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New grad, new job in LTC

by hera78 hera78 (New) New

Hi! I am a new grad and I will be starting my first nursing job as a staff nurse in a few weeks in a LTC facility. I am nervous because I have been out of school for about 5 months and I feel like I have forgotten all of the hands on stuff I learned. I can only review textbooks so much, I just don't feel prepared. (I know in a way nothing can prepare me, it's so much on the job learning, etc) however I am just wondering if you all have any advise on how I can best be prepared and do the best possible job. I am doing things like reviewing the top prescribed drugs in nursing homes, insulin injections, s/sx of stroke, hyperglycemia, etc... am I on the right track? What else can you suggest?

They also left my orientation "open" telling me I would shadow a nurse "until I felt comfortable".. which again makes me nervous.. I don't know if that should be one day, a few days, weeks? ??? What is the normal orientation / training time for a new grad in a new job?

Thanks all :-)


I have worked for a couple of long term care facilities and you will probably be passing meds most of your shift. Just follow the five rights and you will be great. Take your time, you will have a lot of patients. I had to do some wound care too, but there is usually a wound care nurse that you can ask how to do it. Mostly I pass meds.

The difficult part is the charting for me. Now that I have computer charting it is easier, but Medicare charting is A LOT.

Good luck.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

What is the normal orientation / training time for a new grad in a new job?
New grads can expect to receive about three days of orientation and training in the area where I live. If you're not proactive about learning as much as you can during orientation, these days might consist of simply following another nurse around as she pushes the med cart and passes pills.

You really need to learn the paperwork aspects of LTC, as well as the policies and procedures of your specific facility. Unfortunately, the state surveyors do not give a rat's ass if Mrs. Smith received hugs and tender loving care from you. Their main concern is the paperwork and documentation, and you could be on the hook if it wasn't completed properly. Good luck to you!


Specializes in LTC. Has 7 years experience.

My tips for new nurses:

1) Get a good pair of shoes

2) Document! Document! Document! If you don't, it did not happen and your facility will not get paid.

3) Have a good report/assessment sheet for all of your vitals, assessments and to do lists.

4) Ask questions. The only dumb question is the one you do not ask.

5) Get a routine and stick with it.

6) Keep coming to this site....its a HUGE help!



Specializes in LTC.

diabetics...cool and clammy need some candy--hot and dry sugars high...

Thank you all for the good advice! My first day is Monday! I am sure I will be back with more questions or in search of support!

Good luck in your new position. Here in the upper midwest, LTC training for new grad is generally 5 to 10 shifts, depending on the facility.


Specializes in geriatrics Ltc.

Thanks for advice new grad 1st job orientation this tues.


Specializes in geriatrics.

Don't stress yourself out right now trying to relearn your textbook. LTC is stressful enough - give yourself some down time before you start work. You would be smart to review diabetes and heart attack symptoms. But most importantly learn to manage your time. Don't leave your med cart unlocked or forget to sign out your narcotics. Learn which CNA's are reliable and which ones you have to watch. Look out for safety hazards (my pet peeve is residents sitting in front of the fire doors). And ask for help if you're not sure how to do something.


Specializes in geriatrics Ltc.

Thanks abby I'm nervous just like I was going to take the nclex which passed the first go around, I don't know much about facility, nurses or Cnas, little nervous about being a new grad

What has helped me the most was coming in a little early and flaging all of my blood sugars in my MAR so that I can knock those out first. It's going to be hard in the beginning until you get to know your residents. Also don't be afraid to ask questions. I keep some pink post its with me to write down things so I don't forget them later. If I see one someplace then it's like a big reminder to do something.