Help! The worst training ever!

  1. I just started my first job as a new grad in LTC. And yes, I'm truely afraid of what's going to happen once I'm on the floor alone. Orientation consisted of 3 days of watching "How to not slip and fall on the job" and the administrator telling us that she needed to leave early to go pick up her kids. I was excited to hear that I would be allowed to have 5 days of training on the floor instead of the usual 4 (because I'm a new grad), but I soon learned that training is basically a nurse showing me all of her bad habits. I'm just the type of person that wants to do everything the right way regardless of what everyone else is doing. But it seemed like there were no good models to learn from. NO one wears gloves (regardless of what they are doing). No one ever answers call lights unless either it's been going off for 20 minutes or the DON walks past. The nurse training me just casually stood around and conversated with coworkers while giving out 6am meds at 1pm. None of the CNAs scheduled to work showed up for work, and from what I was told this happens all the time. I'm new to this and I just want to see SOME examples of how things should be done, not just told that "If State were here then you should do this..." It was horrible and I was told that this was a GOOD day. :angryfire What should I do? How can I be successful in this type of environment? My choice was not to work in LTC, but I have no experience in any other areas.
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  2. 31 Comments

  3. by   WickedRedRN
    Take a moment and re-read what you posted here. Listen to yourself. You know this is a toxic environment for anyone, let alone a new grad. I am a new grad too, walked away from an offer in LTC for a lot of the same reasons you are talking about. I didn't want to lose a license before I even got it!

    If it was me personally, I would leave this facility and not return. There are other places to work out there, keep looking. Do not put yourself at risk here.

    Best of luck to you!
  4. by   S.T.A.C.E.Y
    What should you do? DON'T GO BACK!

    You've worked too darn hard for that license of yours, don't risk it working for a place that places no value in you or your practice. There are plenty of other jobs out there, don't let this be your first one. You'll get a jaded view of nursing, then end up wanting to leave early, or worse...be forced to leave nursing.

    Find something else anywhere else!
  5. by   savedbutterfly
    I don't think that you have much choice, you have to protect yourelf. I would look for a different job. I also would report the unsafe working environment.
  6. by   MARIAN202
    Run
    Don't Walk
    I Was In The Same Situation
  7. by   Daytonite
    wefdm21. . .a short period of orientation is very typical for LTC. LTC nurses are expected to be more autonomous than acute hospital nurses. There is less staff and many times YOU are where the buck stops in LTC. I'm sorry you didn't know this going into this kind of job. Did you expect to get a crash course in nursing at orientation? Sorry, that doesn't happen. You learned everything to get you started as a nurse in nursing school. And, what you don't know, you have textbooks, the Internet and other employees to use as resources to help you find the answers. The training "on the floor" that you receive is merely to familiarize you with the routine of the facility. It doesn't take more than a few days to introduce this to you. And, if something isn't clear, then ask. As a new charge nurse, no one is going to think less of you for asking. As a new graduate you are going to be looking up a lot of drugs that you've never given before and doing treatments for the first time that you've never done before. LTC is highly regulated. Some of the things crappy nurses did were much worse 30 years ago before all the legislation was passed. And, still, there are plenty of crappy nurses in LTC that persist in practicing their bad ways proudly. Do you realize that there is something psychologically wrong with people who can brag about doing things the wrong way? You can't make these people change their behavior. But, please don't copy them. You can only be responsible for your own actions.

    Are you saying that throughout your entire nursing school program the subject of nurses who didn't follow good nursing practices and do things the "right way" never came up in discussions with instructors? Just because others are exhibiting bad habits, not wearing gloves when handling body fluids, not answering call lights, or giving medications later than scheduled doesn't mean that you will be expected to do the same! You should practice what you were taught in nursing school and nothing less. You had time during your clinical experiences in nursing school to see examples of how things should be done.

    What should you do? You should practice what you were taught in school--not what you see others doing! Students are taught principles of nursing for this very reason. It is so you can think and reason out these kinds of situations.

    I started my career working in LTC and I saw much the same as you are seeing and experiencing. What I did was I kept my integrity. I followed the "rules" of nursing as I was taught them in my nursing program. Some of the other charge nurses laughed and talked about me behind my back. It was difficult, mostly because I was inexperienced and did not have the confidence to stand up to them if they made fun of me to my face. So, I quietly went about what I knew was the right way to do things each day. At home I looked up meds and re-read my textbooks. I learned over time that when meds are getting passed late that changing the administration times on the med sheets kept the facility in compliance and I was no longer late with certain meds. Good nursing has to start with you. You have to decide if you are going to do things the way you were taught or take shortcuts and compromise your integrity. The fact is that in a month or so you will get to know your assigned patients much better and you will be working on your own and have the freedom to organize the way you want to do your work as long as you follow the facility rules. Ones first nursing job is always very stressful. However, you have a lot of growth and maturing as a nurse that you still have to go through. Your first year out of nursing school is still a period of learning, but learning that you have to often do on your own initiative. As time goes on you will find nurses who will become role models and mentors that you will cherish. Unfortunately, like true friends, they are too few and far between.
  8. by   curiousauntie
    PLEASE...Do not think this is a "normal" long term care facility. This is a HORRIBLE place and you should, as another post said, run, do not walk, out of there. I have work LTC for 21+ years, and yes, I started right out of school too. I LOVE working with the geriatric population, but a place like that will eat you up until you are so burned out you don't know what to do with yourself. If you really want to work in LTC (and didn't take the job thinking it would be easier then a hospital, because it it NOT), look on your state Department of Health and Senior Services website. There should be some kind of report card, or annual survey results posted there. New Jersey has a very simple site that compares nursing facilities and gives a score, 1-100. The place were I work has a 97, but in my county there is one with a 49. It sounds like you are in a 49-type place. My place gives ALL nurses a 3 WEEK orientation. And new grads get 3 or 4 days of class first to explain federal regs, how to do a med pass and all that good stuff. Please do not think that all LTC facilities are like the one you are in. There are MANY places out there that are good, clean very well staffed, and have the best interests of the residents at heart.
    Good luck to you.
  9. by   Simplepleasures
    Welcome to LTC. MOST LTC facilities are exactly this bad, dont be fooled.Also, no one in nursing school is told just how bad it is in LTC, because NO ONE would even try to work in one especially right out of school. You are not wrong to be dismayed, I say be afraid, very afraid ,LTCs are not safe for staff as well as for the patients.
  10. by   L&Dnurse2Be
    As stated before, RUN, don't walk. Get OUT NOW! Remember it is your license on the line, protect it. There are plenty of other opportunities out there. Good luck!
  11. by   nurseangel47
    Just wanted to say to Daytonite: GREAT answer!
  12. by   banditrn
    To the OP - how supportive is your DON and administrator? Do they seem willing to answer questions? You will need someone there who can tell you the proper way to do things if none of the nurses can or will.

    Ideally, the place should have an up to date policy and procedure book, but I haven't found that to be the case in the two places I've worked, and have had to quiz the DON in both places about why that is so - I've volunteered to assist the DON in the current place by typing and printing things in my home time, but I don't know if she'll take me up on it or not.

    If it looks as tho you aren't getting any cooperation or help, then, like the others, you need to think about looking around.
  13. by   wefdm21
    Daytonite, I totally agree with what you're saying in your post. By no means did I expect a crash course in nursing during orientation, and I knew that I would have to put my skills and judgement to use on the job. But as you mentioned I am looking to the other nurses for an example of what the facility expects from its employees. I was just mentioning those things as an example of the kind of environment that I'm expected to work in. It is difficult and I want to make sure that I'm not setting my self up for failure as some of the other posters mentioned. I do plan to spend alot of time organizing and studying on my own and I don't have a problem asking others for help. I'm just alittle unsure because like I said the class orientation was a little shaky, and the nurses on the floor do what ever they feel like doing, so if the facility wants you to do a certain procedure this way or chart that way then how will I be sure what's correct. I don't want to be written up for something that was never even explained to me. You know what I mean?
  14. by   penguin2
    I have worked both LTC & acute care. I would suggest getting some good solid experience on a medical or med-surg unit in a hospital setting first. If you like geriatrics you will get plenty of that in a med-surg setting, and if you decide you still want to do LTC you will be much better equipped. LTC needs dedicated nurses, and it takes a special person to do it & do it well!! Good luck to you.
    Last edit by penguin2 on Dec 24, '06

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