New LTC nurse

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Specializes in LVN, Phlebotomy, CNA.

Hi everyone. I just recently graduated from a Vocational Nursing program (recently meaning december 12th). I had a job interview at a Long Term Care facility (for the 3-11pm shift) on the 13th and they said pending reference checks, criminal background check, drug screen and my permit to show up online I would be hired. I will be starting on the 2nd of January. I will have 14 days of orientation and the DON said that if I feel I need more to give her a few days notice so she can schedule it, and if im feeling ready to be let on my own early (which I doubt will happen) to let her know as well. The ratios that I know of are 1 CNA per 10-13 patients, there is a med aide who works 7-7 there is also a LVN who works 12-8pm who is responsible for all admissions during the shift. Once I am done with orientation, it will be 2 LVN's during the shift and there are a total of 40-50 patients on the floor. I will be getting paid 16$ an hour plus 50 cent night diff until I take the boards and once I do that, I will get the raise to 17 an hour. Every third week you get a three day weekend (F,S,S) which I thought was cool. You never work more than 4 days in a row, which I also thought was nice. Since I am full time, I get benefits, but at this time I am unsure of what they consist of. Anyway sorry about the rambling but I wanted to put it all out there.

Please let me know how these ratios measure to what you have experienced!

At this LTC they do IV therapy, so I will be IV certified which I think is great!

Most of my classmates have asked me WHY :angryfire i have chosen to work in LTC, well not that I think I need to defend myself by any means. BUT I really feel that in a nursing home is where I can make the most difference. I worked as a CNA for 4 years and really enjoyed every minute of it, NO its not fun to clean someones butt when they have a BM, but knowing that I am appreciated and that I get to know these people and their families thats what makes it worth it. I am the only one that graduated in my class of 19 (night class) who has found a job. Which is why I dont know what makes them think they even have a right to question me or what decisions I make for MY life!!

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congrats on your job! sounds mostly great,but 10 13 residents to 1 cna is a lot.where is your rn?do u have 3 lvns on your shift? do they share cna work? 4 days in a row is not such a treat. it is nerve racking work,d/t the many emotional need of most residents.btw; are u the rn?i work as an lpn in ltc in wisconsin,gen rate is 18.00 ph. people most likely ask why you have chosen ltc work d/t the emotionally draining work day,but there are other nice things that go on.also, there are skills youv'e learned that u won't be using. it would be nice if u could do prt time in hosp. to utilize these skills, not lose them.good luck to you!

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Specializes in pediatric and geriatric.

Good luck with your new job. I think you will be a great nurse because you already have a positive attitude. Also sounds like a decent facility that is willing to give you good orientation. Schedule sounds nice and getting IV cert. is something you can take with you if you do decide to leave. Sounds like typical staffing ratios (a little higher than I think they should be, but that's the way it is.)

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Specializes in ICU, PICC Nurse, Nursing Supervisor.

sounds pretty standard to me. i'm my area the lvn's tend to make several dollars more but the conditions you are describing sound the same except for the 14 day orientation... most ltc facilities dish out about 3 days orientation , then cut you loose. i hate working during the week so i am a weekend nurse but 4 on 2 off is common . the other poster ask where you rn was, never worked with a rn on the floor just as a don. about 99 % of your ltc is staffed with lvn's . get your feet wet if you don't like it then for the next job you will know what to look for.

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Specializes in LVN, Phlebotomy, CNA.
congrats on your job! sounds mostly great,but 10 13 residents to 1 cna is a lot.where is your rn?do u have 3 lvns on your shift? do they share cna work? 4 days in a row is not such a treat. it is nerve racking work,d/t the many emotional need of most residents.btw; are u the rn?i work as an lpn in ltc in wisconsin,gen rate is 18.00 ph. people most likely ask why you have chosen ltc work d/t the emotionally draining work day,but there are other nice things that go on.also, there are skills youv'e learned that u won't be using. it would be nice if u could do prt time in hosp. to utilize these skills, not lose them.good luck to you!

During my orientation it will be me with 2 LVN's then when done with training, it will be me with one other LVN. There is an RN on shift until 5 pm and then we also have the med aide and the LVN who is responsible for all admissions during the shift. As far as sharing work with the CNA, im not sure what you mean by that. but If a CNA needs help turning a pt or bathing them or whatever the case may be, yes I will help; being a former CNA i know how hard the work is. The facility was described to me as a skilled nursing facility because they do the IV therapy and there are 2 patients with G tubes They currently have 2 trach patients as well, so as far as my skills, I think I will be using them DAILY. I am a graduated Vocational Nurse (not the RN just to clarify). My classmates were asking me why I have chosen LTC because they as most people say I wont use my skills (but I will be doing those things previously listed plus).

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Specializes in LTC.

Congrats on the new job and good luck. And yes I agree you will use MANY skills.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I am a graduated Vocational Nurse (not the RN just to clarify).
The previous poster probably asked if you were the RN, because many people who practice outside California and Texas do not know what a vocational nurse is. California and Texas refer to basic nurses as LVNs (vocational nurses), while the remaining 48 states refer to them as LPNs (practical nurses).
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Specializes in Psych, LTC, Acute Care.

I think it will be a great experience for you! At my facility. The ratio is 9-12 resident per CNA during the day. Depends on who calls out and 15:1 at night. You will get plenty of experience at your job. I have done about 10 caths, GTubes, injections of all kinds, Skin assessments, wound care of all types. You have an advantage because you will be IV certified. Good Luck to you and keep us posted!

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Specializes in LVN, Phlebotomy, CNA.

UPDATE::::nurse:

OK so I was exhausted yesterday when I got home so I was unable to get on here and give you guys an update. So, it is now 12:50 am and I am about to go to bed again! I really thought I would prefer the 3-11 shift since I AM NOT a morning person, but I have to leave my house at 2 so that I can be there by 2:30 and we dont get out until 11:30 at the earliest. Like I have said before, its a Skilled Nursing facility, that being said: there are 50 patients and 2 LVN's 1 med aide and 4-5 CNA's. The work is not hard, there is just SO much of it and I am not sure if I am in for this type of work. I am going to give it at least a month and I will see where it takes me. There just doesnt seem to be enough time in the shift to go say hi to everyone and do a quick assessment, plus do treatments, feedings, peg meds, etc.

I must say that in the 2 days that I have been there: I have perfected my skills of accuchecks and insulin, and cath's we have a pt who gets an in and out q shift, so I have done that twice already, Done 4 bolus feedings and plenty of wound care and dressing changes.

I feel so overwhelmed and I think I should have waited to start working until after I took the NCLEX! I only have a few hours a day now that I am not either working or sleeping so I dont know when I will have time to study:trout:

Any suggestions from how any of you handled this kind of situation? I feel like I am lost!

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Specializes in Case Manager, LTC,Staff Dev/NAT Instr.

Its going to be tough at first until you get familiar with your job description..LTC can be stressful d/t turnovers, short staff etc..3-11 is more laid back than dayshift so hang in there..and please by all means study! study! prepare for your NCLEX this should have been addressed prior to your schedule remember passing NCLEX first time is most important...

GOODLUCK:cheers:

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Specializes in med/surg, telemetry, IV therapy, mgmt.
UPDATE::::nurse:

OK so I was exhausted yesterday when I got home so I was unable to get on here and give you guys an update. So, it is now 12:50 am and I am about to go to bed again! I really thought I would prefer the 3-11 shift since I AM NOT a morning person, but I have to leave my house at 2 so that I can be there by 2:30 and we dont get out until 11:30 at the earliest. Like I have said before, its a Skilled Nursing facility, that being said: there are 50 patients and 2 LVN's 1 med aide and 4-5 CNA's. The work is not hard, there is just SO much of it and I am not sure if I am in for this type of work. I am going to give it at least a month and I will see where it takes me. There just doesnt seem to be enough time in the shift to go say hi to everyone and do a quick assessment, plus do treatments, feedings, peg meds, etc.

I must say that in the 2 days that I have been there: I have perfected my skills of accuchecks and insulin, and cath's we have a pt who gets an in and out q shift, so I have done that twice already, Done 4 bolus feedings and plenty of wound care and dressing changes.

I feel so overwhelmed and I think I should have waited to start working until after I took the NCLEX! I only have a few hours a day now that I am not either working or sleeping so I dont know when I will have time to study:trout:

Any suggestions from how any of you handled this kind of situation? I feel like I am lost!

This is typical for a new nurse. We all went through this phase. You just keep showing up for work and putting one foot in front of the other and getting through your work day. As time goes on you get more confident and skilled at what you are doing and you begin to notice that things are going better.

Skilled nursing in LTC is very, very busy indeed.

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Specializes in Licensed Practical Nurse.

i currently work as an lpn in nyc! ltc was the last!! place i wanted to work as an lpn i tried to avoid it, in fact the ltc i work in now is the only ltc i applied to i applied to mostly hospitals which take forever to hire and had only full time positons, for now this ltc job fits my schedule (since i'm in school for my rn) , it helps pay my tuition and it lets me wet my foot a bit! its frustrating not being able to utilize all the skills you learned in ns, i'm looking for a perdiem or part-time hosp position right now, wish me luck! good luck to you too!

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