nursing home job

[shopaholic42488]

Hey all! So i just recently got offered a job at a nursing home since NO hospitals are hiring here in massachusetts. i am very happy and thankful that i even have a job. i was wondering though if it would hurt me if i wanted to apply to a hospital later on. i don't want to lose all my skills learned in school and wonder if employers would look at it as experience or look down upon it. thnak you for any advice :)

Becky

[iluvnoodles]

CONGRATULATIONS!!! I definitely would not feel guilty for wanting to go back to hospital to get your skills back. That's something that I am definitey going to want to do. That is, unless I find that this job is just the best thing ever!! It's the same thing here in florida. No jobs for GN's in the hospital. Kind of sucks you know?

[shopaholic42488]

I def know what you're talking about. While I am working here, I am still applying to hospitals, so that when the economy gets better, my resume and everything will be in! The DON did say that she has only worked at this nursing home and has learned more than a lot of her friends in hospitals, so I a curious to begin work! Did you start already? How do you like it?

[SunshineRN79]

I might be starting at a nursing home too! I am wondering.... so many things!

[Moogie]

Long-term care has changed over the past several years---as in acute care settings, the residents are often sicker and have more complex needs than they did in the past.

New GNs working in LTC will likely experience a huge range of morbidities---diabetes, cardiovascular disease, Alzheimer's and related dementias, arthritis and other degenerative disorders, and cancer---often many comorbidities in one patient. You will address issues related to mobility, nutrition, elimination, wound prevention and healing, infection control and treatment and you will be involved with end-of-life issues. You will see a lot of psych---depression in many people, but also schizophrenia and personality disorders, psychiatric and behavioral symptoms associated with dementia. You will also deal with pain issues---chronic and acute---and you will learn to assess pain even if the resident articulate the location, quality, or intensity of pain.

In terms of skills, depending on your facility, you may have residents with IVs or PICC lines---not as much as acute or subacute care, but you may have them nonetheless. You will get experience in tube feedings and dressing changes---lots of dressing changes---and you will hone your assessment skills. You will develop skills in time management and, although there will be many times when you feel that you do nothing but give pills all day, you will be doing other things as well and you will become familiar very quickly with a wide variety of medications.

You will also learn how to manage a team as you will be responsible for the oversight of CNAs and, depending on whether or not you're charge, you may supervise other nurses. (I strongly suggest that no new grad takes a position in which he/she is expected to act as a supervisor until he/she has a bit of experience under the belt. While every nurse is expected to supervise unlicensed staff, it is VERY challenging to try to be, say, a unit manager and supervise other nurses when one is trying to learn the ropes as a new nurse oneself.)

Yes, there are some people who will try to diminish or disparage experience in LTC as not being as "good" as acute care, but those people have no ideas of the realities of LTC these days. IMO, you have an edge up because, as the population ages and we see more elderly persons with comorbidities in hospital settings, you will know how to take care of them much better than the nurse who has not dealt with the elderly on a routine basis.

You also might surprise yourselves and find that you love gero. Gero might not be as glamorous as some of the other specialties but honestly, it is an area in which more nurses will be needed in the future and you may find that there are more opportunities for you in the future. Personally, I think there will be growth in opportunities for gerontological nurses in the future as nurse practitioners, educators and researchers due to the increasing numbers of older adults in our population.

The biggest downside of LTC in my opinion is the politics. You have to develop people smarts in a hurry to avoid being chewed up by some of your fellow staff. Keep an open mind, be open to learning from everyone (you would be surprised how much you can learn from the CNAs) and don't get caught up in the gossip machine. I am not saying this to intimidate anyone but so that you jump in with your eyes open---but there are some LTCs that are pretty toxic. You can find out a lot about a place by physically checking it out when you interview: does it smell bad? Do the residents and staff seem pretty happy or does the staff look like the weight of the world is on their shoulders? How does the place measure up on state surveys? (Don't work in a place that has deficiencies so serious that it has been fined, not permitted to train CNAs, or not permitted to admit Medicare patients. That place has PROBLEMS.) Also, ask about staff attrition. If the DON whines about not being able to recruit or retain "good" people, you might have a clue that it's a toxic workplace. If a place is ALWAYS advertising for help and never seems to have enough, it could be toxic. There are places other than LTC that are toxic---I've worked in a couple and they suck the energy out of your soul---but just be aware that some LTC facilities are very dysfunctional.

Best wishes to all three of you who have posted here so far and I do hope all goes well for you!

[felicitypaul]

Is there an agency who are recruiting to work there abroad?

I'm a Registered Nurse in the Philippines..