New Grad SNF work... I am just exhausted and shocked

LPNfurever · Dec 3, 2009

I work at a snf and have on average 18-24 pt. I have found that if I can start getting my 1130 BS at 1115 and just get them all out of the way it runs much smoother. I also dont like giving insulin and checking BS in the dining room. I know state doesnt approve of giving meds in the DR but in the real world there isnt a realistic way around it. I have about 6 skilled assessments to do as well as any alert charting and change in condition. If I start getting flustered I make a list of things according to priority. One evening I got an admit 5 mintues before dinner started and I was in the middle of my 1700 med pass. I did a quick assessment on the pt, admission vitals and got him a meal tray. Other than that the night shift RN had to do the admission paperwork. She wasnt too happy, but hey I got the med pass done......

E.R. Rookie · Dec 3, 2009

Its all about acuity these patients are stable and when they become unstable you call an ambulance. Thats where I would have to disagree with if u can handle 15 you can handle 5. 5 of what? Its sounds like the charting would be a real butt kicker and will become easier with time im sure. I admire you for being able to remember all those names!

Selene006, BSN, LPN · Dec 3, 2009

Hang in there! It's been over a year since I've been working in a SNF, sub-acute floor. I have 30 patients (the lowest census has been 26) on average and the med pass is hell. I try not to think so much about the pace of work before I go in because I become very anxious when half the floor are diabetics or unstable. Just do your best and have patience with yourself--we're all human!

Bre14 · Dec 4, 2009

They have me in the complex care section with 16 patients. So tube feedings, IVs, diabetics, BS checks, those with liver failure with constant dropping blood pressure, and almost all are rehab. There is a large rehab office on the lower floors so each has approx 3 appts per day that need to be taken into account when trying to medicate etc.

imintrouble, BSN, RN · Dec 4, 2009

When I was a new grad 15 yrs ago I started in a SNF. I went home and cried every night for six weeks until I was hired at another SNF. The second facility was so much better. If you can get a routine going you'll be ok. Are you the only new nurse? When I was new, there were six new grads hired at the same time. We stuck together, helped each other and held each others hand....figuratively .... whenever an emergency came up. It was six months before I felt comfortable going to work instead of "what am I doing here" Feel good about yourself and the work you do. After working in a hospital, I would not be able to handle the pace of your job. You on the other hand, would be able to do mine.

Disco_Superfly · Dec 4, 2009

I can give this little tidbit of advice when it comes to managing an overwhelming workload: I always refer back to the director of our nursing program and how she pounded the 'human needs model of care' and 'prioritizing those needs'. When I worked on the cancer unit and had 7 patients every night plus did charge (we were also the 'hospice' unit) I made a list with 3 categories: Have to, Need to, Want to. Coming out of nursing school taking care of 1 or 2 patients, 15 seems impossible; but it can be done. Never punish yourself or feel like a failure because you aren't able to do for those patients what you did for your patients in nursing school. Remember to do the most important things for your patients FIRST and then go from there. You will do just fine! :coollook:

sclpn · Dec 13, 2009

Just wondering.....During nursing school did you guys go to nursing homes for clinicals?? During those clinicals did you work with a facility nurse and her patients or just your preceptor and your own 1-2 patients? If you went there surely you realized that those nurses care for more than 5 or 6 patients?

You must learn to delegate and prioritze to be sucessful in the nursing home enviroment.

Good Luck

Bre14 · Dec 14, 2009

As an RN student no. We stuck strictly to the hospitals in clinicals. From talking with my LVN friends yes they in fact spent alot of their clinical rotations in SNFs. That is an experience that I did not receive. I was aware that SNF nurses did in fact have more than 15 patients a day.... I am also a new grad and want to work. Most of my classmates still are not working. Only a handful were able to get jobs in a hospital. Any advice or pointers if you were able to accomplish this would be appreciated. Thanks for reading.

910hope · Dec 14, 2009

sclpn,

I had a short SNF rotation during nursing school at a public SNF...as a new grad I'm working at a for-profit SNF where the staffing ratio is a lot different and there's little to no equipment...no V/S machines, etc. But I am learning to prioritize and delegate.

I appreciate the advice posted last week; I made a sheet of the patients, BS, Gtubes, other info that is helping.

I also appreciate the support from other new grads who are experiencing the same challenges.

dordogne24 · Jan 5, 2010

Thanks so much to all of you who replied to this thread. I might (MIGHT!) be getting a SNF job here in the Bay Area...if a phone conversation goes well tomorrow. I feel both scared and encouraged by all your advice. Best wishes to everyone here, and I will definitely put into practice the list-making advice and the "Have to, Need To, Want To" prioritization strategy. Thanks again.

910hope · Jan 5, 2010

How many patients will you have? And how many of those are rehab nursing/skilled...straight out of the local hospital?