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.
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.

Yup, our ratio is 1:8-9 (1:25 on 11-7). I'm very thankful to work where I do, because I hear we have the best ratios around compared with other facilities in my area. This is a totally separate subacute unit, not mixed with LTC at all (aside from the occasional patient there for a sub-acute stay after hospitalization that then goes LTC when their rehab is done). The ratios on our LTC units are 1:18 on the smaller unit, and 1:22 on the other two LTC units (1:44 on those units 11-7)

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Specializes in LTC, Psych, Hospice.

I had a full 5 days as a new grad in LTC. If memory serves me correctly, I believe there were 25-30 residents on my hall.

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Specializes in Geriatrics, Home Health.

I got 4 days, where I orientated a diffrent 22 bed hall each day.

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Specializes in LTC.
Yup, our ratio is 1:8-9 (1:25 on 11-7). I'm very thankful to work where I do, because I hear we have the best ratios around compared with other facilities in my area. This is a totally separate subacute unit, not mixed with LTC at all (aside from the occasional patient there for a sub-acute stay after hospitalization that then goes LTC when their rehab is done). The ratios on our LTC units are 1:18 on the smaller unit, and 1:22 on the other two LTC units (1:44 on those units 11-7)

1:9 sounds like a dream. I'm used to 1:23-27. I had 1:21 the other night at work and I was done with my med pass at 7pm. I was sitting at the desk starting my charting by 7:30pm saying to myself.. Who am I forgetting? Why am I done this early? There were 2 empty beds(1 empty and the other in the hospital).

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We give our new nurses, including new grads, approx. 2-3 weeks between 2 units: one a dementia-type unit and the other a higher-acuity unit (trachs, picc lines, tube feedings, rehab., hospice, etc.). Problem is little support, particularily for the new grad, after orientation. Our DON feels you're a full-fledged, experienced nurse within 4-5 months, regardless of the amount of previous nursing experience you've had. I pity the poor new nurse who might ask the 'wrong' question or make a mistake because of insufficient orientation or mentoring. Previous writers are correct, it's 'Sink or Swim' Style for many. Good luck!

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I'm a new RN grad who has just taken a position with the LTC facility that I have worked with as a CNA for the last 2 years. I've been informed I will get at least 5 and up to 10 days of orientation, I can't imagine learning my 18 bed hall and all of the nursing "clerical" duties in just 3 days! And my facility just picked up a new computer charting system Nov 1, so on top of being new and asking a million questions, it's not like everyone else has this down pat either! Orientation starts Monday, wish me luck!

:uhoh21:

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I'm a new RN grad who has just taken a position with the LTC facility that I have worked with as a CNA for the last 2 years. I've been informed I will get at least 5 and up to 10 days of orientation, I can't imagine learning my 18 bed hall and all of the nursing "clerical" duties in just 3 days! And my facility just picked up a new computer charting system Nov 1, so on top of being new and asking a million questions, it's not like everyone else has this down pat either! Orientation starts Monday, wish me luck!

:uhoh21:

Good luck!

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