use to get overwhelmed when I did and with all I had to do. My DON is wonderful and patient, realizing that I am a new nurse. Regarding med errors, all the nurses I work with say they have made them and still may. We assess the resident, call the physician and the DON. Write any new orders, whether that be a med or to observe. We call the family. We fill out the med error form which calls for us to write how it happened. Then the DON will let us know what they want us to do to prevent error again. I developed tricks for that which has really helped.

With time and experience, we improve, get faster. We get to know the residents. Once we know who is who, it makes the rest go smoother.

I also feel that a little bit of anxiety helps to keep us on our toes. Now if it prevents us from doing our jobs, that is another thing entirely.