New Grad RN in LTC Needs Advice Please!!

Specialties Geriatric

Published

Hi All,

I am a new Grad RN recently hired in a LTC/SNF/Rehab with a 25 patient load needing medications, treatments, etc. My question is how on earth can one person pass meds (in typical marge quantities, most crushed in applesauce, several narcotics and G-tubes, etc.) and finish in 3 hours or even 4 hours??? :confused: I did basic math and this leaves 3-5 minutes per client start to finish! Yikes.

This was my only job prospect for the moment, and I do think I am getting some decent experience with clinical skills, handling patients with varying degrees of acuity, etc. as well as daily verbal and telephone orders, lab requests, etc. Whew! I am freaking out on medication administration alone never mind adding in the occasional health crisis or patient crash. On occasion they bring down a certified medication LNA but I am worried about when they DON'T- what then? I'll be passing 8am meds at 12:30? That's crazy.

I know of at least one serious med error recently which resulted in a patient being hospitalized, I'm afraid that's going to be ME!

Any thoughts? I appreciate any feedback, thank you!

I can relate to the recent grads in LTC. I took a job as RN in a rehab/residential facility shortly after graduation. I had limited training and orientation. During my floor training, I was sent home halfway through my shifts because census was low. Day shift has 20 residents to 1 nurse. It takes me 3.5 hours to pass meds. I am completely overwhelmed and ready to call it quits after 5 shifts. Scared to death that my inexperience and high resident to nurse ratio is going to cause an error. Not to mention the large number of meds dispensed to each person!

I know exactly what you mean, I work in LTC on days shift too with 20 residents. I have been there for 11 months (new grad RN), in the first months I never thought I would make it a year but looks like I will. If you have support from coworks and supervisor (as I did) try a little more, many people get used to it and feel less overwhelmed after couple of months. But if you feel it is unsafe and you have no support, it is better to leave. Also, when I finished my orientation I told them that I needed more days because I did not feel confortable on my own and they allowed me to stay as orientee for few more days.

I just want to say that you're not alone.

All the best to you!

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Im a guy but I cried after my second shift. I was overwhelmed with all of the things happening. MED PASS is my worst nightmare plus the residents who do not like new nurses. My shift is usually 3-11 and med pass starts at 4 and supposed to end at 6 but I ended up passing meds until 7:30. That bothers me cause I also got a looot of charting to do. And I keep on applying to several hospitals because of that. A lot have insulin shots, G-tube, etc. etc. But I hope and pray I will improve my med passing skills and charting. And only 3 of us in a 150 bed are RN and then a lot of LVNs and the my best friends the CNAs. Everyone keeps on telling me that they experienced the same thing and that makes me smile in a way.

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Hi All,

I am a new Grad RN recently hired in a LTC/SNF/Rehab with a 25 patient load needing medications, treatments, etc. My question is how on earth can one person pass meds (in typical marge quantities, most crushed in applesauce, several narcotics and G-tubes, etc.) and finish in 3 hours or even 4 hours??? :confused: I did basic math and this leaves 3-5 minutes per client start to finish! Yikes.

This was my only job prospect for the moment, and I do think I am getting some decent experience with clinical skills, handling patients with varying degrees of acuity, etc. as well as daily verbal and telephone orders, lab requests, etc. Whew! I am freaking out on medication administration alone never mind adding in the occasional health crisis or patient crash. On occasion they bring down a certified medication LNA but I am worried about when they DON'T- what then? I'll be passing 8am meds at 12:30? That's crazy.

I know of at least one serious med error recently which resulted in a patient being hospitalized, I'm afraid that's going to be ME!

Any thoughts? I appreciate any feedback, thank you!

So are you still in LTC? How did it all work out? I'm curious because I'll be starting LTC as new grad, but on evening/nocturnal shift so I guess it won't be as chaotic as day for the mean time of transition.

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Im a guy but I cried after my second shift. I was overwhelmed with all of the things happening. MED PASS is my worst nightmare plus the residents who do not like new nurses. My shift is usually 3-11 and med pass starts at 4 and supposed to end at 6 but I ended up passing meds until 7:30. That bothers me cause I also got a looot of charting to do. And I keep on applying to several hospitals because of that. A lot have insulin shots, G-tube, etc. etc. But I hope and pray I will improve my med passing skills and charting. And only 3 of us in a 150 bed are RN and then a lot of LVNs and the my best friends the CNAs. Everyone keeps on telling me that they experienced the same thing and that makes me smile in a way.

So how have your experience been? Is it getting better? I'll be starting on Monday. *crossing Fingers* Your post definitely helps me to mentally prepare myself. Thanks much!

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Specializes in LTC, Rehab, Gerontology.

I am also a new grad and having a difficult time finding work. I finally applied at a LTC/Rehab center recommended to me by two of my former instructors and the timing was perfect! Now I am expecting a job offer and I actually feel excited about it. I know I will have a patient load of about 25 patients (if I work at night). There are two RNs at night and 2-3 RNs during the day, along with CNAs and probably LPNs for a total census of 55-63 patients/residents. They gave me a tour before my interview and I really feel comfortable there and the other employees were very welcoming. I am somewhat nervous about the workload after reading this thread, but management made me feel like it can all work out! :yeah:

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So how have your experience been? Is it getting better? I'll be starting on Monday. *crossing Fingers* Your post definitely helps me to mentally prepare myself. Thanks much!

Im pretty much used to all of the LTC job now lol. *hopefully* :p After 3 months of charge nursing im already a supervisor at 3rd shift and sometimes do some charge nursing on 3-11. you'll get use to it. take it one day at a time.

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What base pay would you suggest is expected with a company who doesn't give differentials as a new grad starting off? Where are you located?

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I am also a new grad and having a difficult time finding work. I finally applied at a LTC/Rehab center recommended to me by two of my former instructors and the timing was perfect! Now I am expecting a job offer and I actually feel excited about it. I know I will have a patient load of about 25 patients (if I work at night). There are two RNs at night and 2-3 RNs during the day, along with CNAs and probably LPNs for a total census of 55-63 patients/residents. They gave me a tour before my interview and I really feel comfortable there and the other employees were very welcoming. I am somewhat nervous about the workload after reading this thread, but management made me feel like it can all work out! :yeah:

Where are you located at? I'm glad you found a job! Something is better than nothing. =) That sounds like the facility I work at, but there is two sides to the facility and there is one nurse on each side.

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Specializes in LTC, Rehab, Gerontology.
Where are you located at? I'm glad you found a job! Something is better than nothing. =) That sounds like the facility I work at, but there is two sides to the facility and there is one nurse on each side.

I'm in Nevada. Our facility also has the two sides. Where are you?

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I'm in Nevada. Our facility also has the two sides. Where are you?

I'm in Oregon.

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I am a new graduated nurse and got a position as a prn nurse in LTC facility. I had 40 pts to pass meds to on night shift. Due to compliance issues this meds have to be passed within a two hour time frame. That is 3 minutes per pt. I had two stna's who didn't pass meds. I was let go because I couldn't keep up with med pass load. There are 3 nurses passing meds during the day. The med pass at night is as heavy as med pass during the day. To say the least I am crushed, humiliated and devastated beyond words. All I do is sleep and cry. I have invested so much of myself and money into this I don't know what to do.

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