New Grad, SNF job

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Hey everyone. So I graduated with my BSN and recently passed my boards. I applied to many acute care jobs and actually was able to land two interviews. I thought both went well, but in both i was turned down because I have no medical experience aside from my education.

I recently had an interview at a SNF and was offered the job next day. I decided to take it because I figured that could help me acquire some experience (even if its not in acute care). I start monday and am freaking out because I was told i would have 4 days of orientation (which i hear is pretty common for SNF). I just need some words of wisdom, advice, whatever you guys can offer.

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Specializes in ICU.

I think you were given an easy out excuse on your two other interviews to be honest and you should work on your interviewing skills and try somewhere else. Four days of orientation for a new grad, on their first job? Sounds very shady to me.

Im going to assume you either submitted a resume or filled out a job application for these other two jobs before calling you in for an interview. They did know going in you had no experience? I just think they went with the easy way out on that instead of saying we went with a different candidate.

You will be responsible for an enormous amount of patients and pretty much no orientation on how to do it. I see this as you burning out quickly. Getting frustrated and quitting quickly, then running the possibility of being considered a job jumper. I would carefully weigh my options on this one.

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Specializes in Nephrology, Cardiology, ER, ICU.

Moved to geriatric nursing

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I only had seven days of orientation when I started my first nursing job 1.5 years ago. It wasn't enough....I am only an AD RN though.

As for advice, just make sure you aren't afraid to give out PRN medications; I get irritated when I start my shift and I hear that "so-and-so" has been in pain all night/has been nauseated and vomiting all night, has diarrhea or whatever.

Also, check your standing orders when an elder has pain or other symptoms but no PRNs ordered.

Hope that helps!

Kev

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Specializes in LTC.

Here is my tips:

Always ask questions....there is no such thing as a dumb questions except the one you do not ask!!

Make a list...stay organized...get a routine. It took me several weeks to get a good solid routine down.

Plan for a fall..it happens...plan for that pop up admission and yes...you are always under staffed.

You will also be surprised how much sub acute care you will actually do. Most SNF have TCU or short stay units. I have seen a lot, and the resident's seem to be getting younger and younger. I had one gal who had a brain tumor removed and had a stroke. She was only 23 and had a 3 yr old at home. I work with trachs, tube feedings, drains, wound vacs ect. I also have quiet a few hospice patients.

Most LTC orientation is about 4-6 shifts. Don't be afraid to ask for more if you need it.

Follow your gut...when in doubt ...send them out...esp if they are a full code.

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Yes, everything ltcnurse4u said is correct.

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NurseGirl has a good point too, the burnout rate for LTC is high and one nursing home administrator once told me that there is an expected worse than usual shortage projected for the next fifteen years. It gets frustrating fast; I threw my smartphone (breaking it) once because of staffing frustrations. Normally I try not to let my aides see me angry.

Oh and speaking of aides, treat them like equals and they will take care of you! That isn't to say that you should delegate stuff outside of their scope of practice--don't do that--but demonstrate to them that you are not above doing some of the things that are normally delegated to them. I do pericare, toilet elders and get my own weights on some days and my aides love me for it!

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Specializes in LTC.
NurseGirl has a good point too, the burnout rate for LTC is high and one nursing home administrator once told me that there is an expected worse than usual shortage projected for the next fifteen years. It gets frustrating fast; I threw my smartphone (breaking it) once because of staffing frustrations. Normally I try not to let my aides see me angry.

Oh and speaking of aides, treat them like equals and they will take care of you! That isn't to say that you should delegate stuff outside of their scope of practice--don't do that--but demonstrate to them that you are not above doing some of the things that are normally delegated to them. I do pericare, toilet elders and get my own weights on some days and my aides love me for it!

I once threw a total hissy in the Med room after I was told I would have 40 pts for the night because the LTC side nurse had called off and the 2 rehab nurses (myself and another) had to split her pts) and I was also going to be down CNAS. I just sat in there stomping my feet and crying until I felt better enough to go out and get report.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Four days of orientation for a new grad, on their first job? Sounds very shady to me.
Where I live, three days of orientation is the norm for new grads in LTC/SNF.
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So, each pt was allowed 1.5 minutes of your time per hour? lol.. wow. I used to take 30 in LTC, at night, with two aides.. that's why I went back for my RN but FORTY PEOPLE!

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Specializes in LTC.
So, each pt was allowed 1.5 minutes of your time per hour? lol.. wow. I used to take 30 in LTC, at night, with two aides.. that's why I went back for my RN but FORTY PEOPLE!

Yup, it's why I left that facility. It was a PM shift too, not a NOC. It happened often when the LTC nurse called off. I just got stuck doing all my rehab pts and half the LTC.

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Specializes in "Wound care - geriatric care.

I think is a smart move. Even though SNF's are not acute care you end up doing a lot of the same kind of work i.e. med pass, assessment, writing orders, sending people to the ER, dealing with death and dying, time management, putting IV's (in some places) inserting Foleys, wound dressing PICC line dressing change, wound measurements, responsible for CNA's. At the end of the day you'll have done a lot of things and some of these places can be crazy busy because you're basically by yourself and have to make a lot more decisions by yourself. The patient load in SNF's are increasingly sick as hospitals discharge patients who are not really ready to leave the hospital. It is also a good place to learn because they are not so tight like hospitals.

Unfortunately hospitals will not give you credit for any of the things you learn in these places. All they think is acute care and nothing else has any value. If you work in a crazy sniff and are used to pass meds for 40 patients and deal with all of the crazy things there you'll learn a lot. I recently visited a med surg. floor and saw everyone nicely seated in their computers and that looked a lot easier to me.

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