I hate being a LPN in LTC. The horror! - page 4

by Plagueis | 15,610 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


  1. 0
    Darimom,

    Just read your post. Thank you!!! You are so right. I am thinking back to PCU during clinical at the hospital and remember RNs having days just as the one your described. You are right again in that this is just a tough field. Thanks for the perspective! Hope you have a great day. Best wishes.
  2. 1
    do hang in there, I remember when I got out of nursing school was scared to death to call a doc I was just 19 years old. I have worked a lot of different areas of nursing, ob, med/surg, wound care, ortho, oncology, chemical dependancy each time was new and scary at first but so glad for each experience and the education I learned but ultimately I love LTC- I go to work for the residents. the paper work can be horrible. sometimes I just hate to ask nurses to document because I remember working and having 2 incidents, transfers and and admission and family yelling at you all in the same shift and the upper management yelling at me did they not teach you how to chart in nursing school. That just made me furious and I went out an bought a book on charting for charge nurses. Went to a few seminars. If your state has training like here in texas go to your state website and see when and where you can go for some education on what the surveyors are looking for. Those seem to help me the best. I usually start out new nurses passing meds also. Because if you become a charge nurse you have to, at least in tx, chart effectiveness of PRN meds, maalox, mom, PAIN MEDS even if the med aide passes them. Initial doses usually have to be signed by nurse. Ask to look at policy and procedure manuals. See if they have like I made up for our nurses JOB DUTY LIST per shift. It kind of explains what they are to do per shift We also do a general orientation for all staff and meet all department heads have topics they cover. There is so much to learn but dont forget to ask for what you need to get your job done. Stock your med cart when you come in-if the previous shift has not done that. keep that PDR handy. Heck honey when I have to on occasion pass out meds I take 2 hours getting my morning meds out. Mainly because I make sure they take them and not just set them down by the bed. ( that is one of those big no-no's I am with Sue just start with meds. Ask for a job description and job responsibility lists. I always say no question is bad just the one you forgot to ask. I think to one of the things we older nurses do is forget to put things simply. Dont forget they did not teach you job specific duties in nursing school. You where taught basic procedures. Wish you the best in your career!!
    Plagueis likes this.
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    oh and one more thing- you have the experience of a CNA-- wish all my nurses did and understood how hard that job is. I started out as a shower aide that is back breaking/foot blistering work!! I really do appreciate nurse aides I teach them in our facility. See I think your already a step ahead girl friend!!
    Plagueis likes this.
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    LTC can be very demanding, hard, sad, grueling, and laborsome......but somehow i always end up back there.... It is very rewarding. i"ve worked off and on in LTC for about 8 yrs and right now i work home health. i do like it however, i kinda miss my residents and don"t get as much satisfaction outof HH. I'll probally go back to LTC soon. I just need a little vacation every now and then to de stress
    However, being a new nurse and just being thrown in there like that is extra stressful. I was only 19 when i was thrown in there and i was scared!!!! i still lived at home with mommmy and daddy for goodness sake and now i was in charge of about25 people and their lives!!! well i got over it pretty quick.
    You learn a lot in LTC. Now i learn nothing in my current job. i feel like a CNA who can give pills. so maybe if you loved being a CNA you might like Home Health...hehe
    I'd love to know if the the person who wrote this stuck with it or quit??
    Plagueis likes this.
  5. 0
    Quote from birdietiel
    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.
    Get outta my mind!
  6. 4
    There is such wonderful support here. Thank you all so much. I hate to know that others are going through the same stress and difficulties that I am, but isn't it also nice to know we are not alone. This is a common experience. I got through my first week, being trained on the Assisted Living and the Memory Care floors. I am going to be the charge nurse for the Memory Care floor this coming Sunday. My Administrator came down for report on a few residents, and I took that opportunity to ask her the many questions I had. She asked me what my comfort level was (regarding being the charge nurse on Sunday). And I was honest with her. I told her as long as I knew she or another nurse on Assisted Living was there to answer questions for me, as they know these residents, I think I'd be okay. I realized she is there to help me. I just have to ask for the help. Each day gets a bit less scarier, and I do fall in "love" with the residents a little more. I realize that I have the love and the clinical skills that they need. I imagine it will get easier as I get to KNOW the residents a little more. I am currently starting Excelsior for my R.N., but I need the experience and am bound and determined to get through this.
    ArmstrongLPN, Plagueis, MauraRN, and 1 other like this.
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    Leeann, I too did 3 yrs in LTC/sub-acute care while doing Excelsior. I have great assessment skills because of LTC. We are just thrown out on the unit to figure it all out, no hospital-like precepting. So practice your assessment skills, get comfy with wet-dry dressings, tube feeds, IV meds, subq insulins and heparins and you will be much more comfy doing the EC CPNE. Get familiar with care plans too. LTC care plans are usually junk in LTC, but look at them anyway and figure out how they SHOULD be done. Work on your documentation skills and consider LTC as paid clinical rotations, it will help you stick it out until you are done with EC. It is such a shame that those of us who love that elder population just can't stay in that industry, it is going to get worse with the 50billion in medicare cuts coming soon. And hope that when you get your RN there will be jobs available again. The cycle of no nursing jobs now should start to be on the upswing in 2 yrs or so. Hang in there.
  8. 1
    MauraRN,

    Thanks so much for the encouragement. I got through my first day as charge nurse, and I am happy to say I made it through. I will look at this experience as "paid clinicals" until I have completed Excelsior. And I will give those residents all the love and care that I possibly can in the interim. I do have a question for you, if you don't mind, as you worked in LTC. Did your LTC facililty expect you to work as an aide? And I mean actually work as an aide. If they are short on aides, and they are not certified in the Assisted Living or Memory units, they call LPNs and ask them to cover their shifts. The LPNs do get paid at their LPN rate, but I was wondering is this a "normal" practice. Also, when I work on the Memory Care floor, I am expected to give my early morning meds, shower and dress 3 people and get them to breakfast. In the afternoon, I am to "toilet" 3 or 4 residents and either help with making beds and replacing towels in the rooms, or help clean the tables off after lunch. My first day was rough. I did my meds, and got my first resident showered and dressed and I heard a resident screaming, he had fallen. Of course, I immediately went to him. In between helping the aides, I had meds, assessments, calls to the MD, dressing changes, speaking with families, incident report, 24-hr report, my shift report and nursing notes. I have to say they have 2 aides on for 15 dementia residents. These aides must shower, serve food, clean up, do activities, toilet...all of it. So, I dont' believe the aides are lazy, just overwhelmed and need and expect help from the nurse on duty. When I am on the Assisted Living floor, it is mostly meds and treatments for 30 residents. Thanks so much for reading this (if you have time...lol lol). Is an LPN working as an aide normal??? Thank you!!! God bless!!!
    Plagueis likes this.
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    I'm still at the same workplace. It's still stressful, but as there's no other place to work, I have to stick with it, as I have a daughter to support, as well.

    I haven't had to do any recaps/changeovers yet. However, whenever I've had a fall or had to send someone to the hospital, it puts me far behind on my med passes, so I end up clocking out late (I work 3 to 11 shift). I had to help with both of those situations regarding the paperwork, as I was never shown how to fill out an incident report before. I still don't know how to do some basic things, such as the procedure for when a doctor writes an order for a lab, how to program and hang a continuous tube feeding, or how to program an IV machine. I'm told that if these situations occur to just ask for help. I'm just trying to stick it out. I'm better at passing meds, I think, but I still get behind if something unusual occurs (i.e. a fall), even though I don't take breaks.
    SuesquatchRN likes this.
  10. 2
    The common idea in this thread seems to me is that nursing is a lot of hard work, rife with libilty, highly regulated and filled with residents,coworkers, administration. Geeze, can't figure why a new nurse has stress. Also happens at the hospital, which some nurses seem to think is nirvana, the stress, too much to deal with etc. I like LTC because I personally like to develop a relationship with residents and try to make their lives better. When I started, I handed many meds in my dreams, cried on my way home from work, all that good stuff. Hang in there, it gets easier. As for some of the questions, borrowing -yes, not narcs.or the stuff you have in the narc box. Combing meds-realize that HS often means right after dinner. Trying to get meds down a sleeping 90yr old will convince you of that. As for supervisors 3-11 and 11-7, please! That's prime time for emergencies. That needs to change. Learning what works and what doesn't comes with experience. There is only one way to get it.
    lisaannjamRN and SuesquatchRN like this.


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