New to LTC, need some advice :)

kermitlady · Jan 7, 2009

It takes time to get used to LTC nursing; it really does. Just keep in mind that you WILL get faster. You'll begin to learn who gets what and when (i.e. you'll be able to remember who needs an accucheck before breakfast and be able to make a list). Personally, I make a list and do my accuchecks before anything else. Then, I do the morning med pass (it takes awhile w/20 some residents - I work days). Then, I'm in the dining room for breakfast. After brkfst, I do those things that aren't med-related; charting, tx's, VS, etc. Then it starts all over again; get the noon accuchecks and then pass the noon meds. It takes awhile to get used to the routine but just remember you WILL get faster. And once you know the residents it helps, too! Good luck.

Rascal1 · Jan 8, 2009

I go through the MAR before I start meds.,take notes, who needs B/P,pulse,FS.,etc.,who's meds. are in fridg. and so on. Also,I check med. cart for any low stock meds., or other needed items that might be missing to eliminate 14 trips back to the med. room !! Sometimes,I ask the previous shift nurse during report,did she notice anything I might need to restock? Charting on Medicare pts. needs to be specific of course with regards medically to why they are on med.A. You do get faster as you get to know the residents. Good luck...

NorthTexasNurse · Jan 9, 2009

thanks for the advice! I think more than anything it is such culture shock to go from acute care where you are expecting the worst, to their "home" where I had so much hit the fan in such a short amount of time... It just made me wonder if there was some organizational thing I was missing, ya know? I agree, time will make all the difference!

SitcomNurse, BSN, MSN, EdD, RN · Jan 25, 2009

I have been in LTC for 16 years. It takes alot of getting used to, but the major part is organization, because you are doing the same things day in and out. Grant, you have admission/discharges, therapies, doctor appointments, and those oh so lovely Incident Reports.... and unless everyone on your unit is a DNR, you have Codes too.... Mostly, you can detect when people are getting ill, you get to intercede before they get very ill, and start IV's and manage PICC lines... and thats the gratitude. Families saying.. I know with you he is always going to be OK. or .. I expect declies but here I know that he is getting the care he needs. And dont forget if you are a larger institution, its MDS's too... dont for get to update the care plans every time there is an episodic issue(illnesses that will resolve/self resolve), and update the care plans every quarter..with appropriate changes for improvement or declines.

Organizing your day is key, but you need to know how to get THEIR stuff done, as well as your own and let them overlap if need be. The needs of the paient will continue to superceede your paperwork, and with desire, you can do it!! :yeah:

kimogieo · Sep 30, 2011

I am new to LTC, I am 23 and a new graduate. I was oriented in our small facility for two weeks, two long term and one sub acute. I started working mid July as a per diem nurse since they didn't have an opening. It's been two months and I still get this jittery anxious feeling everytime my phone would ring and they would call me in. Now I was able to handle sub acute and the long term units, I've been through the crying myself to sleep at night after i got off orientation for a whole week due to the stress of screaming family members, getting pulled aside, being late with med pass. But now, I'm more organized BUT i have yet to do admission lol but i've done the paperwork though, I just need to learn how to do assessment because I dont really know how they do it in that facility.

I don't know how long it takes to get used to be working in long term care or even working as a nurse but this is a stressful one. I got a call this morning from work asking if i could work saturday and sunday, i said yes but about an hour ago, i got a call asking if i could come in tomorrow to work. Then I started to stress for some reason, I'm still not over that feeling of being comfortable working. Not because I am scared to make mistakes but just getting used to what I do. I had told my boyfriend about it and he told me that it would really help if I take a full time job so i can have a schedule and get used to it quicker. I don't know if this is normal for new nurses esp new grads. How long does it take to get used to working in LTC? Because I'm starting to think I'm not cut to be a nurse because of it. I was thinking of working per diem for 6 months, then look for a part time job becaue i wanna continue with school to be an RN. I also think that transition would be great to get used to with what I do but my boyfriend things 6 months is too much.

So, I dont know... I guess I'm posting because I feel disappointed in myself and I wanna pour my heart out to feel a little bit better. Any advises?

SuesquatchRN, BSN, RN · Sep 30, 2011

Gieokhae, your boyfriend doesn't sound too supportive and that's a big red flag to me. Nursing school and working are stressful enough without someone sulking and nagging.

As to getting comfortable, it takes a year. Really. Don't second guess yourself. Nursing school does not prepare one for real-world nursing. You'll get there.

Rascal1 · Sep 30, 2011

You took this job because you couldn't find one with more hours, let alone full-time. I say, give yourself more time to settle in. It is more helpful to you to get a few days straight in a row then you can get into a routine easier and begin to feel more at ease.

It does get easier though. I remember feeling just the way you describe, going home and crying about how impatient the patients were with my slowness at the med.pass and dealing with the families. You can politely ask families that you will address their questions after you're done passing your meds. As a new nurse you should be allowed to seek support from your supervisor in dealing with too many new issues that may come upon you at the same time. Hope this helps a little!