Contrary to the stereotype of care home nursing being ‘deskilling’ and harder work, nursing in a care home can actually be very a fulfilling career path.

Working in social care as a nurse means your work directly impacts a resident’s health and wellbeing, which can be incredibly rewarding when the outcome is positive.

However, it can equally be a challenging role that calls on your soft skills, such as quick decision making as well as complex clinical skills.

As much as you can positively impact a resident’s wellbeing, when things go wrong it can be especially hard.

If you are thinking of becoming a care home nurse, here are a few things you should know before you start out.

1. Don't expect to know everything!

As you would expect, care home nursing requires in-depth knowledge of conditions associated with ageing and understanding of frailty in residents.

Before you start your first shift as a care home nurse, it would be a good idea to do some research and know what is expected of you.

Most care home nurses apply and maintain a person-centred approach to their work and build good relationships with residents and family members.

However, no matter how much you prepare - on your first day on the job, you’ll be a bundle of nerves. Don’t set yourself up for failure by pretending to know everything.

Remember: It’s always better to ask questions than to assume and make avoidable mistakes!

2. Mistakes are practically inevitable. Don’t sweat it.

Despite you doing the right thing and asking questions, mistakes can still happen. As long as you follow correct procedures, and report any issues - you should be fine.

Additionally, you should never hide or try to pass a problem onto someone else.

There’s several resources on how to give a good handover as an independent nurse so you can communicate any issues or mistakes in a professional way.

When working as a care home nurse, holding yourself accountable is incredibly important - perhaps even more so as a care home nurse as you care for particularly vulnerable groups.

Remember, everyone is busy, including yourself. Try and organise your time so you get things right the first time. Learn from mistakes but don’t dwell on them.

3. You will spend more time than you think working on your own.

As a care home nurse you will find there’s always something to do so you may find yourself rushed off your feet.

Everyone has their own workload to manage and you will find yourself working independently during most of your shift.

On the other hand, you will have the chance to develop your leadership and decision-making skills whilst working in a care home.

If you find working independently to be an isolating experience, you can try to catch up with colleagues over coffee breaks.

4. Put your patients first.

Protocols and schedules are put in place with the best interests of the patient in mind. As mentioned before, many nurses who work in care homes use a person-centred approach to nursing.

There are several online resources available to nurses and health professionals, looking to adopt or maintain person-centred approach to care.

Remember - what you call work, residents call their home. Make time to listen to your patients and put their self-defined needs as a priority where possible – try to make their living situation as pleasant as possible.

5. Look after yourself too!

Often as a care home nurse you will be so busy that it will feel impossible to have a break. But if you are running on empty, it will be impossible for you to give 100%!

Although it’s tempting, try to stay away from quick fixes such as chocolate bars and instead try to take healthy and nutritious food in with you.

It’s worth noting that there are several active campaigns surrounding mental health for nurses, as well as safe staffing legislation which you can get involved in.

Resources for nurses facing hardship or in need of support include:

Cavell Nurses’ Trust

The RCN

6. A bad day doesn’t make you a bad nurse.

Care homes can be a demanding environment to work in, and often you will be on your feet most of the day.

Your shift may be short staffed, you may have demanding patients or you may not have a lunch break until late in the day - everyone has bad days.

Don’t let the stress of a bad day continue into your free time - remember to give yourself a break.

You’re still human - even if you don’t react in the most exemplary manner during a bad shift, it’s not the end of the world.

Stop, take a pause for breath and remember, one bad day (or a run of them) doesn’t mean you are a bad nurse.

7. Shifts may not always end on time!

If your colleague is running late, you may have to stay a bit longer than you like after a shift.

You should expect for this to happen as a care home nurse - anything can happen at one given moment and patients are particularly vulnerable.

You may even experience last minute pleas from your manager asking you to work on your days off when a colleague disappoints.

You may not always be able to step in and fill the breach (after all we all have a life outside nursing…don’t we?) but remember it may be you doing the asking one day – what goes around comes around!

8. Understand that you are more than a nurse!

Nursing in a care home is often stereotyped as a boring career, but you’ll be surprised to find the reality is quite different.

Especially when working with vulnerable groups, you’ll find the opportunity to build a closer relationship with residents and their families is bigger than if you worked in a hospital.

You’ll soon realise that with care home nursing comes a multitude of job roles you’ll have to fill to do your job! Waiter, technology guru, family mediator, counsellor, housekeeper – you name it and as a nurse you will probably end up doing it.

9. Keep notes!

Even the best memory in the world would struggle to recall everything that goes on in a nursing shift so write it all down.

Carry a small notebook and jot it all down so that in the event of a problem you have an accurate record, made at the time. Writing notes down throughout your day can also help you with handover.

10. Watching someone die will never get easier (despite what you may hear)

Whether it’s your 1st or 100th time, watching a patient pass away is never easy. If you work in a care home with a significant proportion of residents receiving palliative care - patient death will occur more often than average.

You will learn to cope with experience, but be prepared for each death to affect you differently.

Don’t allow yourself to become accustomed to patient deaths, as you will appear to lack compassion. Always be composed but never appear not to care.

11. You will feel more tired than you ever thought possible

Tiredness is a given in a role which involves being on your feet for hours at a time. You will experience all sorts of aches, from head to toe and you could end up with persistent back and feet problems.

Fortunately, there are ways to combat these common problems for nurses. Investing in good shoes can make all the difference to how you feel after a shift.

You can also ward off chronic back pain with exercises such as yoga or weight training to increase your core strength and correct your posture.

12. Expect your family and friends to treat you as a walking medical dictionary!

You will be expected to be the front of all knowledge – be prepared.

Always remember to let them know that regardless of their relationship with you they should always seek medical advice from their GP.

13. You will miss out on a social life.

As you know, shifts are often 12 hours and often at unsociable times such as evenings and weekends.

It is unfortunately inevitable that you will more than occasionally miss nights out, birthdays and other special occasions.

Make sure you are prepared for this and that your family and friends are too.

14. Be very sure!

Make sure nursing is what you really want to do before you start your training. You need commitment, energy and staying power.

Do your research, talk to other care home nurses and understand the role from their perspective.

The personal rewards of a nursing career are enormous – but it is not an easy path.

Unhelpful stereotypes of nursing (mopping the fevered brow of a soldier and serving tea) has hindered this respected and skilled profession.

It’s up to us - healthcare professionals and those in the health & social care sector to break those stereotypes and be proud of our work.

Become an independent nurse and choose when and where you work.

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