Reality check: new grad in SNF

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Can anyone with experience overseeing or orientating new grad RNs in the SNF environment please tell me where they would expect the new grad to be after five to six weeks of 1 on 1 orientation? How long does your facility give new grads for orientation and at what point is it determined if the person can safely handle an assignment by themselves (with plenty of people available for support and answering questions still, of course).

I'm just wondering if my expectations are way off with where a new nurse should be in this setting at this point in orientation and I think I need a reality check.

Specializes in Geriatrics, Transplant, Education.

I had seven weeks orientation (about 5 weeks on 7-3, 2 on 3-11 before I moved to full-time 3-11 on my own) to my sub-acute unit as a new grad two years ago. I was nervous, but felt fairly comfortable by the time I was on my own. I now orient people (a mix of new grads & experienced nurses) on the same unit...by 5-6 weeks in people are still asking questions, but are developing a flow for time management. On my unit the admissions process is a huge thing to learn, and it takes a while for some to connect all the dots. (especially how to fit the admission process in in between taking care of up to 8 other sub-acute patients).

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Specializes in LTC, OB, psych.
lol...apparently you haven't worked in a facility with a subacute unit...low acuity?? I think not.

Hmmm. Well I came to LTC from EMS . . . perhaps my perspective is still all screwed up.

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Specializes in geriatrics.

I have a question re LTC, and I do not mean to sound naïve, but if there are 28 residents, and they all require meds, how is one nurse supposed to safely administer them all? Not to mention that some older adults take time to swallow their meds. Just honestly wondering...

I'm hoping there will be another nurse to assist with the meds. Thankfully, I am mainly working nights, so not as busy.

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My first job as an LPN many years gave me 2 days orientation on a 40 patients bed unit. The worse part of it was that there was no second nurse for me to ask any question. I quit after 2 week and got me another job that that trained me for 2 wks on a rehab unit.

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Specializes in LTC.

if there are 28 residents, and they all require meds, how is one nurse supposed to safely administer them all?

Of course you can also throw in the behaviors, refusing to take meds :no:, doctors returning calls, families needing updates, finding errors in med postings and having to research for the med order - all at the same time!

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I would say 5-6 wks orientation in a SNF is a very long time. As a new grad in a busy, regional hospital I got twelve weeks.

In a SNF I got 3 days.

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Specializes in SNF, Oncology.

I got about a week at SNF after I graduated RN school. It was too short, in my opinion, for any new grad nurse. It takes time to get a routine down.

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Specializes in Professional Development Specialist.
lol...apparently you haven't worked in a facility with a subacute unit...low acuity?? I think not.

Yup, our medical director has said a few times to me that the patients we have used to be hospital patients. Now they are in subacute. Some are stable but many are barely that.

Anyway as a new grad I got a whopping 2.5 days. We were so understaffed they couldn't afford any longer.

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I'm a new grad LPN working in LTC and I got only 1.5 days of orientation. I asked for more time and on the 3rd day, they had me orienting with a new grad RN; it was our 3rd day for both of us. It was like the blind leading the blind, but we managed to get things done. I'm still there, ask a lot of questions and am learning more and more each day.

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Specializes in Peds Medical Floor.

When I started at my LTCF as a new CNA, on my 10 day orientation I was with 1 other CNA. She'd worked there for years, and then there was me, and that was it for 40 residents.:rolleyes:

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Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

After 6 weeks of one to one orientation you would think the person would be able to function really well! I mean med pass should be coming along really good, and the organization of work priorities whould be established...I would think. There still may be questions, but we all have questions, even after months and years!

Six weeks is a long time in LTC. That is awesome that you all are able to provide that....

The nurse that is the preceptor...is that you? Have you been letting the other nurse do everything and you just observe and be there to answer questions?

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Specializes in Gerontology, Med surg, Home Health.
I had seven weeks orientation (about 5 weeks on 7-3, 2 on 3-11 before I moved to full-time 3-11 on my own) to my sub-acute unit as a new grad two years ago. I was nervous, but felt fairly comfortable by the time I was on my own. I now orient people (a mix of new grads & experienced nurses) on the same unit...by 5-6 weeks in people are still asking questions, but are developing a flow for time management. On my unit the admissions process is a huge thing to learn, and it takes a while for some to connect all the dots. (especially how to fit the admission process in in between taking care of up to 8 other sub-acute patients).

Up to 8 other sub-acute patients? Wow...I had 30 patients to myself and clearly half to 3/4ths were sub-acute. The best ratio I've seen is one to 15...if we had 8 we'd think we had gone to LTC heaven.

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