RN's role in LTC?

SuesquatchRN, BSN, RN · Nov 16, 2008

It really depends on the facility. In some the RN's are in a supervisory capacity, in others they work at the exact same tasks as the LPN's, except they do the assessments on a fall.

SummerGarden, BSN, MSN, RN · Nov 16, 2008

i have a friend who will be working ltc as a rn. she has no interest in working within the hospital setting; clinicals was enough for her! she will be increasing her education and is striving to become an expert within the field. so, your choice is very promising! if you find a place you don't like, quit and find a place where you fit so you do not become jaded. good luck to you!!! :twocents:

NotFlo · Nov 16, 2008

Totally depends on the facility.

In mine, some RNs are supervisors and some work the floor.

The RNs who work the floor have an assignment and the same responsibilities the LPNs do. If there's a fall we call the RN supervisor to assess the patient (and actually even the floor RNs call the supervisor for a fall or change of condition).

Melinurse · Nov 16, 2008

I'm an RN at 2 LTC facilities and like the others have said it depends on the facility.

At facility #1 I am a supervisor and mostly do admit assessments, fall or change of condition assessments. I get called to any deaths or codes. I do alot of paperwork and doctor calls. I also help with med pass or treatments if needed. All RNs are ACLS/BLS for codes. LPNs are all BLS.

At facility #2 I do med pass and treatments pretty much same as the LPNs and med techs. Only difference is if IV therapy is orderd I have to start an IV and hang the med or fluid. Or if TPN is ordered only RNs can hang it. LPNs can hang IV fluids if certified but the facility still won't let them start an IV or hang IV meds.

NursKris82 · Nov 16, 2008

I also work in 2 LTC facilities in Michigan and in both the floor RNs do the exact same job as a the floor LPNs, npo difference. In MI only RNs can start IVs or give IV push meds, but an LPN can hang fluids and piggyback meds. In one facility you have to be an RN to be a supervisor and in the other some LPNs fill these positions. Some nights we may not have an RN in the facility, but one may be on-call.

A typical day shift for a floor RN in my facilities include:

get report, fill out CNA VS sheets and assignments and give them report, do morning med pass, 730-930 often times, then do medicare asssessments, treatments, pull up labs, complete orders, call docs, chart or whatever else has to be done for the day. There may be a 12n or 2p med pass (normally very lght and consists of pain meds or sinimet) - you do do these, complete your charting, report off and go home. With a lunch in there somewhere depending upon what works best for the flow of your shift.

I really like LTC, but want to go into cardiac care. You will be responsible for 15-30 patients, but they are often stable. Different facilities are different, so one facility may make you hate it and another love it. The important thing to remember is it's hard when you're new- but it gets better, each week and each month- it gets better. Give it a try you may love it!! :nurse:

RNfromMN, BSN, RN · Nov 16, 2008

Well, here's my typical day:). I work on a floor that has 13 residents. The only other staff I have on the floor is one other CNA, but that's okay because I don't mind doing cares & all these residents are 1-person (they only need one person to stand them up, get them dressed, get them into bed, etc).

6:00 - 6:30 a.m. I come in & count all the narcs/controlled substances. I get report from the night nurse, then she goes home. I set up my med cart with water pitchers & juice pitchers, a container of apple sauce or pudding, a container of protein supplement and glasses & med cups.

6:30 - 7:00 a.m. I log onto the old computer & read all the charting from the day before, or the last couple days before if I've been off. I'm usually the only RN in the building, so I like to know what went on while I was gone & what stuff needs to be followed up on with ALL the residents, even though I only take care of less than half of them.

7:00 - 10:00 a.m. The morning med pass. I'm passing pills & answering call lights that the aide doesn't have time to get to. I actually love this part of my job - this is my 1st nursing job, so I love all the experience I get with all the meds.

10:00 - 10:45 a.m. - daily morning meeting. I hate it - we have it every single morning except for on the weekends. A nurse from each floor, the DON, ADON, kitchen manager, activities director, social worker, campus administrator get together & talk about what's going on with the residents & if we'll be getting any admissions any time soon. Like I said, I'm a new nurse, so if I have any ?s about anything I'm doing, this is when I ask them.

10:45 - 11:30 a.m. - I get back from the stupid meeting, usually take a little break, give the aide a break & answer call lights until she comes back, draw any blood that needs to be drawn for labs. Then I check to see if any faxes have come in, send faxes out to the MDs that I need to, update any families on stuff that I need to, chart on the residents I'm supposed to chart on. This is the part of the job that I really don't care for - paperwork, trying to communicate with docs via fax machine, updating families on the smallest little things.

11:30 - 12:30 The noon med pass...I start passing a few pills. Then the lunch trays come up & I pass those out. After all the trays get passed, I finish up with the noon meds. After lunch, I go back & collect all the trays & document how much people ate.

12:30 - 1:00 p.m. More desk work. I check the fax machine, send out more faxes, do some more charting.

1:00 - 1:30 p.m. - The 2PM med pass. This one only has 2 people, so I get it done pretty quickly.

1:30 - 2:00 p.m. - finish up my charting for the day, answer call lights. I'm a pretty big procrastinator, so this is when I'm usually running around doing my assessments. I recount all the narcs & clean up the med cart for the next nurse.

2:00 - 2:30 p.m. - give report to the next nurse & GO HOME!

I really like this set up because I get to do it all - which I really think is the best way to provide care. I see all the skin, I see the bowel movements, I see how much people eat, I do all the vitals, I pass the pills, etc.