What should I exactly expect from Geriatric nursing?

JZ_RN · May 2, 2012

The good- you can probably find a job in it. Some of the patients are lovely. Others are at least not needy.

The bad- many ARE very needy, and unless you have the patience of a saint, the dementia patients will be hard to deal with once in a while.

Management doesn't care if you don't have meds, supplies, or anything that you need

Expect RIDICULOUS and unsafe nurse to patient ratios, like 1:50, no joke.

Good luck in whatever you choose.

JonJP · May 2, 2012

The good- you can probably find a job in it. Some of the patients are lovely. Others are at least not needy.
The bad- many ARE very needy, and unless you have the patience of a saint, the dementia patients will be hard to deal with once in a while.
Management doesn't care if you don't have meds, supplies, or anything that you need
Expect RIDICULOUS and unsafe nurse to patient ratios, like 1:50, no joke.
Good luck in whatever you choose.

I am quite patient, I have dealt with elderly people before through volunteer work, and baby sitting children in my family takes a form of patience I'm glad to know thats one of the main traits I'll need because I feel like I have that aspect down quite well.

and wow not having supplies seems like it would be almost impossible to do the job. In situations when meds are needed do the problems just not get fixed? Or do you have procedures to assit those who need meds when you don't actually have them?

The understaffing does seem to a common problem in a lot of the posts that I have read here. I am already understaffed where I work at currently and I agree it can be unsafe at times. It seems that understaffing issues will only get worse the further my education goes so now I'm expecting to be working even harder xD

Thanks for the input as well

as well as the wish of luck :)

JZ_RN · May 2, 2012

I end up calling pharmacy and getting yelled at for authorizing emergency shipments of drugs that the facility then pays for.. But I don't want my patients to go without and I always reorder before it comes down to that but some people don't bother or care, and since I can't be there every day (nor do I want to be there every day hahaha)

I sometimes have to creatively dress wounds then write progress notes on how the facility doesn't have the ordered supplies for the dressing so I improvised to the best of my ability. The wound is clean, covered, packed, whatever it needs to be. I have sometimes had to use TB syringes for insulins for my DM patients when we had no other needles or syringes. I will call in expensive backup if we don't have IV supplies, I don't care because it's not my money, nor my fault they don't stock anything they should, and my patient is all that matters to me. I honestly feel unsafe in my practice with so many patients and management doesn't care about safety, just the bottom line. I love the residents, so I do my best, but I will not be sad to leave this job... though I will miss some coworkers and residents.

Look for someplace and then talk to the nurses there before accepting a job is my best advice. Again. good luck!

JonJP · May 3, 2012

I end up calling pharmacy and getting yelled at for authorizing emergency shipments of drugs that the facility then pays for.. But I don't want my patients to go without and I always reorder before it comes down to that but some people don't bother or care, and since I can't be there every day (nor do I want to be there every day hahaha)
I sometimes have to creatively dress wounds then write progress notes on how the facility doesn't have the ordered supplies for the dressing so I improvised to the best of my ability. The wound is clean, covered, packed, whatever it needs to be. I have sometimes had to use TB syringes for insulins for my DM patients when we had no other needles or syringes. I will call in expensive backup if we don't have IV supplies, I don't care because it's not my money, nor my fault they don't stock anything they should, and my patient is all that matters to me. I honestly feel unsafe in my practice with so many patients and management doesn't care about safety, just the bottom line. I love the residents, so I do my best, but I will not be sad to leave this job... though I will miss some coworkers and residents.
Look for someplace and then talk to the nurses there before accepting a job is my best advice. Again. good luck!

Ahh I see getting creative will be one thing that will be different but interesting to learn I suppose It sounds as if you do go through a lot. This is exactly what I wanted to know and I can't thank you enough for sharing your troubles with me. You sound wonderful at what your doing as well and I don't blame you for not being sad to leave it sounds like a ton of stress to deal with :uhoh3: Thanks for giving me a look into what i'm getting into xD It sounds as if I will need to be prepared

Ill take your advice as well it seems like one of the best things I could do Thanks again for everything and have a wonderful day :hug:

Also best of luck to you as well :)

JZ_RN · May 3, 2012

Best advice I can give you is to make lists and more lists. I have lists (with room number, NOT name) of which people get meds (and what meds at what dose), blood sugar checks, narcs, what treatments, allergies, code statuses, etc. I update is when I go to pass meds or do treatments with the MAR and TAR (I always look before I pop the pills out into the cup, even if I know exactly what they get) and I will know exactly where I stand if one needs an atb (allergywise) or codes, right there with me on my car. Save the demanding patients for last if possible to save time. ALSO, don't take a crappy report, you'd be shocked to find the things I "learn" during my shift that were neglected in report. Also, make a copy of the doctor list, pharmacy numbers, manager extension, etc and put it on your clipboard too. Always keep scissors and skin tear dressing supplies on the cart, and don't be afraid to call that grouchy doc, better safe than sorry, even if it's a dumb question and the doctor thinks I'm an idiot, at least I was safe.

I had nightmares the first few weeks, worried I was missing things, but have gotten better at quick assessments (as this is all you have time for) and picking up subtle changes in people now that I know them. Now I have a destress routine after work so I no longer carry work problems to my home as well. :)

JonJP · May 3, 2012

Best advice I can give you is to make lists and more lists. I have lists (with room number, NOT name) of which people get meds (and what meds at what dose), blood sugar checks, narcs, what treatments, allergies, code statuses, etc. I update is when I go to pass meds or do treatments with the MAR and TAR (I always look before I pop the pills out into the cup, even if I know exactly what they get) and I will know exactly where I stand if one needs an atb (allergywise) or codes, right there with me on my car. Save the demanding patients for last if possible to save time. ALSO, don't take a crappy report, you'd be shocked to find the things I "learn" during my shift that were neglected in report. Also, make a copy of the doctor list, pharmacy numbers, manager extension, etc and put it on your clipboard too. Always keep scissors and skin tear dressing supplies on the cart, and don't be afraid to call that grouchy doc, better safe than sorry, even if it's a dumb question and the doctor thinks I'm an idiot, at least I was safe.
I had nightmares the first few weeks, worried I was missing things, but have gotten better at quick assessments (as this is all you have time for) and picking up subtle changes in people now that I know them. Now I have a destress routine after work so I no longer carry work problems to my home as well. :)

ahaha I ABSOLUTELY LOVE LISTS! They make everything much easier and things fall into place with them. I'm glad to know that I can continue using them in the workplace! :) I use them currently for assignments and projects that need to be done for what class when and how, they are life savers even at my schooling level :) I think I know what you mean by checking even if you know what you need for a patient as well I check notes when doing assignments at the moment even when I know the answers as it never hurts to be double safe that you have everything you need. As you said its better to be safe and that would help with knowing where we stand.

Saving time by going for the demanding patients last also is something that makes sense. Something I wouldn't have thought of firsthand so thanks for the tip I'll be sure to be on the lookout for it during my CNA course this summer and will be trying it out as well when I get in my nursing programs.

Learning things about the shift seems to be a problem where I work at the moment as well. If I don't take the time to look for problems that can happen during a shift it seems they occur as no one tells anybody about them.:icon_roll Its bothersome but I've begun to get used to it.

I agree with the better safe than sorry statement as well. I'd rather call up a doctor and have him or her be a little angry rather than put a patient in harms way because i'm to afraid of talking to a grouch xD Hopefully your doctors aren't too grouchy when you need them

Thats to be expected :3 Everything comes with experience is something that I have been told time and time again, I will probably be the same way when I start :lol2: and de-stress routines are helpful now so I will keep mine for the rest of my life!

JZ_RN · May 3, 2012

One final tip: If you work nights- shut off your phone (I allow mine to ring only for my ICE contacts and my alarm) and invest in black out drapes.

JonJP · May 3, 2012

One final tip: If you work nights- shut off your phone (I allow mine to ring only for my ICE contacts and my alarm) and invest in black out drapes.

The drapes my dad taught me that trick xD Its so hard sleeping during the day

and my phone will be forever off and if people continue calling me I would cancel my home phone service xD

Thanks for all the advice :) You made me feel loads better about the program now that I know what I'm getting into :3 and the tips sound wonderful and I can't wait to see how they work in practice x)

THANK YOU SO MUCH :w00t:

CapeCodMermaid, RN · May 3, 2012

Here is my advice and I've been in long term care since dinosaurs roamed the earth:

Don't listen to people or posters who tell you that all facilities are horrible. I've worked in run down places and beautiful upscale places and no matter what the place looked like, the staff were committed to give excellent care.

I've been a nurses' aide to a DON and everything in between. There are excellent facilities out there with plenty of supplies and reasonable staff.

You can make a difference in someone's life every day.

Not all managers are money grubbing devils.

If you want to work in LTC...listen to yourself.

JonJP · May 4, 2012

Here is my advice and I've been in long term care since dinosaurs roamed the earth:
Don't listen to people or posters who tell you that all facilities are horrible. I've worked in run down places and beautiful upscale places and no matter what the place looked like, the staff were committed to give excellent care.
I've been a nurses' aide to a DON and everything in between. There are excellent facilities out there with plenty of supplies and reasonable staff.
You can make a difference in someone's life every day.
Not all managers are money grubbing devils.
If you want to work in LTC...listen to yourself.

Hello and thanks for the advice!

After looking into what the job is about, this really is what I want to do most. I love elderly people and I want to try and make a difference in as many of their lives as I can. I just wanted to know some of the challenges that some LTC nurses feel they face so I know what I'm getting into. I don't imagine every facility can be a horrid place to work at and with stories like yours I feel like it's the truth. I've also read a lot of happy and fulfilled stories from nurses who work in LTC :yeah: so I'm looking forward to getting farther into it despite some of the challenges I may or may not face.

Thanks so much for the encouragement as well. It is nice having people tell me listening to myself and my dreams is a good thing xD Especially people like you who have experience in what I'm going after. It makes me feel like I'm doing the right thing for sure ^^

And wow a Don that would be interesting It sounds like you have quite the fun carrear I hope it continues to be interesting for you :hug:

Again thank you so much! :)

RpeNa · May 4, 2012

What to expect?...excitement when you notice your residents trust you, or when they are discharged from hospice because they no longer qualify d/t thriving! Sadness when someone passes .... Gratitude when a family member calls to thank you for taking good care of their mom, dad, sister, brother, aunt or uncle. Overwhelmed. just to name a few... Go with your instincts... I knew going into nursing school that I wanted to work in long term care. Its a very rewarding place to work... Ofcourse you will feel frustration when you have cnas who are lazy and dont seem to care... But I dont think I would work anywhere else.. :)