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Tips for a new lpn a a LTC Facility

by jenn_32 jenn_32 (New) New

Hello I am a new nurse and just started a job at a LTC facility at night. I am really struggling on getting my med pass done on time and pts get upset with me. But I go as fast as I can and do everything I am supposed to. I start my 8p med pass at 7 and am finished around 10:30 pm. I am really feeling overwhelmed and don't know if I am doing ahold job. Please give tips on saving time and getting all your work done.


Specializes in Cardiac Care.

Do not be too hard on yourself... as you learn the patients and the meds you will get faster. The important thing is to get it right.I was an LPN in LTC and had 30 residents with two main med passes and 1 small med pass, along with the dinner meal to supervise and the treatments to do.You'll learn your routine of who is quick, who to do first, etc as you go. It is not uncommon for the times your are talking about. You won't believe it but you will actually memorize who gets what at each pass and you'll speed through these med passes with time.


Specializes in Hospice + Palliative. Has 4 years experience.

how many residents do you have? Are you doing treatments during that time, as well? Are you going in order down tht hallway, or jumping around from room to room in no order? need more info to give specific tips on managing time :)


Specializes in geriatrics. Has 2 years experience.

I currently work at a LTC facility, and have for almost 2 years. I worked the majority of that time on night shift with up to 36-38 pts at a time. You will learn who takes time, and who is fast. It will take a little bit to get a routine down, but once you do, you won't believe how much faster it goes. However, my biggest piece of advice is to make sure you are doing it right, even if it takes you longer, even if you are the only nurse doing so, even if your pts get ticked at you. The speed will come with time. You can never go back and undo a big mistake. The other suggestion I have is to save your treatments until after you are done with med pass unless you have something that is actually scheduled for 1930, etc. if you have a general time frame in which to do them, then save them for after med pass. Good luck! Hope your routine settles itself down soon. :)

Thank you so much for the encouragement. I have 30 residents one whole hall and half of a other hall. 7 accu-checks, two peg tubes one with a scheduled feeding at 8 and the other just scheduled flushes.

Edited by jenn_32

sarahlee23, LPN

Specializes in LTC. Has 7 years experience.

It does get better as the residents get to know you as well. I've had some residents get upset because I was late with meds or didn't bring them at the specific time they want them (one lady I care for wants her 12am meds at 12:30am) when I first started working with them. Once I got to know them and they got to know me, it got much better. I usually work nights, but occasionally I pick up part of the PM shift and do the 8pm med pass. Because the residents know me pretty well by now, they are much more understanding when I get behind and bring them their meds late. Instead of getting upset, most of them just tease me now. It takes time, but it does get better. Don't give up.

The 3-11 shift is not Night, but Evening. Evening shift really does have a large med pass, usually have fewer staff than 7-3 shift, and so more interruptions for the nurse passing meds. It is not unusual, especially for a new nurse, to run late on the med pass. Accuracy is far more important than being on time.

Don't be so hard on yourself. It takes every nurse new to our facility or floor about 2-1/2 hours to finish med pass for 30 residents. Even experienced nurses take extra time when they float or are moved to a new unit.

I agree it is more important that you do it "right" than do it "quickly" - the speed will come in a few months. I also agree with saving treatments until after med pass. It is easy to change most dressings on sleeping residents, even sacrums. And as you get to know your residents, it will become easier to prioritize and know which resident should get what when.

I'm having the same problem. I'm a new nurse at a LTC facility with 28 residents; I have 5 BGMs to perform before dinner, a CRAZY heavy med pass (one resident has 30 daily meds + 4 PRNs), and I'm trying to learn safe shortcuts. Many of the residents actually belong on different units due to combativeness, memory issues, etc., but I think they try to keep residents where they are for as long as they can get away with it. I've also found that some nurses on my unit are not as thorough, which leads to serious errors. I find it so stressful that my stomach turns before I walk onto the unit. I enjoy working with (most) of the people, but it's hard. I have only been there a few short weeks and my orientation was 5 days on the floor. I don't know what's normal for LTC but that doesn't seem long enough. I'm just really really hoping it'll get easier with time, because if it doesn't I'm not sure if I'll be able to handle it.

I have been working the 3-11 shift for 18 months now and I have 36 residents. I agree with the comments suggesting to leave your treatments until after med pass. It definitely speeds up the med pass. Make sure your cart has everything you will need so you can save unnecessary trips up and down the hallway, especially insulins! Its very annoying when you have to go to the fridge multiple times because all of the flexpens are almost empty! I also mark which residents have 4 and/or 8 pm meds and when their accuchecks are and I cross them off when they are done, so I feel like I'm making progress! :)


Has 8 years experience.

Not sure if it's good practice but I do my accuchecks first AsaP! And I do those who are always high last. ... so I can get them coverage immediately before dinner.

i'm trying to learn as i go...i'm a brand new nurse working the 11 to 7 shift....its challenging but up for the challenge....i think the hardest part is gaining the cna's respect and support....how do i adjust?