[NREMT-P/RN]

If you are not comfortable, you are not comfortable.

Period.

3 days and be told to "Go forth, may God be with you", not good.

Your license and future are in your hands. Protect them.

Another poster mentions 3 days orientation and then "Poof!". Yep, that is true for experienced travelers. New grads with zero experience - just say no.

I say don't call out and resign. Bad form. Explain your position and then part on up-front terms if you cannot resolve the situation. Just makes for good juju in the future.

Good Luck.

Practice SAFE!

[GrumpyRN63]

Originally Posted by trimeduLPN

Yes, it is a LTF. But it's not easy at all. The responsibility that is on a nurse is a lot. Anything that goes wrong would fall on me because I would be the only nurse covering the unit at night.

I am only asking b/c I don't know what the usual orientation in a LTF for a new grad would be and/or if you had a orientation commitment in writing, I know for the hospital its 12 plus weeks, regardless, 4 days is b*ll$hit, I am sure the work is not easy, I personally wouldn't care for 30 pts myself,even if I luv the old people, and these days they are much more complex then when I started out.
I'd hit the road, you don't owe them anything, sounds very unsafe. Just pretend it never happened, you don't need to explain it to future employees or put it on your resume, you don't owe them 2 hours nevermind 2 weeks, get a fresh start, good luck!!

[pagandeva2000]

Unfortunately, I keep hearing that this is the norm for LTC, which is why I avoid them like the plague. How can it be that there is one nurse covering a shift in an entire facility? I don't even like the idea of working alone on a floor! I have heard of one LPN working with 60 patients in a unit alone, with 2 or 3 CNAs. It makes me get the willies just thinking about it, and this also shows me just how much they devalue the elderly and helpless.

[TheCommuter]

I hope I can disagree with everyone, without being too disagreeable.

I have spent my entire short career in LTCFs. In my metropolitan area, the typical orientation period in nursing homes is 3 days before the nurse is cut loose to start working the floor on his/her own. At my first job right out of school, I received a whopping 8 hours of orientation before being "thrown to the wolves" to work on my own.

Here are the realities of nursing homes. They are extremely desperate for staff, and they typically do not have the time or money to train nurses for extended periods of time. A 4 to 8 week preceptorship is simply not within the budget of most LTCFs.

In addition, it is assumed that licensed nurses should have learned basic nursing skills in school. The orientation period in LTCFs is primarily used to familiarize oneself with the paperwork, residents, facility layout, and routines. The nursing home is paying you in exchange for your labor. They're not offering you a paid practicum period.

This is why I have so much respect for charge nurses in LTC. They started with virtually no support or training, accrued knowledge and experience on the job, and are able to do amazing things for their residents. You need to be an independent, motivated person who is willing to "jump in there" if you are to succeed in the caustic environment of the nursing home.

[trimeduLPN]

Originally Posted by TheCommuter

I hope I can disagree with everyone, without being too disagreeable.

I have spent my entire short career in LTCFs. In my metropolitan area, the typical orientation period in nursing homes is 3 days before the nurse is cut loose to start working the floor on his/her own. At my first job right out of school, I received a whopping 8 hours of orientation before being "thrown to the wolves" to work on my own.

Here are the realities of nursing homes. They are extremely desperate for staff, and they typically do not have the time or money to train nurses for extended periods of time. A 4 to 8 week preceptorship is simply not within the budget of most LTCFs.

In addition, it is assumed that licensed nurses should have learned basic nursing skills in school. The orientation period in LTCFs is primarily used to familiarize oneself with the paperwork, residents, facility layout, and routines. The nursing home is paying you in exchange for your labor. They're not offering you a paid practicum period.

This is why I have so much respect for charge nurses in LTC. They started with virtually no support or training, accrued knowledge and experience on the job, and are able to do amazing things for their residents. You need to be an independent, motivated person who is willing to "jump in there" if you are to succeed in the caustic environment of the nursing home.

I am not speaking of nursing skills. I have no problems with wound care, labs, pegs, giving meds, etc. Its the paperwork, not knowing the unit or the residents, etc. Im sure there are those that will hit the ground running and dont care whether something happens and they are reported to the board and it comes back to the DON saying, well she never said she needed more time. I have worked very hard to get my license, and I dont want to lose it because im expected to handle a 33 pt unit alone with 2 CNA's after 2 nights of orienting on nights. Last night, I was able to handle 18 patient on my own. But I prefer to feel comfortable. I dont want to be one of those nurses that are thrown in to sink or swim, and end up drowning.

Thanks

[TheCommuter]

Originally Posted by trimeduLPN

I dont want to be one of those nurses that are thrown in to sink or swim, and end up drowning.

If you feel that uncomfortable with large patient loads, perhaps it is time to start submitting your applications at acute care hospitals where the patient loads always tend to be much lower than those being presented at nursing homes. Bouncing to another LTCF will, unfortunately, bring more of the same: more patients, short orientation periods, and so forth.

[earle58]

Originally Posted by TheCommuter

If you feel that uncomfortable with large patient loads, perhaps it is time to start submitting your applications at acute care hospitals where the patient loads always tend to be much lower than those being presented at nursing homes. Bouncing to another LTCF will, unfortunately, bring more of the same: more patients, short orientation periods, and so forth.

maybe it's that way in your immediate area, commuter.
here around boston, new grads get anywhere from 3-4 wks of orientation:
some ltc facilities, even longer.

i'd love to hear what other states get.

leslie

[ingelein]

Here in WI , its the same as Commuter describes,lucky if you get a week of orientation and if you have experience a night or two, or none, as in my last place of employment.I worked there over 5 years, 67 patients and 4 CNAs ,night shift. One supervisor that was so busy helping on the acute care unit that she often never made it up to my floor.

[trimeduLPN]

Originally Posted by TheCommuter

If you feel that uncomfortable with large patient loads, perhaps it is time to start submitting your applications at acute care hospitals where the patient loads always tend to be much lower than those being presented at nursing homes. Bouncing to another LTCF will, unfortunately, bring more of the same: more patients, short orientation periods, and so forth.

Well, my first day on orientation, I was able to handle 18 patients. Maybe on my 2nd day, I will be able to handle more. I am not a quitter. I just dont like the way they treat the new grads. Im not bouncing around. I actually interviewed at this other LTCF before I got this job. Another influence in me taking the other position is that I live 2 minutes away from this other LTCF instead of 25 min.

I dont bounce around. The position I held before as a Tech in the hospital was for over 6 yrs. I believe in a challenge, and I love being pushed. But not being pushed off the cliff. If im equipped with the information I need, I can do anything.

And im sorry that you feel I should give up because I came here for opinions on my 1st week on the job.

[TheCommuter]

Originally Posted by trimeduLPN

And im sorry that you feel I should give up because I came here for opinions on my 1st week on the job.

I don't feel strongly one way or the other regarding the issue of staying at or leaving your current place of employment. I don't know you personally, and I frankly do not possess the emotional involvement to have strong feelings about the decisions that you face.

You came to these forums for suggestions, and you are receiving them.