Amanda3RN

I know there are a lot of situations out there that are not so wonderful but there are facilities that are not as nightmarish We have 100 residents spread across 3 different units. We have 5 nurses (1 RN, 4 LPN) on the floor. 6 CNA's on our skilled unit. 2 on our rehab unit and 3 on our Alzheimer's unit. We have myself (ADON), a treatment nurse and a clinical services supervisor that assist with everyday activities on the floor. After 6pm on second shift our staff changes to 4 nurses on the floor, 1 med aid and 2 CNA's on the Alzheimer's unit. The other CNA's stay the same. Then we have the RN Nurse Manager. On 3rd we have 2 nurses, 2 CNA's on the rehab unit, 3 CNA's on the skilled unit and 2 CNA's on the Alzheimer's unit. There are always going to be days that staffing changes in an instant and we do not have on call so I may have to wear many different hats within the day. But LTC nursing truly is about loving what you do and for the most part if you try to be appreciative and good to your staff they work with you. :redbeathe

I agree you need to make sure that you will be training with someone for a while and I would definitely check into a state training course. They usually offer a beginner's course. I would also try to figure out how the MDS affects your facilities pay. In NC we are paid by how certain things are answered on the MDS and whether we followed the documentation guidelines, and a couple other things but... of course administration is going to be wanting you to make sure that they are getting the most money possible. But I honestly don't know if it is different for different states?? The best advice I can give you though is to go in knowing it is a hard position so don't be hard on yourself. It will probably take you a good year to get to a point that you feel comfortable. Make sure that you get phone numbers of support people and call them...don't feel like there is too silly of a question. Best of luck to you. I will help answer any questions I can...I worked in that position for 5 years and have trained a couple people:). Now gearing up to learn 3.0

Hey Megan, I have worked in a privately owned LTC for almost 10 years and absolutely love it!!! The key to working LTC is finding the right place to do it. I work as the Monday thru Friday nurse manager and I assist with most of the nursing interviews. If I were to go to another place I would definitely ask about their training program...many LTC's are trial by fire . I know nursing is nursing but the paperwork and regulations for LTC are quite different. I would also ask about the physician services that they have. How often does the MD/NP make rounds? Is it one doctor or a service? How active is the MD/NP in the care of the residents? Are they active with meeting with families? Having an apathetic physician servicing your residents can make your life very difficult. Ask how they did on their state survey? What sort of things were they sited on? Ask what their turnover rate is? Fortunately many of our nurses and CNAs have been with us for years, some 15-20 years. Ask to take a tour of the facility. Look at the condition of the residents and ask yourself if your would want your parent or grandparent to live there. If the answer is no then your probably don't want to work there. I would also ask what type of alarm/lock systems they have to protect wandering patients, because if someone escapes or gets hurt then your license could be the one on the line. What type of management support do you have? On your tour notice if all the administrative people are sitting in their offices or are they involved with the daily life of the facility? Good luck! I hope you find a great place to work!