new grad offered a job at LTC in santa rosa california..should I accept?

thekid · Jul 17, 2009

I think it sounds pretty good! Is LTC something that interests you? It may be a great stepping stone. Are you a RN or LPN?

I've worked ltc and some places are horrible, inadequate staffing, etc..and others were more like assisted living and were 'cake' . Did you get a tour?

I'm in bay area too ..SF

ris_03tdgz · Jul 17, 2009

Well I honestly really don't know what interests me yet. I liked my nursing rotation in LTC when I was in nursing school but then again I was only taking care of 1 patient. I dont really know what it will be like in the real world. People are telling me its too soon to accept the job offer, that I should wait for hospitals to open up new positions for new grads and apply. But at the same time I don't want to miss the job offer opportunity too. I am an RN, jst recently graduated from the ADN program. Will my pay be enough for the standard of living there? I will get paid 29/hr for it. How do you like it working in LTC? Did you work there as a new grad? How long till you got used to the workload? Is it less stressful than working at the hospital?

ris_03tdgz · Jul 17, 2009

I haven't been there yet, I'm planning to take a look at the place this weekend before I make my decision this coming Monday. I'm really very confused right now because people who I ask advices from are against it.

ris_03tdgz · Jul 17, 2009

anyone else would like to share their thoughts? please do!!

thekid · Jul 17, 2009

Did you hear about hospitals out here opening up new grad opportunities?

I don't consider 29/hr to be bad pay at all but I've been living in Hawaii the past four years :) I'm not sure the 'norm' pay for this area for ltc. You might want to ask over in the geri/ltc forum about that. Personally I can live on 20/hr full time but my expenses are minimal and once I move to bay area permanently, I'll be sharing a house.

I started working LTC as an LPN, not as an RN. I was a med nurse..it was overwhelming. I caught on after a few months and developed a bit of a flow to the day but crossed my fingers every day that nothing would happen ie admit, falls, etc. I did med passes, trach care, tube feedings, nebulizers, accu-checks, helped the CNA'S since we were almost always understaffed.

One facility I worked at had a split floor..we had more acute patients on one side, then there was a more residential side, and then a locked Alzheimers unit. I LOVED working the Alzheimers unit..my background is in psych and relatively speaking compared to the more acute wing, it was an easy job. The med pass was easy but you also had to prepare for anything happening. One of our residents broke through and jumped out a window and started running down the street (not on my shift but I heard about it). I remember being able to spend more one on one time with residents and I enjoyed that. There were rare times when everyone was in bed that you could almost say it was..um..relaxed :) I would work Alzheimers unit again in a heartbeat.

As a new grad you may have to work in various areas to find your niche. One good thing about working ltc now, if you found out you could tolerate it..you could later work for an agency and the pay is usually better. I just got hired on with an agency in Hawaii ..the RN shifts for ltc are not as available as LPN shifts but if it's a decent facility, I don't mind working as an LPN until I move to bay area or find something else. Agency is great temp work and you can get a feel for many different facilities. But that's just my preference, I don't like to be locked in to any one facility until I feel certain that there's decent working conditions.

If you have a supportive and helpful DON that sounds awesome.

ris_03tdgz · Jul 17, 2009

I see. Thank you so much for your input thekid! any tips on how to survive in LTC? hehe..the DON said that they have desk nurses and treatment nurses in the facility to lessen the burden on RNs and to make sure things get done quickly because they also discourage overtime..is that better? What are the main responsibilities of RNs in LTC?

thekid · Jul 17, 2009

I just asked that same question over in the ltc forum :yeah: as I had only worked as an LPN in the past.

JMO.. if you have desk clerks, a supportive DON, and treatment nurses that could really take a lot of burden off. I have been staffed in places where we had to answer phones and do treatments all during med pass.

There is a lot of useful info in the ltc forum. Nurses' experiences and survival tips :) Hopefully there will be more responses about the tasks of the RN ..I know we oversee the LPN'S and CNA'S but more specifics would be great.

Hey if I end up in agency out here in the bay I may run into you!

Midwest4me · Jul 18, 2009

i see. thank you so much for your input thekid! any tips on how to survive in ltc? hehe..the don said that they have desk nurses and treatment nurses in the facility to lessen the burden on rns and to make sure things get done quickly because they also discourage overtime..is that better? what are the main responsibilities of rns in ltc?

i would discourage it. there is no way that i would recommend an ltc job to be the first for any new grad. i do so, based on plenty of experience.(such a job was my first job 24 years ago!!!) the don may be supportive now, may be painting rosy pictures of adequate numbers of cnas, etc but there may come a time when you don't have adequate staff and you have to care for 2-3 patients as well as do the tx, meds, new pt admissions, rounds with mds. it's too much responsibility for a seasoned nurse in my opinion so i feel you will be overwhelmed.

Midwest4me · Jul 18, 2009

i just asked that same question over in the ltc forum as i had only worked as an lpn in the past.
jmo.. if you have desk clerks, a supportive don, and treatment nurses that could really take a lot of burden off. i have been staffed in places where we had to answer phones and do treatments all during med pass.
there is a lot of useful info in the ltc forum. nurses' experiences and survival tips :) hopefully there will be more responses about the tasks of the rn ..i know we oversee the lpn's and cna's but more specifics would be great.
hey if i end up in agency out here in the bay i may run into you!

the desk clerks probably work 8am-5pm so the op would still be responsible for the paperwork during the evening hours. there is no guarantee that the treatment nurses or med nurses will be there each day; in which case the op could/would get stuck doing it all. again, as i've stated in another reply, i really feel that it's too much for a new nurse.

ris_03tdgz · Jul 18, 2009

thekid, yes that is what a friend of mine told me, she also works in the same facility. But I will probably be assigned in the afternoon and evening shifts and I forgot to ask if the treatment and desk nurses will still be available on those shifts.

midwest4me, oh...wow im scared now..and i've been reading about new grads' horror stories about working first in LTC too... its just so difficult to get a job at a hospital these days..anyone else have another opinion? *looking for a glimmer of hope*lol. Is it really that bad? How long did it take you to get used to it?

Midwest4me · Jul 18, 2009

thekid, yes that is what a friend of mine told me, she also works in the same facility. but i will probably be assigned in the afternoon and evening shifts and i forgot to ask if the treatment and desk nurses will still be available on those shifts.
midwest4me, oh...wow im scared now..and i've been reading about new grads' horror stories about working first in ltc too... its just so difficult to get a job at a hospital these days..anyone else have another opinion? *looking for a glimmer of hope*lol. is it really that bad? how long did it take you to get used to it?

i don't mean to scare you for goodness sakes! i'm speaking from experience(all the ltcs i worked in were the same--) and i imagine there are a lot of other nurses who've had similar experiences in ltc. you asked for advice; the ltcs i worked in were very challenging environments with high turnover in staff due to the high expectations(high #s of patients, low #s of staff and grief given to staff over the amount of overtime put in to just get the job done). these were the reasons i got out of that specialty.