The Low Down on Nursing Homes...Is It All That Bad?

Nurses General Nursing

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New grad considering working in nursing home. Pay is decent, hours are great...is it as bad as everyone says?

Specializes in Geriatrics, ICU, OR, PACU.

You've received a lot of great advice. My take on it, from a DON perspective is this:

I don't generally hire new grads. Why? I believe that our nurse:patient ratios are overwhelming and disheartening to someone who is just out of school. They are normal for the industry (30:1 on LTC, 20:1 on short-term rehab), but for a new grad just getting their feet wet, it can be completely overwhelming. There's a rhythm to LTC nursing that comes from experience--knowing how to organize a med pass, knowing what residents don't need a head-toe assessment (most of them, they LIVE there and are stable), and knowing what to chart on, and how to organize your time. Also, since we don't have MDs coming in everyday, a nurse needs to have an idea of what she wants to ask for when she makes the call.

All in all--I'd like to see a nurse spend some time in acute care developing those assessment skills that become second nature before they head to LTC/STR. Those are the ones that really shine.

My two cents.

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Specializes in Med Surg, Nursing Administration for SNF.

Hi - I have worked in both long term and in a large hospital. I started at the hospital and that is where I picked up skills, good habits, and basically "paid my dues". I would strongly suggest that all new grads do the same. There is no substitute for getting experienced with LOTS of NG's, IV's, GT's, labs, etc in an acute setting. You learn sooooo much and the opportunities are endless. As for LTC facilities (here in Fla anyway) most are half short term rehab and half LTC. On the LTC side the ratio is typically 30+ pts to one nurse, but usually all you do is chart, do accu checks, and give meds (whole, crushed or via GT). The paitents are stable and in a well established routine. Some homes will have a wound care nurse just for that purpose. On the ST side, you will see acute care pts - some needing IV therapy, wound vacs, physical and occupational therapy, etc. These patients are NOT as stable and hopefully you have good assessment skills as you have about 3 minutes a pt to assess and give meds. The rest of the time is paperwork, admissions, discharges, dressing changes, PRN pain meds, answering call lights, etc. On average 15 - 20 patients a nurse. Personally I did not care for either. I never felt I had the time to thoroughly do a GOOD job for my patient and then some. I always seemed to "be in the weeds". So I got into management, where I CAN make a difference. Good luck, try both then listen to your heart. :nurse:

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Specializes in hospital/physicians office/long term car.

My orientation was only 4 days and then I was on my own. I have been a LPN for 18 years and have a broad range of knowledge and they were really short staffed so I kinda got thrown into it! Even though I love being on a permanent hall now, I floated for the first 6 weeks and it was really good for me becuase now I know every resident in the building and in addition to being able to greet each of them, I know a little about the medical background and social history so it makes it a little easier if someone has a question. I think you give it a try and a job shadow would be a good idea if they would allow it. However, you will find as I am that you will still be learning new things long after you start working about everyday practice and protocol in the long term nursing world. good Luck!:nurse:

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Specializes in LPN.

I don't generally hire new grads. Why? I believe that our nurse:patient ratios are overwhelming and disheartening to someone who is just out of school. They are normal for the industry (30:1 on LTC, 20:1 on short-term rehab), but for a new grad just getting their feet wet, it can be completely overwhelming. There's a rhythm to LTC nursing that comes from experience--knowing how to organize a med pass, knowing what residents don't need a head-toe assessment (most of them, they LIVE there and are stable), and knowing what to chart on, and how to organize your time. Also, since we don't have MDs coming in everyday, a nurse needs to have an idea of what she wants to ask for when she makes the call.

All in all--I'd like to see a nurse spend some time in acute care developing those assessment skills that become second nature before they head to LTC/STR. Those are the ones that really shine.

My two cents.

My supervisor said basically this when I left. I was so frustrated at not having held my first job for a year like you are "supposed" to, but it was reassuring to know I wasn't incompetent. It's just a difficult (even if common) place to start.

I prefer to think of it in the opposite way - if you can handle a nursing home, you can do anything. :D

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I graduated in December 2007, passed boards in Feb 08, started in a hospital environment with no training and did not succeed. Look into hospitals that offer new grad positions and don't have the time to train. I am currently working in a nursing home on the night shift and although it is not where I want to be, it has been a great learning experience as I had only my clinicals in nursing school and had never worked as a CNA.

I would like to find out from anyone who has worked in a nursing home and how hospitals view you when you apply to work in a hospital. I am going to spend a year in a nursing home just for time management, learning experience and to gain confidence.

I will apply to a hospital because that is where I want to be eventually but I am scared that they will not look at my resume as experience since I work in a nursing home. Any information would be great.

Thanks.

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