nursing homes

KaroSnowQueen, RN · Jan 5, 2004

Passing meds to 20 to 40 pts. Treatments. More meds. Charting. More charting. Helping the good aides, yelling at the bad ones. Worst thing is the meds, but just know it will take you a long time and they KNOW it will take you a long time.

eddy · Jan 7, 2004

Originally posted by kirarn
I recently registered with an agency and I'm thinking about taking nursing home assignments. I've never worked at a nursing home, however coming from a hectic hospital setting I figure it can't be much more difficult. A girlfriend of mine said that I don't need any prior nursing home experience, but I'm a little nervous about it. What's a typical day at a nursing home like? Any advise?

I've had some terrific experiences in nursing homes and some very very bad ones as well. For the worst example you should head to the Geri forum. It'll make you sick no doubt.

Here's my take on NH's. Take it for what it's worth. I think it's a bad idea to jump into NH work if you haven't done it in a "staff" capacity before. Contrary to your friends advice I think a busy ER, ICU or Step-down unit is cake compared to most nursing home assignments from my experience. More often than not you will find a med cart in disorder, the bulk of the cna/pca staff has terrible attitudes while a few are gems but are afraid to say anything about the rest, the staffing ratios are often terrible and dangerous and you will generally get little or no assistance from the staff in regard to taking proper care of the residents (they've often got their own problems).

Now, someone who is fairly comfortable with the NH front can generally make their way through the mess and somehow come out the other side having done a pretty good job, but someone who has never been in the situation will likely drown and is putting their license on the line just being there.

I hope I am not scaring you away so as much encouraging you to seek out an NH that provides an orientation first, which may be hard to find, but worth seeking out. I regularly work at NH's but I prefer hospitals. There are some NH's where I actually really enjoy going to, but it has nothing to do with an easy workload, rather a good staff and caring administration.

I give an incredible amount of credit to those nurses working day in and day out in NH's. It's a very tough job, and I admire those who have such a passion for their work. To be a good NH nurse, you have to be there for more than a paycheck. I've met a lot of very good ones along the way, but I've met some that make me sick too.

Now, if you truly do find yourself at a "good" facility, you will still have plenty of challenges. Rather than having say 4-8 patients to tend to and become pretty familiar with over the course of a shift, you'll find yourself responsible for 20-40. You will have a hard enough time just finding their charts, proper meds and so forth. Then throw in a couple of upset family members of a couple residents and try to explain to them that you understand and will do your best to help. Some will have rediculous expectations while others (the majority) simply want the most basic needs tended to for their loved ones. This "encounter" often comes right in the middle of one of your ENORMOUS med passes and creates even more problems. Couple all that with an often very depressing environment and it can be more than a lot of people can take.

The bottom line is that it is no piece of cake in most facilities, so I don't want you to be misled. It can also be the most rewarding assignment you'll ever take, but easy it is not.

Good luck and I hope you are able to find a role in NH work. We could use a LOT more good nurses who work in this particularly demanding segment.

Sorry for the book. :)