Starting work in a LTC facility.. what to expect

[Epona]

Hi all. I come from a Med/Surg, Neurosugery backgorund. I have about a year of solid nursing experience.

I was just offered a job at a LTC facillity. The hiring manager said the environment here is going to be VERY DIFFERENT and CALM from where I came from... Level One Trauma hosptial in a big city... now to small LTC facility in the country.

I was told I would have 30 patients to manage.... DOES THAT SOUND RIGHT?? I had 4 to 5 on my Neurosurgery unit and I ran my tail off... she said the patients in the LTC were not anywhere as near acute as Brain Trauma patients... she said the worst I would encounter is a UTI... no labs to draw, no IV pumps to run, etc. I have never worked in LTC... anyone have any advice?? They pretty much hired me the same day I went in for the interview. THANKS!!! :)

[Samantha11481]

I have worked in a long term care facility for 6 months now, my first job out of nursing school. When I work afternoon shift, we have a wing and a third each, about 30 residents. When I work nights, we get two wings a piece, about 42 residents depending on the census. So yes, 30 seems about right. LOL yes you will frequently encounter UTIs. However, in my facility, we do the lab draws, and we have IVs and PICC lines. We have S/P caths, foley caths, residents who need suctioning prn, skin tears, and falls, neuro checks, etc. We are busy, however, you will do fine handeling it. You will also most likely have two huge med passes depending on your shift, which will up a lot of your shift. Good luck with your job!! You will do great :)

[HHLinda]

LTCs are different now. Many patients come to these facilities before transitioning to their homes. It's busy and the assignment was correctly posted by the previous nurse. IVs, PICCs, labs, wound vacs, vents, GTubes, lots of respiratory, hospice and yes UTI are all residents. It's busy depending on the shift you work.

[SitcomNurse, BSN, MSN, EdD, RN]

WOW, I would like to work there.. just worry about some mental status changes r/t UTI, toss some meds and be done with it!!

I ran respiratory, PICC, IV, Trach, Dementia, GTF.. and sometimes all on one person! THAT LTC is kickin if you dont even have to draw a Coumadin!

Hospice? The patient was easy, Roxinol, comfort measures, soft music, quiet atmosphere. The relatives? HYSTERICAL in the hallway at 3 am, bawling and tearful.. and still needing comfort and a hug and the respect for ther relative, and their greiving process...

CHALLENGING!! I loved every minute of it. (except for the pee on my sneakers) and if you love Nursing, you will find the atmosphere you want to work in too.

LTC s are very different now, but if you have a relaxed atmosphere, then God Bless!! Im sure you will still find your challenges.

The shift plays a role, no doubt, as does the attitude with which you approach it.

Now Im doing LTC Short Term rehab! Yep, I work in LTC providing Nursing Rehab concurrent with PT/OT for a smooth discharge. New challenge in LTC... making it Short Term.

Good Luck!!

[NC4RN]

The challenges where I work (LTC/SNF/Rehab) are the same as those mentioned above. The SNF/rehab is relatively new, and used to be a locked Alzheimer's/dementia unit. They left the "farthest gone" residents there so that they wouldn't be totally messed up by moving to a new unit on the LTC side. Unfortunately for me (when I'm on that unit) and for the residents, there is only one RN (me) and 36 of them. I talked to my RCC about it the other day while gathering up supplies for med pass, about how I lament the fact that there isn't time to do more "nursey" stuff for the patients and residents, between PRN pain meds, keeping the dementia residents seated, fall charting, scheduled meds, coumadin orders, blood draws, and calling physicians. She said, "yeah, it's quantity, not quality." This was a rude awakening to me, for her to actually admit that. I'm a new grad, mind you, this is my first "real" job. I worked my a** off to get this degree, and not so I could be a glorified medication aide. I want to help make people better, I want to use and gain more skills. I'm afraid that by the time I get my year experience, any hospital will dismiss me. Like most others, I LOVE the residents. They're awesome and fiery and funny and keep me sane. But the institution itself, and the LTC system in this country need a serious overhaul, starting with GETTING RID OF PAPER MARS. I still can't wrap my brain around that little gem, and this is my fourth month at this job.