new grad RN in LTC- overwhelmed!



i have a question about SNF/LTC's. I am a new grad. I applied for a nursing home in pomona, ca. i accepted the job as an RN and the mistake which i made was i didnt even ask how many RN patient ratio. or what my title would be.

I just came from an orientation today and i just found out that that facility only has 1 RN per shift without a DON! and that 1 RN is assisgned to 4 nursing stations! with 200++ patients.and my title would be an RN supervisor. although there are LVNs. Honestly i overwhelmed and didnt know what i got into. I dont know what ill do during my shift because tomorrow ill be the only RN at night shift.

I was only oriented for 2 days and the RN that oriented me today was the last orienatation ill have with an RN.

Also, i told the guy that hired me that i dont have a certification for IV and would not insert IV's.

is that normal to have only 1 RN supervisior or just 1 RN for the whole facility???

Im thinking of quiting because i dont i can handle 4 nursing stations and being an RN supervisor and just being a new grad RN.

Specializes in CT ICU, OR, Orthopedic.

This sounds like a very bad situation... I wish I had some advice, but I would not feel way! I think the LVNs will try to take advantage of you (bc they've been there for so long I mean) Your license is on the line...


167 Posts

before quiting definitely find out what exactly they expect of you and see if you can get more orientation first! good luck!! and take care!

TheCommuter, BSN, RN

226 Articles; 27,608 Posts

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 17 years experience.

This is normal.

Most states have laws that require one RN to be present in the nursing home for at least 8 hours per day. It will be the LVNs who provide all the nursing care, paperwork completion, charting, etc. Your primary function is to be present in the building because the state legally requires an RN to be there.

My former workplace was a 200-bed facility. The RN supervisor basically fulfilled the state requirement by being a warm body in the building. He checked trays in the dining room during meal times, obtained information about census changes, handled staffing issues, was knowledgeable about policies and procedures, and offered assistance if an emergency situation popped up. The LVNs had their own patient loads. The RN supervisor does not have a patient load, although they are responsible for whatever occurs in the facility. My RN supervisor never performed patient care, and he would only do so when hell froze over.

Since you are an RN, you DO NOT need IV certification in order to perform IV therapy, since this was covered during your nursing program. IV therapy is automatically included within the scope of practice of all RNs.

I am an LVN, and I had to take an IV certification class since IV therapy is not automatically included in my scope of practice.


80 Posts

I doubt the LVN would try to take "advantage" of the situation. In most cases there is only one RN on a shift especially during nites. Remember not only is your license on the line so is all the other nurses. I know in my situation as a LPN who works at a LTC i only use the RN for resources or what is your opinion type questions. I assess my assigned residents, call the DR if there are any issues, Send residents out if thier status changes and any other needs. Teamwork is how it should be!!

***Praying through one more semester*****

Specializes in CT ICU, OR, Orthopedic.

sorry! That prolly came out wrong! It was rude and I apologize...


470 Posts

I have never worked in a SNF but when I have visited them in a capacity as a PHN or as a visitor for my mom during a rehab after a fall, there is usually only 1-2 RNs. The LVNs seem like they provide the direct patient care. The RNs I saw were either a DON or something like it. Be thankful to have a job and soak everything up like a sponge.

Like time I checked you do not need to have a special cert for basic IVs. You are certified-its called your licence. You should be able to insert an IV which was taught in nursing school. You will be ok. Relax and take one day at a time. I wouldnt quit though-jobs are scare.


225 Posts

Egads, I wouldn't do it. As DNP suggested, you worked awfully hard to get that license. To be an RN supervisor as a new grad sounds completely unreasonable.

Best of luck to you!!!!


917 Posts

i wouldnt work as supervisor as a new grad because if something goes wrong, supervisors are held responsible for it and it can effect their license. i think its good idea to work as a staff nurse for few years, then work as supervisor. you wil be used to all the politics and work of staff nurses so you can direct them in the right direction.

Specializes in ICU, PICC Nurse, Nursing Supervisor. Has 20 years experience.

you wont be providing nursing care for the entire building are just there if issues arise . i am sure if you need help with iv's or need some direction the lvn's will step in and help you out...

achot chavi

980 Posts

Specializes in acute care and geriatric. Has 20 years experience.

If you dont feel comfortable, you have an obligation to consult with the DON and tell her,

Is the DON on call at night so you can call her with any problems?

Is the staff helpful?

Is a certificate for IV's mandatory for the job, if this was a problem, the DON should have brought it up, I wuld guess it isn't a problem or they will teach u..

Personally I have done 8 units or 320 pts on a night shift, never liked it but I had great LPN's on each unit, I just made sure to keep doing rounds and keeping them awake!!

Good luck whatever you decide!!


167 Posts

And since you are orienting get your skills updated. Ask the LVN's to let you do some of the IV's and such.

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