New Grad: Where to start a career with geriatric patients

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I graduated in December 2009 and know that I want to work with geriatric patients. In the future, I hope to obtain a DNP and work as a Geriatric NP. I'm wondering what setting will provide me with the best experience to develop my skills for working with this population.

Currently, I am looking at hospital jobs in med/surg/tele or internal medicine. I figured that this will give me a strong background for dealing with complex patients. However, having had only one 16 hour opportunity to do clinicals at a nursing home and one 8 hour day with a visiting hospice nurse, I am less familiar with LTC, SNFs, Assisted Living, Hospice, and Palliative care settings. Are any of these good places to start out as a new graduate interested in geriatric care? What about the hospital settings I mentioned above?

Thank you in advance for any information! :nurse:

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Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

I think that every nurse should have at least one year of hospital experience before going into long term care- that is just my opinion. There are many, many nurses who go into LTC as soon as they graduate and do excellent, however I feel that one year of hospital nursing prepares you for many things and in the hospital you get to experience some things that just don't go on in LTC. BUT---let me add that now with some skilled nursing centers and the fact that the acuity of care has risen so drastically that you could possibly get all you would ever want or need working on a heavy skilled unit. It would depend on the type of skilled care that is provided- whether it is heavily nursing or rehab.

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I work on an Acute geriatric medical unit. It would be the perfect type of unit for u.

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I work on an Acute geriatric medical unit. It would be the perfect type of unit for u.

Is you unit a general med/surg but designed for geriatrics or does the unit cater to dementia/Alzheimer's pts?:coollook:

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Its a general medical floor for geriatric patients. We have geriatric nurse specialists on board. We don't necessarily cater to dementia pts, but we sure do get a lot of them, naturally.

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That sounds awesome! How can I figure out which hospitals have this special type of unit?

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Specializes in cardiovascular.

i worked as a cna in a snf/ltc facility while i was in nursing school. it was a great experience and i don't regret it a bit.

however, reasons to avoid working full time in a facilty include:

1. hospital benefits are exponentially better.

2. it is difficult to get back into a hospital to work after you have worked in a facility. i know one bsn who has tried for years and cannot even though she has a good appearance, is well spoken, educated, and experienced.

3. they are chronically short handed and will work you until you drop, weird shifts, doubles, long stretches with no time off, etc., and any mistakes you make will be yours no matter what drivel they tell you in your interview about 'support'. i know one nurse who is fighting for her license in court because of this.

4. it can be insanely busy and you may not have any back up on evenings, nights and/or weekends. in my facility a nurse would be responsible for up to 40 patients and may or may not have a med tech, meaning she would not only be doing all treatments, tube feedings, and insulins, but also passing all the medications. in the meantime patients may try, and some i have seen succeed, in leaving the facility (confused wandering), fall, get into fights with each other/family/staff, or get caught in flagrante delecto w/each other. in the meantime families are around, a hospice patient is crashing, a cna left on a smoke break a half an hour ago and isn't back and the call lights are blinking, another cna may come up to you and say "so and so is acting confused and is all sweaty" and there's an admission coming in. and oh yeah, it's saturday and two cnas aren't going to show up because they went out partying and forgot they had to work, good luck finding a replacement.

on nights one nurse could have two floors and up to 80 patients, better hope you have a med tech because if you don't morning meds are going to be a b***h. the thing is, once you clock in the assignment is yours and you cannot leave or it's abandonment and management is fully aware of this happy little fact.

on a brighter note if you like the over 70 crowd you will fall in love with most of them and have your heart broken every time you lose one. it's been five this year so far for me and i am still grieving for those wonderful people.

if you still want to work in a facility i would go in and shadow a cna for a while, their responsibilities are a little different than a hospital pct, so you know what to look for as a nurse to tell whether they are doing their job. many will try to wiggle out of responsibilities like giving showers/shaving etc especially if you are new. then i would also go in and shadow the nurses on evenings and weekends when the boss isn't around. that's really the only way to get a true picture of how things work.

still, i would stay prn or part time, they always need reliable weekend personnel and usually are willing to pay well for them. that way you can get your experience and enjoy yourself too.

in the future, any experience with things related to senior health issues like heart, kidney, diabetes, parkinson's and alzheimer's will help you in the geriatric field. if you work for a doctor who specializes in any of those you will have a large number of seniors in your practice automatically.

best, andie

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Andie,

Thanks for your comprehensive response! It gives me a much better idea of the challenges a facility nurse can face and how to get some first-hand experience/exposure if I choose to go that route.

In my clinicals, I also noticed that many of the hospital floors, though not specifically geriatric floors, had a high volume of geriatric patients, so it seems there are many opportunities to gain experience with older patients.

I appreciate all the input so far. :yeah:

Obtaining a hospital position (first/exclusively) is sounding like the best option for me.

Rachel

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I am a new grad. Graduated in February. There is so much competition for the new grad positions at hospitals in my area. I have been hired as a charge nurse in a SNF/LTC. I've only had four days so far, but staff seems very supportive and helpful in training me. I will get a total of 10 days orientation and have 30 pts. No med tech. I am really nervous about it, but keep telling myself that if others have done it, I can do it too. I did not have previous medical experience prior to school, but did have a 20 day clinical at a SNF/LTC facility. I like where my new job is. It's close to home, clean and everyone I've worked with has a genuine concern for the patients. I just hope that I can do well for these patients!

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That's a great point, cjroan. "I am really nervous about it, but keep telling myself that if others have done it, I can do it too."

It may be challenging, but, as others have proved, it is not impossible. Congratulations on your new job. With your positive attitude, you'll do well!

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