LTC is making me hate nursing!!!

  1. 1
    I'm a new grad charge nurse in a LTC facility. I've been there for almost 2 months and I'm at the point where I'm literally scared to go to work. At first I floated, and that was ok, but I just became a regular on a dementia/psych floor. The paperwork and charting is sooo heavy, and I'm the only nurse on a 40-bed unit. I know I have to "manage my time" more effectively, but there's not enough time in one 8 hr shift to do everything that is required of me.. and i don't take lunch.

    I have to pass meds (and the time schedules of the meds are so crazy), start tube feedings, supervise CNAs, chart, pick up orders, check orders, treatments, and various other paper work that come in books.. and the worst of all is getting an admission.. i always fear that i'll get an admission .. and on top of all that, i JUST learned that i'm required to re-do the whole treatment book for the new month.. and my god, the daily interruptions i get.. supervisors coming every 5 mins to check the medex while i'm giving meds, CNAs calling me for this and that, residents not wanting to take their meds (i have to spend so much time just to encourage them to do so).

    I don't want to quit because I want to be able to handle everything, and I've floated to every floor to know that other floors are easier to handle; still hard, but a little easier. I just don't believe one nurse can do it all safely.
    Nightnitenurse likes this.
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  4. 9
    Welcome to LTC.

    Time management and repitition will be the key.

    Once you learn your residents you will know who likes what and when, which will allow you to pass your meds very quickly. It also takes time to learn the paperwork to be able to do it fast.

    Give it time and think of it as boot camp. This will be your first test of many as a Registered Nurse
  5. 18
    This is called being used and abused by an employer (corporation). In other words, exploitation. Instead of hiring 3 nurses - they use one nurse to do the job of 3 nurses, paid for one nurse (to save $).
    LTCangel, karmkandy, payang0722, and 15 others like this.
  6. 1
    That sounds tough...the reason I don't do LTC. I know that someone has to do it but it's not going to be me. Give me my 2 in the unit or 6 on the regular floor and call it a day. I imagine that everything will get easier with time, but I just can't imagine how one nurse can safely take care of so many residents. That why when we admit SNF patients we find all those bedsores, etc...the nurses just don't have time to turn 40 patients every 2 hrs..it's impossible. I really can't give you advice for the LTC b/c I've never worked it...only heard horror stories. I suggest you hold onto your job while you look for something else...at the end of the day, it's your license...and this experience is still work experience. If you don't stay for at least 6 months...don't even bother putting it on your resume...that is if you want to leave...but not all of nursing is like that...although almost all of nursing will frustrate you.
    Not_A_Hat_Person likes this.
  7. 0
    Didn't you say that some of the other units are not as bad. Is there any possibility of a transfer to one of them.
  8. 1
    I was in this same position once. I had two different halls I worked on. I had to take care and give meds to 48-52 patients each night. Tons of narcotics. Atleast 30 blood sugar checks and I also had to cross over into another building and do eye drops. I lost 14 lbs the first month I worked there because I ran the whole time I was there. I had 6 CNAS but they couldn't pass the meds. I was a new grad and thought this was normal. It isn't. I stayed 3 weeks then went to another LTC and it was 1/2 the patients. I don't know how they get away with this when state board shows up.
    If you feel like your compromising patient care, then you problably are. It's normal to feel like this anywhere but if you feel you could make a mistake and lose your license, then you need to talk to your superior or quit.
    tyvin likes this.
  9. 23
    Hi Newboy; sounds like you work where I work. The only thing its 50 patients to care for instead of 40. I agree with what one other person stated, we are being used and abused, plain and simple. And the reason is because us nurses are too gutless to speak up with a unified voice and say enough. Nurses need to Unionize, what real profession is not unionized? Pilots are unionized, plumbers and electricians are unionized but not us nurses. We want to be everyones hero and be there for the patients. In reality if we don't take of ourselves and treat ourselves as human beings,who deserve descent work loads and regular breaks; then we are no good to anyone.

    Now as far as the ones that say it'll get better once you get a routine, no it won't. The minute the powers that be see you can get it done they will only pile more on. That is how it has been going where I work. You see management wants everyone , in particular customers , to think is that they care for their patients and want them "properly" cared for. Yeah right, that is why you keep cutting staff? All management really cares about is someone signing they did a task and then collecting the cash each month. Cold sounding? Just the reality.

    Instead of us nurses getting burnt out and hating nursing we need to be what college taught us we were supposed to be; namely patient advocates. Because understaffing is directly affecting our patients, whether anyone wants to admit it or not. I know my comments may not be popular but hopefully they will be thought provoking. One last comment the good book states we are to " love our neighbors as ourselves". So we need to stand up for and love ourselves so we can serve and love our neighbors better. And that is my
  10. 1
    Hey Newboy,

    My first job out of nursing school was in LTC, too. I was the only RN in charge of 30 residents, so I hear you re: workload issues. My advice: you've put in your time, you now have something on your resume, so start a job search. I put in six months of LTC and then went to the US for a year to get some good med-surg experience (I acted on the advice of two of my former nursing instructors -- and it really was good advice). Then, once you have some med-surg experience, you can "springboard" to more specialized areas of nursing, unless you have decided that med-surg is your niche (I've been doing med-surg ever since).

    You're new and the profession needs you!!! We don't want you to burn out. And don't be afraid of having to move/travel (if this is possible for you) to seek out new opportunities.

    All the best, and good luck!
    1smrtnurse likes this.
  11. 6
    Erie77 said it very well, and is correct. 40 residents is astronomically too many, and while routine may help, there ARE people who just don't like to take their meds - whether or not you knew to first crush it, put it in ice cream, then do three cartwheels on your way over to give it to them. Heck, that's true for *non* psych residents, as well. Just today I spent 20 minutes between two residents to convince them to take their meds. I graduated in 2007, did a short stint in ALF, 2 years in rehab, and I'm just five months into a SNF/LTC for the first time, and I have the same gripes that I keep seeing over and over - understaffing keeps us from doing a great job - most days I feel the job I did is BARELY adequate. That's really hard on your self esteem after awhile. Like many people, I have a very high standard of care that is absolutely impossible to carry out in these circumstances. There are days that I feel a twinge of irritation when a resident asks for something extra - "Can you help me change my hearing aid battery?" because that's how busy I am - that ANY minute interruption can turn my med pass into a catastrophe. That's just wrong. And it's not the person I am, or the nurse I am or want to be. I want to listen and care, and have time to do those little things without it putting me so far behind. I don't think it's ever going to be like that in LTC, and so I've been and will continue to look elsewhere. Unfortunately the job market is tight right now. OP, don't let this paint your picture of nursing, because you haven't been given a chance to succeed.
    LovedRN, Chin up, Not_A_Hat_Person, and 3 others like this.
  12. 3
    Quote from newboy
    .....I don't want to quit because I want to be able to handle everything, and I've floated to every floor to know that other floors are easier to handle; still hard, but a little easier. I just don't believe one nurse can do it all safely.
    I am in a very similar situation and gave notice. Three shifts left!

    You have to do the best thing for your individual circumstances. One thing you can do is assess how the other nurses are doing. Are the ones who have been there > 6 months to years doing alright? Are they safe and getting things done within their shift? How do they feel about their jobs?

    There were numerous reasons I gave notice so soon after starting my new LTC/SNF job (including the fear of losing my license), but the one BIG factor was that the LPN's who have been there for YEARS were still clocking out at the end of their shift and staying 2 hours later to chart and finish things up. Its like a bad family secret there, everyone has to do it, everyone knows it is illegal and the workload is impossible, but nobody says anything out of fear for their jobs.

    Take some time to assess the situation honestly to see if it will get any better or if it will be pointless and better to move on. Good luck.
    Chin up, namazonian, and Anna S, RN like this.


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