depressed about new ltc job - Page 2

Hello Miss Jessica... I can so relate to your situation. I was very unsafe in my first nursing job. I went into nursing in my earyl 30's and was so excited to get my first job. After one week orinetation on a high risk antinetal floor, I was on my own from 11PM - 7 AM with one other nurse who was also a new grad... talk about unsafe!

Listen to your instincts... don't give meds off schedule. If your admin won't help you, look for another job. I did and then loved my life. I went to a major teaching hospital in Boston and had a ten week orientation with a preceptor and then staff support for the next twelve weeks. I learned tons...

Best of luck to you....

This is my first time posting on this site... I just found it today and love it. What a great resource for nurses. After 23 years in nursing, I now work from home and love it.

I'm a new LPN and started my first job working in an LTC in April. I work 7a to 7p every Sat and Sun.

Its really hard in the beginning until you get to know your residents. Now that I know their meds, accu check times, etc. my time management is getting better.

Its still a hard job, I'm always watching my time and trying to stay on top of everything that needs to be done. I usually have 20 residents to pass meds on, chart and do wound care. But this weekend I had 30 because we didn't have a third nurse for some reason or other. And no, I couldn't get everything done.

I can tell you that I have ended up in tears a few times at work. And I'm always waiting for that phone call on Monday giving me hell for missing something or other.

It does get better, I promise. I keep telling myself the same thing...it gets better.

I like my residents, even the needy ones who can consume a lot of my time. I had one this weekend who was terribly upset and acting out. She needed TLC. I made a phone call to someone special to her and my resident talked to her. Not even 10 minutes after getting off the phone this LOL was sound asleep. When she woke up she was in much better spirits. This made my day

I'm not a LVN but I worked for yrs as a CNA in LTC. At first it was really hard, we were so short handed most of the time I was the only CNA that worked there (not registry or NA student) So I was the go to person for every question! and I was pregnant! there were times I hated it so much, but after I had my son and went back to work, I realized under improved cautions in the same place, that I was glad I had that experience, I was ready for anything and every time we were short and everyone else was flipping out I was like "this is nothing we got this" and I was always done early without cutting corners and able to help out others and give extra care to those who needed it. I really think it was a very good learning experience. You may not stay there forever or even very long but you might learn how to handle a lot of things that will help you latter in your career and life.

as far as bending the rules again I'm not an LVN but I'd be careful about that, you don't want to be stuck in a situation that you can't even really recall were things went wrong or have feel guilty about something that something could have been avoided.

I have just finished my first week as a new grad RN at a sub-acute LTC. I sort of enjoyed it, and I'm starting to really know the residents. I also have pts with picc lines, g tubes and stuff, so I am doing more than just passing meds. I will still be working with another nurse for the next few weeks before I go on nights. I think you should ask for more orientation.

When I was on orientation, my preceptor told me that if there are residents that only gets a sleeping pill at night or 1-2 medicine at 9pm to just give it all at once by 5pm to save some time. Did I ever followed her advice? NO. Whatever you do, it's your license is on the line. What if that resident died before 9pm, and you gave her Ambien before the she is supposed to get it? How would you explain this situation? You were given an option, but that doesn't mean that it was the only choice you have.

When I started LTC, believe me, I didn't stop whining/complaining about my job. You could read all of my posts after I got the job. It wasn't my dream job. Being in nursing for quite awhile, I came to a realization that there's no 'DREAM JOB'. Every job will have its pros and cons and later on, you'll realize that your 'dream job' may not be really the kind of job you think of. But you know what? It does get better. There are days that I always still find time to interact with my patients. I take a quick minute or two to ask them how they are doing, share some stories and a whole bunch of stuff. It may seem like we're only shoving pills down people's throats but you could always change that perspective. And eventually you'll enjoy it. If it doesn't get better for you, then you just gotta find your niche. Everything takes time.

We need our jobs to pay the bills. But I truly believe the saying that, "We work to live not live to work. Life is short-lived. Try not to be miserable, if you are, it's time to change jobs."

Good Luck!

Giving meds ahead of schedule or all at 9pm is not something I am proud of but its one of the tricks of the trade.

Be careful about it and use your judgement, but if its a daily med or colace. Don't wake them up. Also I don't wake them up to give them ordered supplements either.

Yes with dementia patients I combine their meds in one, because sometimes all you have is one try to get it in.

I just finished my first year as a LPN in LTC. Like you, in the beginning, I was scared, depressed and hated my job.

It does get better! I'm no longer scared, don't dread going to work and while I don't love my job, I don't hate it either. I look at this experience as "basic training" or "boot camp" for my future endeavors.

I work nights, but have done all 3 shifts. You will develop a routine, get to know the residents, get to know the med passes and become more efficient as time goes on. No, you don't pass 1700 meds with 2030/HS meds.

Getting to know your meds and residents will help. Know why certain meds are given at certain times and how often they are given. You will get to know who goes to bed when, who easily takes meds and who is impossible to wake up once they are asleep. Then use common sense/nursing judgement to bend the rules (maybe not legal, but reality). If someone gets a statin once daily at HS and is in bed sound asleep by 1900, I will give it to then @ 1830. BP meds given q4 or q8 hours need to be kept in the legal timeframe (usually 1 hour before/after the stated time).

I work nights, so the AM med pass and FBS is for 0630. If I have an early riser, I have no problem giving synthroid or doing a FBS @ 0400 which gives me a jump on my AM med pass. However I will not give insulin that early as it is too far from breakfast. Again, know your meds - how they act, interact and react with the body and other meds will help you expidite your med pass and be safe at the same time.

It took me about 6 months before I felt in any way proficient and comfortable doing this. Give yourself time. Try to find an experienced nurse you can go to as a mentor to ask questions and get feedback. That helped me a lot! Best of luck to you.

HS meds are just that.. The residents bedtime, I have alot of Residents that are in bed sleeping by 8pm, and have no prob giving their HS meds at 7-7:30 even thou the MAR will say HS and 10pm. (That HS gives us liberity to use our judgement based to the individual Residents bedtime) And I agree with DaJulieness, Sometimes you only get one shot to give meds, and if there is no contraindications they can be combined. In most cases talking with the Dr. or NP to change times will prove effective. Like the little ole lady that has xanax sched at 9p, but really could use it at 6p. They usually have no prob changing times if warranted. My 9p med pass mostly consist of my diabetics along with a few sleeping aids. Think about it a Res gets a new order for Sched lasix BID, the Mar will automatically come out at sched 9a and 9p... Are you really gonna want to give lasix at 9p? No your should get the order changed BID doesn't always have to be Q12/hrs

I give some of the residents their HS meds before 9p. If they go to sleep before 9p why can't they have it before 9p? Insulin is one med that I never give at a different time.

You have a job. Be thankful for that. There are far too many unemployed nurses who would die to have your lousy job. You could be just as unhappy waiting tables or cleaning hotel rooms or even working as the press secretary for the president. Just thank heavens you are employed. Things will even out eventually and you will either adjust to this job or find a better one.