Ratios for long term care?

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I'm considering a position at a long term care facility. I am a new grad. The orientation is 4 weeks (which they said is "plenty" to learn). Is this sufficient for LTC? Also, the ratios are 15-1 on subacutes and 22-1 on LTC.

The facility looked clean, staff was very friendly, residents looked happy and cared for.

What do you think?

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The staffing ratios you describe are the best I've ever heard of. If you are impressed with the place, I say go for it.

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Thank you :)

Is a 4 week orientation good for LTC?

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Thank you :)

Is a 4 week orientation good for LTC?

Yes, if it is a good one. If your preceptor has been trained to precept, and wants to do it (wasn't forced) and there is an orientation plan- not just hap-hazard following a nurse around, four weeks should be enough time in LTC. If not, most reasonable managers will extend it by a couple of weeks if you don't feel ready.

If you will doing a big med pass, you may feel overwhelmed at first- most nurses do. In time you will learn various tricks, learn your pts, and will get faster and faster.

Whenever I'm orienting to a new place, as soon as I get to the floor, the first thing I ask for is a list of the pts I will be caring for, with their names and room numbers. Have your preceptor check the list to make sure it is accurate and up-to-date. Often, they're not. The second thing I do is have them show me the crash cart, and go over it with me.

I find out who is a full code and write a little "fc" by their name, DNRs, I leave blank. I find out who gets their meds crushed, and write a little "c" by their name. For pts who take meds whole, I leave it blank.

I find out who is diabetic, and use a pink highlighter and make a line after their name. Then I write the finger-stick times in the line. Later, I write the results next to the time, followed by how much insulin given. I draw a "0" w/ a line thru it if reg insulin was held. Next to tube feeders, I write a little "tf" and draw a circle around it. For pts with foleys, I use a yellow highlighter to draw a line by their name and write "I" and "O" in the yellow line, and use the space to fill in their I&O for report/charting.

After report, the first thing I do is fill out the V/S list for the CNAs, and check/make their assignments. I then do quick rounds on my pts to make sure all are breathing, and are where they are supposed to be.

If a pt has not had a BM in awhile, I use a brown highlighter and make a line by their name. The empty line reminds me to follow-up- does the pt need a laxative? Need checked for impaction? When they have a BM, I write the results in the brown line.

If a pt seems different, not their usual self, the big things to check (for) in the elderly are blood sugar, UTI, dehydration, fecal impaction, pneumonia, hypoxia, and neuro. Always check VS, first.

Lots of places don't have pulse ox machines, so I bought one myself. Got a little portable one on ebay.

Hope this helps.

Anyone have anything to add?:D

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Oh wow thank you for that info!

I admit, it scared the crap out of me LOL because I am a brand new grad... I hope one day I can get that organized and efficient.

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Oh wow thank you for that info!

I admit, it scared the crap out of me LOL because I am a brand new grad... I hope one day I can get that organized and efficient.

You're welcome!

Once you've gotten to know your pts, you won't need to highlight nearly as much. Best of luck to you.

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