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What is a typical day like?

Posted

Specializes in Telemetry, CCU.

Hi all you LTC nurses out there! Believe it or not, the hospital I work at will be laying off 20 or so nurses after the first of the year, unless enough retire early or resign (with severance pay) before Dec. 31st. Since I have been at my facility for less than a year, I might be getting laid off simply due to lack of seniority :crying2: There are two other hospitals close to home but the chances of getting a job there are looking slim because there isn't much hiring going on around here.

So my question is: What is a typical day (or night) like in LTC? What kind of assessments are done? I am used to doing a thorough assessment each shift, vitals Q4 hours and work on a tele unit. I hear a lot about passing meds in LTC but am curious about what the other duties are. What things are you typically calling the doctors for?

Also, what are some questions to ask the DON when interviewing? What are some red flags to look for?

I really enjoy working with the elderly but of course I am a bit nervous of the unknown. I am very much in a comfortable place working in telemetry but I think I will enjoy LTC very much as long as the management is good.

Any info about LTC would help!!

Well I'm an LPN in a LTC and have been doing it for a little over a year now at a couple facilities. I usually work the 2p-10p or 3p-11p depending on the facility.

Day starts with report that usually takes 5-10 minutes. Very simple report, who's fallen, skin tears, antibiotics, no BM etc.

After report I get all my assessments done. Usually brief focused assessments for antibiotics, wounds, IR's. Skilled residents are the only ones that really get a full head to toe.

Once those are done, usually by 1500 I give any scheduled breathing Tx and other little things depending on the day. At 1600 do any fingersticks that are needed and then usually take a break at 1630 before dinner.

If it is my day to be in the dining room, then that is where I am from 1700- 1815 or so. If it's not my day for the dining room then I answer call lights during that time and get the faxes/orders done.

After dinner I take my dinner break then get all the evening treatments done that can take from 1-3 hours depending on how many and what they are. Then do HS fingersticks.

All through the day I try to stay caught up on charting and faxes so I don't have much to do in the last hour or so. This gives me some extra time in case there is an IR or have to ship someone out and I'm not stuck there till midnight noting orders. It is rare that I do not get out at my scheduled time.

During an interview the I would definitely find out about staffing of med aides and CNA's. If they routinely don't stay adequately staffed then your job will be much more difficult.

Remember while you are a nurse and it is a medical facility, it is also their home and many residents do only need minimal care and perform much on their own.

achot chavi

Specializes in acute care and geriatric. Has 20 years experience.

hi all you ltc nurses out there!

so my question is: what is a typical day (or night) like in ltc? what kind of assessments are done? .... what things are you typically calling the doctors for?

every facility is different, and you will have to be flexible and learn- mostly assessments are adl related, vitals, skin assessments, hearing, vision, pain, toileting skills, etc.

we call the doctor for pretty much the same things you do in the hospital- change in condition, vitals unstable- fever, pain that doesn;t respond to current treatment, suspected uti or resp infection, skin breakdown (some places let you start treatment and just tell the doc when s/he comes in) i am sure that there is more- and others can add- like i said- be flexible and expect to learn from mistakes

also, what are some questions to ask the don when interviewing? what are some red flags to look for?

to look for: is the place clean, neat, smelly, well decorated, cheerful, bathrooms well stocked, do the patients look well cared for, what projects have they undertaken...

as to questions- it depends what is important to you- salary, benefits, what responsibilities will be expected of you, vacation days, how much of an orientation will you get, to whom are you accountable- who is your immediate supervisor, etc

i really enjoy working with the elderly but of course i am a bit nervous of the unknown. i am very much in a comfortable place working in telemetry but i think i will enjoy ltc very much as long as the management is good.

any info about ltc would help!!

ltc is a great opportunity to develop long term relationships and set goals that you couldn't do in a hosp setting. you want to focus on holistic care- seeing the whole patient instead of just parts, you will grow close to your patients, and their families and that is a good thing. you will learn to use your creativity but stick to the nuts and bolts of the job and of nursing theory- they are important.

i hope you found this helpful- all the best and good luck

I've been a LPN in a LTC for about six months. The heaviest med pass is in the morning. Its not uncommon for a resident to have ten meds at 0800. You will have between 20-30 residents. Also many residents have DM so there is the BG monitoring and insulin. There maybe tube feedings. There will be neb treatments, wound treatments. The NP's order labs that have to be called in and orders taken and faxed to the pharmacy. There are often behaviors that have to be addressed. The facility that I work at is still all paper charting on the LTC units so that has to be done also. All in all, it's a full day. One other thing, people pass away on this unit and sometimes you've really developed a relationship with them and that can be tough to deal with. I love my job. I feel I make a difference in the residents lives every day.

is the 3-11 shift as bad as some think??I know timing is bad with your own family but is med pass worse at this time??is the actual shift easier or harder then say a 7-3

is the 3-11 shift as bad as some think??I know timing is bad with your own family but is med pass worse at this time??is the actual shift easier or harder then say a 7-3

3-11 is my favorite shift. All the administration is usually gone by 5pm. Everyone is back from Dr.'s appointments and trips with family by then. Most of any new admit stuff to be done is done by 5 or 6. Faxes from Dr.'s are all done by 6. You only have one meal instead of two.

On 7-3 you start your day off running then usually slow down where as your 3-11 is just a steady even keel with a little pick up around dinner and bed time. Plus from 9-11 everyone is in bed and you can catch up on any charting.

thank you,it seems like this is the only shift out there at this time and I am just worried

thank you,it seems like this is the only shift out there at this time and I am just worried

It is frequently the only shift available and where many people start. I think the number one reason for this is because it takes away from family time 4-5 days a week. But if you don't have a family yet, it's the perfect shift. Still can go out at nights with friends, don't have to get up early and have most of the day to do stuff. During the summer I can be found at the pool or lake everyday before work :)

thank you,it seems like this is the only shift out there at this time and I am just worried

Wow I feel dumb now... it's early ok. Disregard my last post. You will miss time with your kids in the evening but you will also have the time with them before school not to mention that summer time you will be able to be around them during the day.

I really think the 3-11 is a great place to start. There is always turnover so in a few months a day spot may open up if you decide you want it or another home in your area may have one open up.

Thats okay LOL,my kids are kinda older a preteen,teenager and one away in college but dad is very involved when he is home and has somewhat flexable if need be.wish me luck because again I am having a hard time finding a job in my area

Thats okay LOL,my kids are kinda older a preteen,teenager and one away in college but dad is very involved when he is home and has somewhat flexable if need be.wish me luck because again I am having a hard time finding a job in my area

Good luck to you!! I reread your original post and noticed that you might be leaving a hospital. One thing I have noticed is hospital nurses tend to be overwhelmed by the sheer ratio you will have in nursing homes vs. hospitals. But again, it is their home and there are many residents that require nothing but a smile and a 'howdy' in passing and then there are even more that require only that and maybe some barrier cream at HS. For the most part, the acuity of most residents is very low.

I am actually a new LPN looking in LTC never worked hospital and in my area never will as an LPN

okay another question,there is an 11-7 open,how would that be??anyone ever do this shift??

achot chavi

Specializes in acute care and geriatric. Has 20 years experience.

okay another question,there is an 11-7 open,how would that be??anyone ever do this shift??

Did it for 7 years while my kids were very young- it takes getting used to- your body might or might not adjust. Some nurses love it - the peace and quiet...

When you arrive the pts are in bed (or should be unless they want to stay up and watch TV) You get report, make rounds, do charting, do vitals, give meds if needed. Its usually calm ( unless the flu is going around and then you are jumping from pt to pt as the ratio is higher at night). The hours of 5 to 7 are more active as you "open" the unit and pts start to get up. Every facility has its own schedule and demands on the night shift. If you work only nights and then come in once day you will not recognize your pts.

You also get night differential in your salary.

Latest research connects working nights with a rise in certain cancers due to the inbalance of the hormone Melatonin.

If you drive you must be careful- both coming and leaving work (theres another thread on that)

You must learn to sleep in the mornings. I used to come home at 7:30, do a bit o housework till i was sleepy( about 10) then slept till 3 or 4. My kids still tell humorous stories of me during that sleep deprived state. I remember fighting more with my neighbors!

My advise: try it and see!

Good Luck

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