New Grad RN in Skilled Nursing/Rehab...5 days orientation?

classicdame, MSN, EdD · Aug 19, 2013

Very old fashioned. Generally I would expect more, but if they put you with a preceptor you should be fine. Otherwise, you will be learning as you work and that is difficult.

Despareux · Aug 19, 2013

My very first job was at a brand new LTC/rehab. I had four days with a preceptor and on my own on day five, working a double and was NOT prepared at all. Thankfully, I was offered (and accepted) a hospital position right after day five.

A few days or even just a mere few weeks of orientation is not enough for a new grad, in my opinion. Now that I have a year of experience, I would be much more prepared to work LTC with minimal precepting.

I wouldn't want a new grad taking care of my loved-one without adequate training. Just because we graduate from nursing school and pass the NCLEX, it does not mean we are prepared for the real world of nursing.

Sessa RN · Aug 19, 2013

Just accepted a full-time position working 3rd shift at a LTC working in the skilled/rehab unit I'm a little wary as they only offer 5 days of orientation with 1:16 nurse to patient ratios; is this standard for this type of position or should I be running the other way? The facility is brand new and seems like a really nice facility; haven't had much staff interaction as of yet though either.[/quote']
I am also a new grad, who was hired onto a skilled unit with up to 17 pts. I am being given a two-week orientation.

proud nurse, BSN, RN · Aug 19, 2013

I worked at the same LTC for 7 years. I oriented many nurses, saw a few come and go. Honestly (and sadly), if a nurse needed more than 2 weeks of orientation she/he probably wouldn't work out. It was the expectation that you'd spend a day or two learning the paperwork and computer system on day shift, and have maybe 2 day shifts on the floor, then go on your hired shift for about 2 days. Many came into work thinking they were still on orientation only to find out they've been pushed onto the floor before they felt ready. I think as long as there's someone as a resource and decent staffing, you can do fine especially if the orientation is of good quality.

fmxkrazyone · Aug 20, 2013

My first job after passing NCLEX was at an LTC, I got 6 shifts of orientation and had 20-30 pts per shift to pass meds, do dressing changes, give treatments to and keep safe on night shift. I'll admit my first few weeks I was pretty overwhelmed, it would take me a really long time to pass meds and get all my other work done. It was all paper charting and the other nurses were not that interested in helping me, they would fight over who had to orient me. I learned a lot on my own, I got my own rhythm, but ultimately I realized it was not the job for me. When I was able to get into a hospital I gave them my notice and moved on. Some people love LTC setting and the autonomy, some don't. I would definitely give the place a chance and see if it works out for you. If nothing else you will gain experience and take that with you to your next job. Good luck to you!

Fiona59 · Aug 20, 2013

Orientation really isn't meant to be a time to learn your craft. It's a time for you to learn how the unit works, their paperwork, routines. Employers expect you to come with basic nursing skills and med knowledge.

I've only ever had five shifts orientation, even as a new grad. 3 day shifts, 2 evenings and off I went.

LTC teaches you time management.

scott5698 · Aug 20, 2013

Well, someone should wake up the boards of nursing! I don't feel prepared either, mostly because we aren't. Maybe a little less time on papers and apa format and a little more on skills. Really tired of hearing "read the book" as the solution to everything. When you have crappy clinical sites, there isn't much you can do...

AWannerLPN · Aug 20, 2013

Yikes!!! Tomorrow is My first day on the job in a Skilled/LTC facility and lets just says IM TERRIFIED! Glad to hear im not alone.

Good Luck to you!

A

lindseylpn · Aug 20, 2013

I started out in ltc with 5 days orientation and between 25-55 patients. 25 in the skilled unit, 30ish in the lockdown unit and 55 (eek) in the non skilled unit. I'll be overwhelming for a while but, it'll get easier. Use your time wisely. I found it helpful to make myself out a schedule of what I was going to do during the shift and at what time. I'd tape it up where I sat at the nursing station and mark things off as I did them. It also helped me not forget anything. For me the hardest thing was to make time to chart, many days I had to stay over to finish charting. Good luck!

starlisa14 · Aug 20, 2013

Answering the easiest question first: At my LTC facility on 3rd shift, the LPN charge nurses have 22 and 21 residents each on the rehab unit and 32 and 33 on the other side. So I'd say 1:16 is awesome! And is abnormal from my experience in 3 different LTC facilities.

I started orientation with an RN that had never worked in a LTC facility before whereas I had 2 years experience. After 2 weeks of orientation, I felt confident enough to learn as I go meaning its pretty much the same duties just different paper or different hands it may go through. The other RN, after a month and a half is still in orientation. Absolutely nothing against her for taking a bit longer than me. I had the experience, she didn't. I loved and appreciated the way she asked questions about "EVERYTHING" and was easy to point out flaws- which I'm sorry to say LTC has many.

I'm the RN Supervisor, so my duties are different in that, not only do I have my responsibilities as a supervisor (staffing, assignments, med destruction, creating the culture/attitude/pace of my shift, but I'm also responsible for delegating to others and receiving the cart to pass the 5am/6am meds. From your post I'm assuming your actually taking a cart and passing meds the entire shift? If so, remember you are responsible for that ENTIRE building! It's not really as overwhelming as it sounds IF:

You make absolutely sure you can trust your staff -if you can't document that you've taught them and you yourself must take up the slack for residents' sake until they are up to your standard and at the same time completing your supervisory duties. You must be able to do this with respect, ability to teach without being an ogre, have more energy than most, willing to do more than you ever thought you could do...because bottom line, it is all under your license.

starlisa14 · Aug 20, 2013

Also, use your resources: the unit managers, the DON and the Human Resource Director. If you can't utilize them during this learning experience, then get out..