New grad and new job=new fears...

Specialties LTC Directors

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I have just started orientation at a LTC facility earlier this week and I have some fears/questions that I would like any help with. First of all, the facility has 77 residents. I was hired for the night charge RN position. During the night, I will either have the wing with 53 residents or the one with 24. I will have 6 nights of orientation (3 on each side). I have started my daytime orientation which has 2 nurses caring for the 53 residents and 1 nurse with the 24. I get 2 day shifts per unit.

So here lies the problem, what is the easiest and MOST effective way that you have found to memorize who is who in LTC and quickly? I have looked at the pictures that are in the MAR and they were taken when the resident was first admitted...we all know that could have been 1 year, 2 years or maybe more years ago. They have changed in looks. I am so scared that I will give the wrong meds to the wrong resident.

I do feel comfortable on the unit with 24 residents so I am thinking I may discuss this with the DON (who is extremely nice) and ask her to allow me to work on that unit until I feel more comfortable with names/faces on the other unit. I know that I can ask my fellow teammates for help with identification but if there is any trick(s) that have worked for any of you, I would appreciate your help. Any other advice that you have for LTC will be greatly appreciated also :).

Also, how are state surveyors with new employess (and new grads)? Are they extra hard on them because they can see that we are shaking in our boots? Apparently state has not been there yet and I am fearing they will come as soon as I am of orientation-just hoping that none of them are "night owls".

So here lies the problem, what is the easiest and MOST effective way that you have found to memorize who is who in LTC and quickly? I have looked at the pictures that are in the MAR and they were taken when the resident was first admitted...we all know that could have been 1 year, 2 years or maybe more years ago. They have changed in looks. I am so scared that I will give the wrong meds to the wrong resident.

Hopefully the majority should be in bed at night and you always check the arm band. If your facility does not ID the patients then ask one of the the CNAs for help identifying the patient.

I do feel comfortable on the unit with 24 residents so I am thinking I may discuss this with the DON (who is extremely nice) and ask her to allow me to work on that unit until I feel more comfortable with names/faces on the other unit. I know that I can ask my fellow teammates for help with identification but if there is any trick(s) that have worked for any of you, I would appreciate your help. Any other advice that you have for LTC will be greatly appreciated also :).

Gut feeling tells me the unit with 24 will be the hard unit. Most likely a reason why one unit has twice the patients as the other, likely twice the problems.

Also, how are state surveyors with new employees (and new grads)? Are they extra hard on them because they can see that we are shaking in our boots? Apparently state has not been there yet and I am fearing they will come as soon as I am of orientation-just hoping that none of them are "night owls".

Don't shake in your boots and they won't know the difference. Seriously, the secret to state is not to be afraid to talk to them. If they see you're nervous they will HOUND you. State usually spend 98% of their time on days unless there have been specific complaints against nights.

Congrats BTW.

Specializes in OB, Peds, Med Surg and Geriatric Nsg.

so here lies the problem, what is the easiest and most effective way that you have found to memorize who is who in ltc and quickly? i have looked at the pictures that are in the mar and they were taken when the resident was first admitted...we all know that could have been 1 year, 2 years or maybe more years ago. they have changed in looks. i am so scared that i will give the wrong meds to the wrong resident.

perhaps suggest to your don to take recent pictures in that way it helps you recognize the residents. in my facility, we take new ones annually. second, these residents should have an id bracelet. if they are alert and oriented, try asking their name and dob (i know this can be time consuming).

i do feel comfortable on the unit with 24 residents so i am thinking i may discuss this with the don (who is extremely nice) and ask her to allow me to work on that unit until i feel more comfortable with names/faces on the other unit. i know that i can ask my fellow teammates for help with identification but if there is any trick(s) that have worked for any of you, i would appreciate your help. any other advice that you have for ltc will be greatly appreciated also :).

if you only have 6 nights of orientation, i don't think that's quite enough for a new grad. when that 6th night is up and you still don't feel comfortable being on the floor on your own, don't hesitate to ask more time to help ease out the 'newbie nerves'.

also, how are state surveyors with new employess (and new grads)? are they extra hard on them because they can see that we are shaking in our boots? apparently state has not been there yet and i am fearing they will come as soon as i am of orientation-just hoping that none of them are "night owls".

my first state survey went fairly well. though by the time they arrived, i was done with my med pass. i do think that state surveyors come in during dayshift. i haven't heard of a state survey during the night though if they come, just try and be calm. check the pictures of your residents as well as their id bracelet prior to giving their meds. with pain medicines, always ask where the pain is and the pain scale and always reassess after 30 minutes.

good luck!

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