I hate being a LPN in LTC. The horror! - page 3

by Plagueis

14,850 Views | 40 Comments

I'm a LPN, and I'm conflicted about whether to leave the LTCF I work at, even though I'm still on "orientation." I loved working in LTC as a CNA, but ever since I've been on orientation as a LPN, I hate it! Although I'm still... Read More


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    Ohhkay, well thanx for the reply.
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    I am going through the same thing. I was thrown on the med cart. I have seen other nurses combining meds for 4 and 8, and other things that shouldn't be done. I am always out late because I do things by the book. Half the time the med isn't there. We even run out of narcotics for the residents, and have to use the emergency box. One time even that was out. There is a huge lack of communication at my ltc facility. There is no team work. People gossip all the time about each other. I don't get wrapped up in it. I don't feel very liked at my job because I'm new. I haven't learned all the forms yet either. I am learning them as I go. I'm stuck at the place I am, because there are no hospital jobs available here. Hopefully you can apply somewhere else. Good luck to you, and hang in there.
    luvmyguys and Plagueis like this.
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    Hi - one quick note for all of you at LTC that state you're stuck there as there are no other hospital jobs available near you - just a quick warning. Everything you're struggling with at the LTC is the SAME things I struggle with at the hospital (new grad too - May 09). I see things done like combining meds by other nurses AND nurses borrowing from other patients drawers AND the pharmacy doesn't send all meds up on time or at all also. AND I also have to answer to my boss if the meds aren't given to the patients AND I'm still learning the forms etc. So honestly a hospital is no bed of roses either. While it may not sound like a lot I had five critically ill patients yesterday on my unit under my care - 1 of which required me to be in his room almost 15-30 minutes out of EVERY hour of my shift - to hang IV piggybacks, give him morphine, assist with his BIPAP, help him urinate, etc etc etc the patient REALLY needed to go to ICU and I suggested same to the doctor who adamently disagreed with me (charge nurse did agree with me also - problem is he's a DNI so ICU doesn't really want someone who isn't a full code).........Then add to that my other four patients - 2 with chest pain (one on tridil-nitro drip), a complete care patient whose IV had to be removed due to bleeding and I had to start a new one plus attend to the skin on her diabetic ulcer legs and feet and skin on her buttocks also - of course passing all meds for 5 patients and contacting doctors regarding abnormal labs, writing orders, watching other patients so another nurse could do lunch (of course I didn't do lunch!) and the list goes on.........

    I do feel for all of us - believe me - this is not any easy field to enter no matter WHERE you work - LTC, hospital etc. but I guess the focus of my warning here is don't jump from the frying pan to the fire thinking a hospital job will be better. Prayers to you all (they're the only thing that gets me through my shift!).
    lisaannjamRN and Plagueis like this.
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    Quote from Plagueis

    In addition, I've been told about some of the "interesting" habits that I've read about on this site, which I'm told is nursing-home gospel, such as:
    combining meds from different times into one pass ("you won't get done, otherwise")
    borrowing meds ("everybody does it; you can get in trouble if you don't give the med")
    no supervisor, except on dayshift ("there are hardly any emergencies on 3-11 or 11-7")
    signing that a med was given, when it wasn't even available, and couldn't be borrowed ("you can't write 'not available'")

    I know there's more to list, but based on my experience, I seriously long for the days when I was a CNA. I wanted to be a nurse, but after this, I need to get away to another place where I have a better breaking-in period. I don't think I can last another day at this place, and I'm scared for my license, to be honest. I want to quit, but some of my friends think I should just tolerate the madness because I make more money. I can always work as a CNA until something better comes along, but I am still struggling with what to do. Any ideas, thoughts, or other horror stories would be appreciated. I apologize for the length.
    No, these things you list aren't "right," but you also have to consider the reason you may be expected to do things like you describe above. Healthcare is one of the most heavily government-regulated industries, where beaurocracy (as nonsensical it may be) rules and staying in business boils down to having your papers in order and following the nit-pickiest rules--or being shut down. It's definitely a balancing priorities act and looking at the bigger overall picture. It's a game, though not a fun one. And unfortunately, staying in the game requires jumping through some of the most ridiculous hoops.
    Plagueis likes this.
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    Quote from Plagueis
    As far as writing "med not available," I found out that my facility can be cited if a nurse writes that.
    We have a 24 hr back up pharmacy.
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    Quote from IMABSNRN
    We have a 24 hr back up pharmacy.
    We have an emergency kit but it doesn't contain everything.

    I WILL combine meds that don't have much of a medicinal effect and don't combine with others. As an example, I have people I am supposed to awaken at 6 am for a stinking calcium tablet or vitamin. I don't think so.
    Plagueis, nurse_mo1986, and TootsieRN like this.
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    Hi. Dont let the bad information given to you by others spoil your long term care experience. There is only one way to do things and that is the right way. As far as the med issue is concerned. If a resident is out of medication, the correct thing to call the pharmacy and reorder it. Then you must call the MD and notify the MD. Record that in the nurses notes. There is also an emergency medical supply that might have the medication in it. I am not sure what you meant by combining meds. Legally the time frame for medications in LTC is you have up to one hour before and one hour after the time to administer it. With the exception of insulin. Legally you cant sign a med that wasnt given. You can sign it, circle it and write on the back of the med sheet it wasnt available and write in the nurses notes that you called the pharmacy and MD. Sometimes the MD will allow you to give it once it arrives.

    Remember it is always better to risk getting fired from a job than it is to loose your nursing license. If the work load is unreasonable and it prevents you from legally performing your job you might want to pass it up for something that you can do in a safe manner.
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    This is such a coincidence! I just had 2 days feeling exactly as you so perfectly described!! I am at my 1st job as an LPN. I graduated August 27, 2009. I just had orientation last Wed., Thurs., I was with an LPN a 1/2 day and by Sunday, I was left totally alone on the med cart. I got through the med pass and treatments for 29 residents. I was exhausted and terrified, but I got through it. I can't believe I was alone. It seemed as if I was being tested to see how I would handle myself. I felt everything that you wrote. And as far as borrowing meds...that happens where I work as well. I actually wrote on the MAR med not available-ordered from Pharmacy and that it was not given. I think the thing that I absolutely want to cry about is that I see the looks on the faces of the residents when they see me coming with the cart. I have to give as many meds as I can while they are dining for breakfast and lunch in their dining room. I am the "pill girl". I miss the hospital. I wish I had known LTC would have been my only option as an LPN. I am so sad. Thank you for your post. It truly gave me great comfort tonight!! Good luck with things. I am sure you will figure out what is going to work for you. I guess time will help?
    ArmstrongLPN and Plagueis like this.
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    Okay you guys are scaring me. I am a new nurse and finished my pre employment info today for a LTC facility. It is one of the much nicer ones in town I believe orientation is coming soon they are suppose to let me know either this week or the next. I am excited to work as a LPN. I have worked at a hospital as a unit secretary and I was definitely thrown under the bus and have witness other nurses thrown to the wolves. I will let you all know how it goes wish me luck. I hope that things will get better, it is hard to get a job as a new grad unless you had prior experice in the medical feild. May god bless us all.
    Plagueis likes this.
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    Hi Williamsa! So sorry...didn't mean to scare you with my thread. I do sincerely wish you the best of luck. You are so right about it being difficult to get a job as a new grad. I too, got a job in a beautiful place. I also want to let you know when I went in today, I keep plugging along doing my best. In the afternoon, when I was just on the verge of tears, my Administrator called me in her office to tell me what an awesome job I am doing, and how much my co-workers and more importantly, the residents love me. I had to hold back the tears. And I could feel my eyes welling up. I thought of my insructors in school telling us how tough the first year of nursing would be. They told us they cried themselves. I do feel that I am truly caring and loving the residents even in the very short time I have been at my job. I have to remind myself...this is going to be tough. But it will get easier and it will be rewarding. I am absolutely exhausted, but I wanted to let you know I wish you luck, and hang in there in the beginning. It's tough but we can get there. Best of luck.
    Plagueis and williamsa like this.


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