New LPN in LTC...trying to do the right things

[pinkiepinkPN]

Hello all :-)

So I am a new LPN. I graduated in May and had to delay jobhunting a bit due to recovery from a major surgery, but here I am now, in my first job as a nurse in a LTC facility. I've trained on the floor now for 4 shifts total, and while I really do like the facility and the employees (I work alongside a few of my classmates so that's nice to be in it together) I find myself a little nervous about the way I'm being trained.

Now, I'm no fool. I know that the real world and "NCLEX world" are two different things, and I never expected it to be any other way. BUT. I have had 4 different preceptors in my 4 training shifts so far, and they all do things differently, which is fine...but each have coached me to do something that I know would get the facility DINGS from a state audit. I know they're not cutting corners out of true carelessness but because of time crunch. Like not washing hands like they're supposed to, or giving insulin in the dining room, or not wearing gloves to check BGs. And so I ask, "Would that get us into trouble with state?"

And they say, "Well yeah, but when you have to get BGs on 12 people before you even start the 0800 med pass, it wastes too much time."

I get it. I do. And I'm not tsk tsking experienced nurses here...I'm just frustrated that I'm not having the right things modeled to me, and that when my preceptor follows me into a room and I wash my hands, she says "You really don't have to do that." Or when I pull a resident out of the dining room while they're waiting for lunch to give them insulin, one laughs and says "You can do it in there just don't let anyone see you."

I'm just trying to stay afloat learning all this new stuff and not develop habits I know will bite me or my facility in the butt later, and the last thing I want to do is make my co-workers think that I'm criticizing them when I ask genuine questions about the right way to do things. Any advice on things to say or ways to handle my training period and make my first state visit as stress free as possible are much appreciated!

[heartsgal, ADN, RN]

You are right, they do a lot of things that aren't by the book so to speak. All you can do is say okay when they tell you how to perform a certain task and then when you get on your own you do what you know is right. If you followed 10 nurses on any given day you would see 10 different ways or styles to do something. For instance at my SNF the nurse who trained me told me to chart BS for blood sugar and I said I'm sorry they hammered BG into me in nursing school and she still said type BS that's what we use here. Nevertheless Im on my own now and I type BG, because I don't want to form a bad habit since I know I will be a hospital nurse someday. You'll find you're way and you find yourself cutting corners some places where you can, because it's not humanly possible to care for as many pts in LTC as it is in the hospital in the same manner, so something has to go. I use the alcohol foam my cart way more than I thought I would in place of hand washing, because that is simply the reality of the time constraints. Do I like it? NO, but I also know I won't be here forever so for me it's a means to an ends, regardless of how much I adore the patients.

[chrisrn24]

You are right they do a lot of things that aren't by the book so to speak. All you can do is say okay when they tell you how to perform a certain task and then when you get on your own you do what you know is right. If you followed 10 nurses on any given day you would see 10 different ways or styles to do something. For instance at my SNF the nurse who trained me told me to chart BS for blood sugar and I said I'm sorry they hammered BG into me in nursing school and she still said type BS that's what we use here. Nevertheless Im on my own now and I type BG, because I don't want to form a bad habit since I know I will be a hospital nurse someday. You'll find you're way and you find yourself cutting corners some places where you can, because it's not humanly possible to care for as many pts in LTC as it is in the hospital in the same manner, so something has to go. I use the alcohol foam my cart way more than I thought I would in place of hand washing, because that is simply the reality of the time constraints. Do I like it? NO, but I also know I won't be here forever so for me it's a means to an ends, regardless of how much I adore the patients.[/quote']

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