New grad nursing home charge nurse.. help?!

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I am a new grad BSN RN and I was just hired as a charge nurse in a nursing home. This is my first job as an RN and I will be supervising 2 lpns and 6 cnas on a 60-bed unit. I took the job because it has taken me 3 months of searching to even get an interview and when they offered me the position how could I turn it down?! At first I was excited but now am scared. I believe I can do it but I'm most afraid of what emergencies I will run into most often and what skills I should brush up on, any ideas? Is it silly of me to think I will be able to sucessfully hold this position as a new graduate? Is it normal for a new grad to be hired into this position?

Hi there,

I started out as a new grad in a charge nurse/supervisor role. I was the sole nurse on 3-11 so it was considered a supervisor position.

1. Ask for as MUCH orientation as you can get.

2. Make a list of situations that you a nervous about and try to ask another supervisors advice, but keep in mind every situation is unique

3. Get to know your staff and residents

4. Follow your gut! When you get the feeling that something is wrong, go with it! Those feelings are usually right.

LPN's aren't allowed to "assess" in my state...it is out of their scope of practice. But come on ..if they tell you something is wrong with a resident that they have taken care of for who knows how long, believe them!

You will do fine!!

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So how are things going now? I was just hired in a nursing home in a supervisor position. I am feeling everything you were feeling a couple months ago. I would love to get some tips and advice.

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I've been there for a little over 2 months now and it was a lot to take in at first. As a new nurse I was put in a position where I have to make important decisions but thankfully I have a lot of support. I found it hard to be a very young new nurse that is in charge of staff that is much older and much more experienced. Mostly the nurse's aides give me a hard time, not the LPN's, but from what I hear that happens everywhere. The most important thing is to cover your butt and document everything! There's a book charting made incredibly easy that's helpful. I made friends with another RN supervisor that works my shift so I can phone-a-friend when I need some advice, which happens at least twice a day. Also, I now think that long term care nurse's don't get the respect they need. When I got the job I was happy to get a job because a lot of my friends were having a hard time finding something. I didn't like the idea of working in a nursing home, which is petty on my part. I like working there now. I like seeing the same people everyday and I truly care about their health because I'm going to have to care for them today, tomorrow and the next day. It's not like a med/surg floor where your likely not going to have many patients for multiple days in a row. And i think it's good experience. I address labs and other test results, perform procedures and handle emergencies. The exciting things just don't happen as frequently as they do in the hospital. I think this is a great position for a new nurse if they're ready to work hard and have a lot of patience. Congratulations!

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I've read all your comments here, wow... I'm happy for Bairkr.

I have a question for experienced nurses out there: would you recommend a new grad RN a home health agency job or a nursing home job? I understand they are not ideal jobs for inexperienced new grads, but I was wondering which one of these poses less threat to having your license suspended?? Thank you,

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Specializes in Wound Care, LTC, Sub-Acute, Vents.
i've read all your comments here, wow... i'm happy for bairkr.

i have a question for experienced nurses out there: would you recommend a new grad rn a home health agency job or a nursing home job? i understand they are not ideal jobs for inexperienced new grads, but i was wondering which one of these poses less threat to having your license suspended?? thank you,

i have never done home health but as i understand it, you will be by yourself when you go to their house and only have a phone to call your supervisor for advice (i hope). anyway, i will pick ltc. you will learn tons of things and you have people that will come and help when you have emergencies.

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I have several years experience as an LPN, frequently thrown into the position of leadership. I just graduated with my ADN. I have been offered a RN supervisor job near my home. During the interview I got the distinct impression they weren't concerned about my lack of "proficiency" in their paperwork (it is a rehab/subacute setting). They were more interested in my ability to take control of the facility once the administration goes home for the day (3-11 shift position). I gathered that the CNA's more or less run wild, and they need a strong personality to regain control. I am a new RN, but I have been a leader for a long time....this should be an interesting experiment! Any other words of wisdom Nurses?

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Specializes in Geriatrics, Ambulatory Care.

"I have several years experience as an LPN, frequently thrown into the position of leadership. I just graduated with my ADN. I have been offered a RN supervisor job near my home. During the interview I got the distinct impression they weren't concerned about my lack of "proficiency" in their paperwork (it is a rehab/subacute setting). They were more interested in my ability to take control of the facility once the administration goes home for the day (3-11 shift position). I gathered that the CNA's more or less run wild, and they need a strong personality to regain control. I am a new RN, but I have been a leader for a long time....this should be an interesting experiment! Any other words of wisdom Nurses?"

Words of wisdom from a DON

1) Leadership is about mentoring not controlling.

2) Praise in public -- criticize in private.

3) Do unto others as you would have them do unto you.

4) Always show respect. (and believe me you can reprimand someone with respect.)

5) Customer Service is the top of the list when administration is out of the building

6) Fear and intimidation are not useful tools for leadership. A title does not give you power, you must earn it.

7) Get a good leadership book (My favorites are by John Maxwell)

I hope that helps.

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I work at a nursing home and recently felt like I got thrown under the bus for not knowing exactly what to do after a patient falls. If the facility doesn't teach you what to do after and incident then ask because elderly, confused patients tend to fall often. I is not like the hopital where everything and every test is at your fingertips so make sure any tests requested by the md done the same day of a fall and f/u to see that it is done to cya and of course for the patient's safety.

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Having a RN act as supervisor and LPNs act as floor/med nurses is the best possible staffing model in LTC. Having to be charge AND pass meds is a recipe for disaster. Where I work, on 7-3 and 3-11 shifts there is one RN supervisor and one LPN med nurse for every unit (49 pts). Plus a couple wound LPNs for the facility. This works perfectly. You can moan and groan about how demeaning or whatever task-oriented nursing is, but it WORKS. One nurse to pass meds. One nurse to dress wounds one nurse to be charge.

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Made me smile the one who mention that they wouldn't trust to look after a roach I agree I am a CNA and work in a nursing home seen the good the bad and the ugly. Also starting RN school in Jan.

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"I have several years experience as an LPN, frequently thrown into the position of leadership. I just graduated with my ADN. I have been offered a RN supervisor job near my home. During the interview I got the distinct impression they weren't concerned about my lack of "proficiency" in their paperwork (it is a rehab/subacute setting). They were more interested in my ability to take control of the facility once the administration goes home for the day (3-11 shift position). I gathered that the CNA's more or less run wild, and they need a strong personality to regain control. I am a new RN, but I have been a leader for a long time....this should be an interesting experiment! Any other words of wisdom Nurses?"

Words of wisdom from a DON

1) Leadership is about mentoring not controlling.

2) Praise in public -- criticize in private.

3) Do unto others as you would have them do unto you.

4) Always show respect. (and believe me you can reprimand someone with respect.)

5) Customer Service is the top of the list when administration is out of the building

6) Fear and intimidation are not useful tools for leadership. A title does not give you power, you must earn it.

7) Get a good leadership book (My favorites are by John Maxwell)

I hope that helps.

"Praise in public, criticize in private." I'm writing this down to remember forever. My unit manager is all about criticizing in public, and it does nothing but breed resentment and hurt morale. And never any praise, ever...

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I am also a new RN after having been an LPN since '75 (have not worked since '90). most of my years working i was in LTC and loved it. So when I graduated I decided to go back into this kind of work. Horrible experience. I worked there a total of 12 days in one month. My schedule was first 2 weeks following the nurse around. Last 2 weeks I passed meds on 3 floors 2x, one floor once and as a Nurse's Aide/ nurse for one night. I do not know if this is how they orientate nurses now but I was not learning anything. there were not that many meds to pass anyhow. The nurses orientating me made me feel so stupid. Finally after my 12th day the DON wanted me to switch to 7-3 because I was not catching on to passing meds (not one time did the 7-3 nurse have to wait for me to finish). Just everything was wrong for me. I handed in my resignation and walked out. Just follow your intuition as to whether you are ready for this or not. I am sure you will be fine.

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