Thrown in head first

  1. The first facility I went to ever as an agency LPN gave me a night to shadow a nurse before passing meds the next day. Well, now, this next facility I didn't so much get thru the door and they wanted to give me the keys. I told them I was there for orientation as I had never worked there. Well, it didn't happen and I spent the night behind the med cart and none of the patients had wristbands on and the MAR pictures were way out of date. So I had to rely on another nurse(who had only been there a week) and NAs to point out the patients. Do you all get an orientation before you take over a floor or just get thrown in cold?
    •  
  2. 12 Comments

  3. by   ZASHAGALKA
    As agency, you are not intrinsic staff that the company has a vested interest in bringing up to snuff.

    You are SUPPOSED to be able to 'hit the ground running'. They aren't paying you for your long term availability. They are paying you to be an effective contribution to staffing, today.

    I worked agency before. I never had more than a walkthrough of where things are and an invitation to ask for help, if I needed it.

    I didn't see this as a negative thing. After all, THAT is why they were paying me. I consider being an agency nurse means having the organization and ability to hit the ground running.

    ~faith,
    Timothy.
  4. by   LadyNASDAQ
    I have worked local agency for years and years. Trust me... what's an orientation especially in small hospitals!

    The whole deal is experience. You could throw me into Nebraska,Idaho, Hawaii or Rhode Island. I have worked all kinds of hospitals with all kinds of situations with computerized vs paper charting and yes, have even been asked to take charge. This is an example of how critical our Nursing shortage is out there.

    Do you know that the average time that most new grads last working is? ( months to 1 year. They really see how hard a life it is and what it entails. You wake up early and you work hard. You are a laborer and as we call it, you walk the floors for some people both emotionally and physically.

    As Local Agency, we get paid more but our assignments can be harder, more imbalanced and many staff Nurses take exception for this like you're an intruder until they get to know you and also they don't get hot with extra patients to care for.

    Keep your skills up and learn the ins and outs. I've been doing this for 28 years. I do travel, Local Agency and later plan to go to N. Calif. and work in house agency. It's truly the smorgasbord of all fields. I am living in a paid for home with a nice paid for car with no debts. I also work hard to stay that way so I am saying if you love what you do, work for what you want. Eventally you will retire and have something to show for it later on.
  5. by   bshaw96
    Pretty much the norm. As long as you tell me who needs their meds crushed and who may die on me today, I'm good. Actually, it's a little unnerving when I go to a facility that tries to hold my hand the whole shift. I just want to scream " I know what I"m doing, RELAX!" Of course, at least they care!, I tell myself :spin: I can't imagine a whole shift for orientation, but it was nice of them to do that for ya!
  6. by   gt4everpn
    Agencies usually don't give very long orientations at all, my advice find a hosp or LTC facility that will give u a good orientation, you need it , your a newbie I assume, or if not just try your best to pick up on things - and fast! Good Luck!
  7. by   feisty_lpn
    Wow. You got an orientation?? Count your blessings on that one. I've been an agency LPN for a year and I have never once received an orientation. And I go to all sorts of facilities... hospitals, LTC/AL, in-patient rehab, prisons/jails, residential psych. Most of the time, I don't even know which floor I'm assigned to, let alone which building. I find out when I get there.
  8. by   txspadequeenRN
    since when do agency nurses get a orientation besides an orientation to paperwork...been a agency nurse for many years...never..and i mean never had a orientation longer than 1 hour and that is only to sign my life away about hippa or however you spell it......when you are a agency nurse you should be able to come in at any point during the shift and pick up the patient load without missing a beat....
  9. by   gt4everpn
    Quote from feisty_lpn
    Wow. You got an orientation?? Count your blessings on that one. I've been an agency LPN for a year and I have never once received an orientation. And I go to all sorts of facilities... hospitals, LTC/AL, in-patient rehab, prisons/jails, residential psych. Most of the time, I don't even know which floor I'm assigned to, let alone which building. I find out when I get there.
    Hey fiestypn, did you get orientation as a new grad or were you already experienced when you started working for an agency?
  10. by   feisty_lpn
    Quote from gt4everpn
    Hey fiestypn, did you get orientation as a new grad or were you already experienced when you started working for an agency?

    I had a year under my belt in LTC (psych and MRDD). Then I had pregnancy complications and took 7 months off. I went back into nursing last May as agency. I guess you could say I was a new grad. I sure felt like one after 7 months off, let me tell you.

    Most agencies require at least a year, but I've heard of some that allow 6 months. I certainly don't know of any that hire new grads. A new grad working as agency? Thats asking for trouble and jeopardizes patient safety, IMO.
  11. by   mimimartina
    Just curious...I've been in school for the past 2 years, and am about to begin job hunting for a LTC (LPN) position. You that work agency, what is your "secret" to identifying patients without wristbands, getting the meds out in a timely manner when they are scattered here and there and no current pictures to identify them. I remember my 1st LTC job, my morning med pass took me hours and hours....that was a long time ago when I had 63 residents to give meds to, but even now 30 is average,,that's still a lot of people to not "know" who they are or what they look like, or which drawer their meds are in....Any tips ????
  12. by   feisty_lpn
    mimi - That was a big issue for me too when I first started agency. Then I figured out a system that works well for me.

    1] I make sure to ask the previous nurse during report who takes their meds whole, crushed, or tube.

    2] I go through the MAR book. I write on my report sheet beside each pt's name... med times, insulin times, accu-check times, narcs, aerosols, BP and P checks, etc. I love MARs that have tabs to pull because I can just use those and color code my times (7am = red tab, Noon = green tab, etc). But I still write everything else on my report sheet and I take that with me EVERYWHERE. It lays on the top of my med cart during the med pass for easy reference. When that pt's meds are passed, I either cross the time off my sheet or push in the tab.

    3] I start my med pass at the beginning of the MAR book. If that patient is not in their room, I go to the next one. After I get all the 'roomed pts' finished, then I concentrate on the AWOLs (thats what I call them, to myself of course, if they're not in their room). They're generally in the dining room. I am not shy about asking an aide or dietary where I can find the person I'm looking for. Once in a great while, someone will be in PT and I'll have to go to them or wait for them to get back.

    I know that sounds like alot of work, especially at the beginning of the shift. But honestly, its a time-saver. I spend roughly 30 secs on each pt's MAR, making my notes. The 10-15mins I spend doing that saves me a whole lot of frustration/confusion/headaches throughout my shift. Before I started doing this, a med pass for 24 patients I never met before that shift would take me nearly 3 hours. Now, even double-checking the MAR to make sure I don't miss anything, an HS med pass for 26 patients takes me about 90 minutes.

    The med cart usually is labelled with patient names or room numbers. I have yet to have a med cart that was "naked".

    HTH
  13. by   kiszi
    fiesty-- You worked only in LTC before agency? Was it difficult to transition to hospital work? I plan to go agency after first year is up, and I was wondering about that. Did the agency mind that you didn't have hosp. experience? I think I can do well in the hospital, but I don't know since I haven't been in a hospital since clinicals! Fiestylpn or anyone, any insight?
  14. by   feisty_lpn
    kiszi - Hospital work is definately different from LTC. The only hospital experience I had was from nursing school clinicals. When my agency asked me if I'd be willing to do acute care, I absolutely jumped on it and I LOVE IT! I admit the 1st 3 or 4 shifts kicked my butt and I felt like a brand new nurse thrown to the wolves. I left the 1st two shifts in tears... from bil feet pain and frustration. I seriously had thoughts that nursing is not for me, what the heck was I thinking, etc. I was ready to quit nursing altogether. It didn't help that the charge RNs treated me like crap... rolling their eyes when I had a question or let them know pt needed an IV push, etc. But I toughed it out and now I beg for hospital shifts. LOL

    Now, when I leave a hospital shift... I feel like I've done 'real nursing'. LTC is nursing, don't get me wrong. Its just a different kind of nursing and not one I want to do for the rest of my career. Although it is nice that I can take a LTC shift after doing a few hospital shifts... slow down a bit and enjoy the calm. And not leave with a sore feet and back too. LOL

    I dont recommend that you accept hospital shifts from the start since you don't have experience. Being agency is hard enough the first few months. At least it was for me.

    HTH, GL

Must Read Topics


close