Warning to New Grads

mag_new · Oct 6, 2009

Thanks for sharing. Wish you the best in searching for the next job.

busymom101 · Oct 6, 2009

I am a new LPN grad, I started a job where I worked as a LNA. I left the position d/t to same conditions. A med pass that takes all shift to do, having no time to care for the residents. Having to get all your documentation done before the end of your shift, so that you don't get written up by the DON. I feel your pain.

BABO · Oct 7, 2009

WOW, that sounds scary, what area/city is this SNF at, from the link you posted did your SNF not meet requirments for staff? How much were you getting paid, if you don't mind me asking. I hope you find something better, good luck.

DestinedRN09 · Oct 7, 2009

Wow!!! Your story just solidified all of my convictions just taking any old job that comes my way! I wish you luck on your Job Search.

KAYBDT6, BSN, RN · Oct 8, 2009

Thanks for sharing your story.

ibme · Oct 8, 2009

I just quit today after two weeks. I thought I was lucky enough to land a job at a SNF/subacute place nearby. After the first week, I was in for a rude awakening.
I had only 5 days of orientation in a 98 bed facility and was labeled charge nurse. Half the place is LTC, the other half subacute. 1st and 2nd shift have 3 nurses--usually 1RN and 3 LVN; 3rd shift usually has 2LVNs. Once I was on my own, passing meds to about 35 pts (in the LTC side) pretty much took me my entire shift. It was overwhelming and frustrating. On top of that, since I was an RN, I was responsible to hang IVs for all IV pts, no matter what side. I barely had time to document, and little to no time to assess the pts. As a friend had said, it felt like an assembly line--and that's how I felt I was treating the pts. There was no time to chat, no time to care, no time to critically think. Many of the staff members actually work on their OWN time (i.e. Not getting paid!) to chart, since many of them are afraid to get too much overtime since Administration will question them about it and may affect their performance review.
Many of my co workers were trying to convince me to stay, saying that it'll get better, that everything will become routine. But why is it that they are still taking more than their shift to do their work? It's simple: it's understaffed.
I brought all my issues up to the DON. All she said to me was, "I told you it's a lot of work and that it's a lot of patients. It wasn't going to be easy." Of course I didn't expect the work to be "easy", but I explained to her that there was no amount of training that could help me provide quality patient care if there is no time given to do that. She said she would like to hire more nurses, but Administration apparently doesn't want to hire anymore for any one shift. She just didn't seem to care too much.
I just had to vent and bring this up to all you new grads. I know I'm not the only that experienced this since I spoke and heard about a few people that experienced the same thing. I just want to give you some advice if you're looking into LTC or SNF. Some things I wish I had done before hand:
1) Research the facility.
Go to http://www.medicare.gov/Nursing/Overview.asp and do a nursing home comparison.
2) Tour the facility.
You may not see everything that goes on behind the scenes with this, but at least it's a good overview of the place. It's better than making any judgements based on how nice the building looks upfront or the nice painting and furniture in the reception area.
3) Ask the DON a lot of questions.
How many beds? As a new grad RN what are the job responsibilities? The job description? Expectations? Number of patients in your care? What is used for documentation/charting?
4)If you do commit, remember to buy some malpractice insurance (I guess that goes for any place you work at, but especially at a high liability job)
I hope this will be of some help to someone out there considering a job in a nursing home. I understand that many of us are still looking for a hospital job, but the pickings are few and far between. I haven't given up hope in finding that job, or even finding a job at another, better LTC facility in the mean time, but these are just some things to consider... Hopefully it'll save you from being burnt out or at least some tears.

Thank you for sharing your story. I can't believe those conditions! This is EXACTLY why I refuse to start in a SNF because it seems like that is the trend among them-yes, I understand why it is like that, BUT I don't have to agree with it or be the nurse working there....along with the smells :eek: .

MauraRN · Oct 8, 2009

That is a very accurate description of so-called sub-acute care. I did 3 years as an LPN and our "sub-acutes" came straight out of ICU's in Boston, s/p CABG, total hips, laminectomies, neuosurg, etc. Got my RN this June, have a Bachelor's in another field, started my MSN , have TNCC Trauma Nurse Core Course, ACLS, PALS, IV Therapy Cert, Basic Dysrhythmia Course and have done 97 applications!! That's right, 97. Finally got thru on the phone today after much pushing at the HR clerk and got an actual nurse who told me the following; "I recognize your name, and I was so impressed with your resume that I walked it over to the Nurse Manager in the ED. She refuses to even interview you because you are just a "New Grad". Now this woman was plenty irritable because this ED is in dire need of nurses but won't hire new grads. So the moral of the story is sub-acute care doesn't count if you did it as an LPN, even if you started hundreds of IV's, ran codes, pronounced deaths, supervised staffs, ordered meds, performed therapies, and did major wound tx, including wound vacs, assessed pts for s/s of anything requiring an ambulance ride to the ED, change g-tubes, foley caths, remove prostetic eyes for cleansing, (yuk), remove staples, stitches, etc.

This situation may be unique to Massachusetts, for instance, we have to do pt summaries which are based on CNA reports and are used to bill Medicare. Most of us had to do them on our days off every month because no OT was allowed and even nurses like me, "aerobic nursing nurses" could not get them done without using my day off.

I am 52 years old and don't feel like waiting around for this profession to wake up. I think I may be moving on. :cry:

SuesquatchRN, BSN, RN · Oct 8, 2009

Oh, Maura, that bites.

SantaCruzNewGrad · Oct 9, 2009

Best post on LTC I have seen in these forums. I am in your same situation. I almost walked out today after getting chewed out about not being fast enough and too much overtime. I have 90 patients and 8 hours to do any treatments they need. I told them I am going as fast as I can while maintaining my standards for human dignity and treating my residents with compassion. If that doesn't work for them too bad. I refuse to compromise safe patient care so my DON doesn't get chewed out for too much overtime. Glad to know I am not the only New Grad RN standing up to the 'old guard.' I am sick of hearing other nurses say 'get used to it, you'll be just like me one day.' That is what's wrong with our health care system. It weeds out good people! Stay strong and keep up the good work.

Thank_You_RNs · Oct 10, 2009

Oh my god! I felt the same way. This is so true. I've been working in a LTC (SNF + Sub Acute) for almost 2 months now. And I am assigned to a Sub-Acute Unit 12 hour shift. Honestly, Im thinking of quitting it soon because of too much stress. Even though I have LVN's and CNA to delegate, I feel as if we're still understaff. Sometimes, I think if they do their job by the book, they wont have time to finish their duties (med pass, treatment nurse) even in a 12-hour shift because of too much work load. Yes, Passing meds may sound easy, but in this facility, its more than meets the eye! As a charge nurse, I feel as if my license is at risk everyday. I barely see patient because of excessive paperworks, follow ups (labs, pharmacy, physician's calls), family complaints, IV meds, meetings, etc.. I'm lucky if I get to eat lunch on time, which rarely happens. I feel sorry for some of the nurses who has to go thru all this trouble everyday because they don't have a choice to quit their job. I dont know maybe because they have luxury expenses (new house, new car, etc.) or have family back home (Philippines, Mexico, etc.) they have to support. For those who have choice, please research they job you're getting into. In this bad economy, its a tough choice.

iRN86 · Oct 10, 2009

Oh my god! I felt the same way. This is so true. I've been working in a LTC (SNF + Sub Acute) for almost 2 months now. And I am assigned to a Sub-Acute Unit 12 hour shift. Honestly, Im thinking of quitting it soon because of too much stress. Even though I have LVN's and CNA to delegate, I feel as if we're still understaff. Sometimes, I think if they do their job by the book, they wont have time to finish their duties (med pass, treatment nurse) even in a 12-hour shift because of too much work load. Yes, Passing meds may sound easy, but in this facility, its more than meets the eye! As a charge nurse, I feel as if my license is at risk everyday. I barely see patient because of excessive paperworks, follow ups (labs, pharmacy, physician's calls), family complaints, IV meds, meetings, etc.. I'm lucky if I get to eat lunch on time, which rarely happens. I feel sorry for some of the nurses who has to go thru all this trouble everyday because they don't have a choice to quit their job. I dont know maybe because they have luxury expenses (new house, new car, etc.) or have family back home (Philippines, Mexico, etc.) they have to support. For those who have choice, please research they job you're getting into. In this bad economy, its a tough choice.

whats your patient to nurse ratio?