Working in a nursing home

[Jonathan55]

I am an RN. I have thought about exploring the world outside of the hospital. Nursing homes sound interesting because I like geriatrics.

When I mention this to colleagues I get mostly negative comments like: You wouldn't like it, you just supervise, or you just pass meds.

I have visited people I know in "nursing homes" and I know there is a huge difference in the physical surroundings.

I'd like to hear others experiences. Is it interesting? Boring? Crazy busy?

Thanks for any thoughts or opinions,

Jonathan

[TopazLover, BSN, RN]

When I was young I hated it. As I got a little older and started to understand more about the pace outside Critical Care, I fell in love with geriatrics. Nursing Homes can be great places if they staff correctly. Many of the for profit facilities seem to think it is better to short staff than go without new furniture in the lobby.

I love working with people with dementia so I have found time to spend with them. It really is love it or leave it.

Others may have different stories. I think if you like elders than at least try it. You do not have to be boxed in and you will get to do the most unusual assessments. Just a reminder that geri is like peds, when things go bad they do so quickly. Many problems exist that you might not look for until you have some time in geri under your belt.

[NCMountainWoman]

I graduated nursing school and did the requisite gig in med/surg to learn skills. Part of me wanted the excitement of the er, but i was not a spring chicken when i became a nurse. I took a prn job at the local nursing home to do something different and because I really found myself loving the elderly I worked with at the hospital. Here I am, became a staff nurse at the nursing home and now a wing supervisor on the dementia unit and I love it. I so adore my residents and it really makes my day to see them smile at me when I come in.

It can be difficult like any other field, just has it's own special plusses and minuses. And, again, it's all the facility you work at. You can love your residents, but if you are being beaten down by the facility itself it's hard. Ours just happens to have great management which makes it so much nicer. But I don't think I'll ever go back to the hospital, I just love my residents too much and I enjoy having the same people every day to work with.

so, hey, you can always work prn to see how you like it, or take a ft position and go on to something else if you don't like it, but i say take the plunge! Geriatrics needs great nurses.

Lisa

[CHATSDALE]

every thing has pluses and minuses

most rns in a nursing home do do supervisory work

but you learn to know the residents as humans with good/bad personalities

no niche is goof for everyone but all parts of nursing are important

[Valerie Salva, BSN, RN]

In the VA system, RNs in the nursing home pass meds, do incontinence rounds, get pts dressed, feed them, and so on. It's been kind of like going back to being an LPN or CNA again.

It is crazy-busy.

I've worked other nursing homes in which RNs mostly do med passes and chart.

[Daytonite, BSN, RN]

during the years i worked i often worked part time in nursing homes. i started and ended my career working full time in nursing homes. i loved them. there is a regular routine that you seldom deviate from because the elderly get upset and confused with dramatic routine changes. so, medications, diets and treatments tend to remain the same over longer periods of time. because of that you get very good at organizing because you will have a larger number of patients you will be responsible for. you will be a charge nurse in the strictest sense. you will be managing the care of the patients you are assigned to during your shift. you are expected to know facility policies as well as state regulations pertaining to the care of nursing home patients and follow them. you will also be supervising the cnas working with the patients you manage, so this may be the first time you will be exposed to the actual supervision of another person's work. delegation and supervision of tasks is extremely important to know or the cnas will walk all over you. because you are pretty much performing the supervisor's role as well, you need to know what to do in emergencies. there are generally not too many other nurses and usually no doctors around when a serious patient problem comes up. you can't always get a doctor on the phone. you probably will be the acting physical therapist, respiratory therapist, dietician, central supply person and maintenance guy some of the time. you will find that calling 911 isn't always the right thing, believe it or not. we do have to be aware of who is paying the patient's bill and who we can and can't order stuff from for them. i suppose the most aggravating thing of it is the state and federal laws that have to be followed. for hospitals it is jcaho that is feared; for ltc it is the state and federal regulations and these homes are inspected by medicare officials (it's called surveyed).

still, i thought that i had more autonomy in nursing homes than i ever had in acute hospitals and i was a supervisor and manager in the acute hospitals as well as a staff nurse for many years. i really learned more about one on one supervision of subordinate staff (and discipline) in nursing homes. you wear many hats in the nursing home so there is great opportunity to grow. but, if you want to go back to hospital nursing, it will be almost impossible. acute hospitals do not accept ltc experience in applicants applying for work.

[flashpoint]

:yeahthat:

[Jonathan55]

Thanks everyone for the input!