New grad starting LTC job next week...

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Specializes in ED, acute care, home health, hospice.

I have been reading this board since before I started nursing school 2 years ago. I live in a small town, only 2 small hospitals nearby and we have 2 nursing schools in the vicinity graduating at the same time. I have held my CNA cert for several years, but my only experience is caregiving for older adults in their homes. I would eventually like to work home health or an outreach clinic for low income clients.

I was fortunate to be offered a job in a LTC facility with a good reputation just prior to taking my boards. I never had the opportunity to do any of my clinicals there, but it seems they are well staffed. My orientation will be 6 days where I am paired with another nurse, then I am off on my own. I will be passing meds and doing treatments. There are 4 med/treatment nurses per shift (day and swing) I believe, each responsible for one wing. There is a charge nurse that is separate from the med/treatment nurses. I am not sure how many residents I will have. I have heard horror stories from other nurses that worked LTC, so I am a bit anxious as to how it will all work out.

I am so excited to get to work and put all my nursing knowledge and compassion to good use, but I am afraid of being burnt out quickly. Like I said, I consider myself very fortunate to have secured a job in this economy and I know once I get some paid nursing experience under my belt, I can seek out other areas of nursing I am interested in. Any advice any of you with LTC experience can offer? Am I being overly optimistic that LTC is a good place for me to start as a new RN?

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Specializes in peds palliative care and hospice.

Hi,

First off, Congrats on passing NCLEX!

Second off...I too, am a recent grad (sort of) and got my first "real" RN job at a long term care facility for pediatric patients. I think the important thing is that no matter what you are doing, you learn. If all you get out of it is how to manage your time, that is a skill that will serve you well.

As far as working at a LTC facility, It is a good experiance...but if you want to get into a hospital you may have a hard time (as I am now) as most hospitals want hospital experiance/background.

I would suggest you just keep learning and seek things out...Good luck! hope that helped. I just got off work and my brain is a little scrambled :)

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Congrats on passing the NCLEX and getting your first job! With the way things are right now for new grads (and old grads too!) it's a step in the right direction to get a job, even if it's not your dream job right out of school.

It's a good sign that the facility has a good reputation.

It's not just a problem with this facility, it's a problem industry-wide, but I wish LTCs offered a more supportive orientation for new grads. I had about five days when I was a new grad on a busy sub-acute floor. I made it through, and I'm sure you will, but I think any new grad deserves some more time. My facility has been really good about it. Our most recent new grad had almost a month, three weeks were on the floor and she also had a day at the desk with the unit manager to learn the paperwork, how we communicate with doctors, etc., several days with the wound nurse (invaluable experience I think), etc. She has been with us for about six months now and is doing great.

One thing I notice facilities doing to new-grad RNs is trying to rush them into supervisory positions almost immediately. I have seen too many crash and burn and would caution you to just get the floor down first and then think about taking on more reponsibility after you feel really comfortable in your assessment skills and your floor duties.

Hopefully this will be a great experience for you. Keep us updated on how it goes.

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Specializes in ED, acute care, home health, hospice.

Thanks so much for your good wishes and advice!

I think that is so true what you say about rushing new grads into charge nurse positions. When I interviewed, I also interviewed for night shift charge nurse. I thought the med/treatment nurse would be a better fit for me as a new grad as I need to gain the experience of working on the floor. As a new grad and a new nurse to the facility, I wonder how much respect I could command from the staff. I would rather learn the ropes before taking on that role. The nurse who is in charge of training was very adamant that the facility and the nurses takes no shortcuts, so I also feel that is a good sign.

I will definitely keep you all posted, thanks again for the encouragement :)

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I just started in LTC 2 wks ago and things are going well. I am learning alot. The only thing i dislike is the large patient load. you have over 30 pt to care for where i work.

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I too am starting. 5 days training on each floor, there are and 30 patients each floor. The DON said we could have more training if needed and I definately will be asking if I don't feel comfortable.

NotFlo is right too, my friend was 6 months out of school and became a supervisor and I see her burning out and seems unhappy. She only makes $2 more than me but same weekend rate, plus she has 50 patients to my 30.

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Specializes in ED, acute care, home health, hospice.

I have been working for a few weeks now. There are most certainly good days, bad days and VERY BAD days. I have been working in the rehab portion of our facility for the past week or so and I am really liking that. It is like a mini med surg, except for I am caring for all 15-20 of the patients. I have gotten to know the residents and some of their families and some days when things go well, I stay organized and nothing terrible happens, I stay on track and get things done on time. I am starting to familiarize myself with the residents dressing changes, and bring dressing supplies or creams into the room with their meds or tube feedings so I can group cares, this saves time and allows me to move onto the next item on the never ending "to do" list. I know it will take time, but I have to be patient with myself and give myself time to adapt and acclimate to this environment...one that nursing school most certainly did not directly prepare me for!

However, using the critical thinking, assessment and prioritization skills I learned and practiced in nursing school are all applicable in their own way and I am thrilled to be able to use them.

It is still weird/amazing to me that I am the nurse, now! No more student nurse...I am truly running the show! Of course I am relying on seasoned nurses in my facility still, as they know the residents baseline, and what is grossly abnormal...so I am very thankful when I have a supportive charge nurse and aides I can count on to be there...

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I have been working for a few weeks now. There are most certainly good days, bad days and VERY BAD days. I have been working in the rehab portion of our facility for the past week or so and I am really liking that. It is like a mini med surg, except for I am caring for all 15-20 of the patients. I have gotten to know the residents and some of their families and some days when things go well, I stay organized and nothing terrible happens, I stay on track and get things done on time. I am starting to familiarize myself with the residents dressing changes, and bring dressing supplies or creams into the room with their meds or tube feedings so I can group cares, this saves time and allows me to move onto the next item on the never ending "to do" list. I know it will take time, but I have to be patient with myself and give myself time to adapt and acclimate to this environment...one that nursing school most certainly did not directly prepare me for!

However, using the critical thinking, assessment and prioritization skills I learned and practiced in nursing school are all applicable in their own way and I am thrilled to be able to use them.

It is still weird/amazing to me that I am the nurse, now! No more student nurse...I am truly running the show! Of course I am relying on seasoned nurses in my facility still, as they know the residents baseline, and what is grossly abnormal...so I am very thankful when I have a supportive charge nurse and aides I can count on to be there...

This is very encouraging! I start in the subacute unit of a LTC facility but I'm fortunate to get 8 weeks orientation and then 2 weeks on the floor with my mentor so I'm definately eased into everything. It's not the ED job that I wanted but I'll get there eventually.

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