Nursing home LVN charge position

achot chavi · Feb 6, 2009

Oh this has been addresses so many times. Try searching for previous threads that have dealt with new charge nurses. Good luck!!!

suzanne4, RN · Feb 6, 2009

First word: Don't do it.

As a new grad, you do not possess the skills to be in charge and on a night shift. And if the facility is willing to put a new grad in charge, then there are issues with the facility as well. Seriously doubt that they are going to be giving you at least 6 weeks of full-time orientation, more likely they will not give you more than a week or two.

Please be aware that working in LTC is one of the highest areas of license loss. Be very careful with what you are planning to do.

As the above poster has mentioned, much has already been written on this topic.

Some things to think about:

What if there is an emergency, are you going to know what to do? Think of all of the problems that can happen and they usually occur at night when you do not have all of the back-up. What would you be doing besides calling 911?

bebe5 · Feb 6, 2009

Ur gonna be busy..Woudnt do it if I were you.

~MIA~, ASN, RN · Feb 7, 2009

:uhoh21:They couldn't PAY ME ENOUGH to do that~~NO WAY!!! :down: :nono:

iwanna · Feb 7, 2009

But, aren't all LPN's in nursing homes charge nurses of the CNA's? Now, I am starting to get nervous. I am not a new nurse, but new to LTC. Well, kinda, sorta. I once worked in LTC per-diem, and I quit 6 weeks later. It was overwhelming. The amount of residents was ridiculous.

I have just accepted a position where I will be medication nurse and the charting nurse. And, charge of CNA's. The staffing ratio is 5-6 nurses to 93 residents. And, there is a separate treatment nurse. Also, she told me that I can take more time for orienting, if I feel that I need it.

This offer sounded much better than the one I had many years ago. I had 50 pts. and I was sick everyday that I had to go to work. I truly, truly hated the job. And, on my days off, I would just be in bed exhausted. And, I only worked two days a week. Perhaps, I was just not ready for that job, yet. I was seriously ill with sarcoidosis complications in Dec. 96. I took my boards 3/97. I got the job 5/97 and quit 6/97.

mrsjenk · Mar 22, 2009

Hey! I have worked long term care for years.. I started out on night shift. The best advice i can give is to "just do it" come to work check your mars and get started as you work there longer you will develop your own routine. Good luck

eldragon · Mar 25, 2009

I don't think a new grad nurse should ever be charge. There are too many things that take time to learn. It has nothing to do with your grades in school or your confidence, but your exposure to many things.

Dayshift is the place to start as a new grad. There are others there to help you. And a new grad in a charge position is not safe for the residents.

You will be the person left holding the bag when someone falls or needs to be sent out and the paperwork isn't right. Nevermind that they always promise you that you can have more orientation if you need it. You will of course need it but I guarantee you the extra teaching offer will be gone. If they had enough staff to orientate you for 6 weeks they wouldn't have an opening!

Sorry, but I have seen it before. New grads cannot charge effectively.

Start in an entry level dayshift position and learn the ropes.

bluegeegoo2, LPN · Mar 27, 2009

I work 3rds in LTC, and have learned a few things along the way. #1. Know who your codes are! If a res that is a full code is going remotely bad, get them out of the building, PRONTO! That way, you're covered. I'd MUCH rather send someone out and have them come right back rather than to have them code on me. #2. Do rounds as soon as you hit the floor. I used to not do that until one of my aides came to get me at 0000 to "check on" a res who turned out to be deceased. Judging by the skin temp and pooling of blood in dependent tissues, she had been deceased since the previous shift, and she was a code. Bad scene. #3. Get vitals early and gather other pertinent info on your res's that are on alert and get to charting. You never know when a crisis will hit and the more you have accomplished, the less you have to catch up on. #4. ALWAYS give your aides a thorough report. They are your eyes and ears on the floor, and will almost always see a change in a res before we do. If someone has had a decline, they deserve to know. They care about the res's as much if not more than we do. #5. Speaking of aides, always listen to what they're telling you, and follow up on their concerns. They will save your butt more often than you know. #6. Work like you have half of the time you see on the clock. More often than not, you'll be glad you did. #7. Do another round. I have found res's half out of bed during a round. A few minutes rounding will save a lot of time doing paperwork, sending someone out, etc., due to a fall. #8. Thank your aides nightly for the job they do. Answer calls lights if you can, toilet people if you can. It means the world to our overworked, underpaid aides. I hope this helps. Good luck!