[maestrotee]

I just started my first nursing job two weeks ago at a LTC facility and was thrown out on the floor with 12-18 patients after only 2 days of orientation!!! I guess that the staff 'shortage' has stretched them thin and I have to be utilized instead of just 'wasting' the company's time by following around a nurse! I have been doing this for a week and a half and, although things are starting to make a little more sense to me, how irresponsible is it for a facility to do this anyway? Today I had a new admit and I have NEVER seen this paperwork. Do you think anyone stayed to help me through it? NO! Every night I have been getting out at around 1 AM and my shift ends at 11:30. Has this happened to anyone else and how did you handle it? I am on a fast track to burn out!!! I want to look for another job, but I am getting paid more than at any other facility in the area ... atleast from what I hear. By the way, I have been written in on the schedule with 'orientation' written by my name, but something always takes the nurse that I am 'orienting' with away and leaves me with a whole hall of patients by myself. It is true that when I have a question I could ask another nurse, but do you know how much time would be wasted if I went looking in everybody else's room for this other nurse to ask them a question (50+ patients on our wing)? I'm don't even get all the charting that I know needs to be done when I leave 1-2 hours after my shift! I seriously don't know what to do. The noc nurses told me tonight to stick it out, that, if I learn all the stuff I need to know by this sink-or-swim approach, that I will make a great nurse. Is it really worth it, though?

[TheCommuter]

I started my first nursing job at an LTCF a couple of years ago and, while I was promised 3 days of orientation, I only received 1 eight hour shift of orientation before being cut loose to work the floor by myself. By the way, my patient load consisted of 30 elderly residents. Those first few days were admittedly overwhelming, but something started to occur. I began to adopt a routine, things became easier with the passage of time, and I began to feel more confident in my abilities and judgment.

The harsh reality is that nursing homes generally do not have large budgets for new employee orientation and training. When LTCFs hire a nurse, it is usually because their staffing needs are immediate and pressing. They need to get you on the floor as soon as humanly possible, regardless of your lack of real world experience in nursing. Nursing home managers also conclude that since you have graduated from a nursing program, you most likely have the basic skills to practice competently. Nursing home work is paid employment, not paid clinical practicum time.

I'd suggest for you to hang in there. Your patient load of 12 to 18 patients would be an absolute dream to many LTC nurses out there who cope with 30+ patients. You say the pay is good. The paperwork will become easier with time and grace. In addition, it is normal for even the most experienced LTC nurse to stay behind a couple of hours if they are working evenings, since that is generally the busiest shift. Good luck with whatever you decide.

[Fiona59]

When you graduate nursing school, it is assumed that you know your skills and meds. Orientation is to get used to the floor, the paperwork, and hopefully figure out who the patients are.

The longest I've ever had is four shifts and that was in acute care.

Fill in your overtime slips. When faced with having to pay you, help often becomes available.

[maestrotee]

Thanks for the replies. I know I will have to stick it out and one thing that I've noticed is that the things that tripped me up the first couple of days are getting progressively more routine. It just feels like every day there is that one or two something 'new' that is a struggle and time consuming ... and then I get behind on med-pass, or whatever. I am encouraged by your feedback, however. I know it will get better with time. I just don't want to do something harmful in the process.