Recent LVN grad, 1st time working in an assisted living TIPS PLS

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    Yesterday was actually my 1st time working on the floor as a nurse in an Assisted Living Facility. I was in charged of 2 floors which consists of approximately 80+ residents. I was seriously about to loose my mind. I didn't take a break because my med pass were not done plus there was an emergency, in which I had to notify the MD, family, and the nursing director. I guess my concerns are:
    1. How can I speed up my med passes to 80+ residents?
    2. Is having 80+ resident normal in an assisted living?
    3. This is my 1st official job as a nurse, is it normal to feel uneasy after working for only a day on the floor?

    Thanks!
  2. 15 Comments so far...

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    I consider myself a fairly new nurse (just hit a year) & also work in AL. I'm not sure what the set up is at your facility, but 80 residents!? I would say, you should ask your more experienced fellow nurses, how they get all their meds passed & paperwork & tasks done daily. I'm certain that it will get easier for you, with experience. Everyday you will get a little quicker. Once you get a routine down, you'll be more on top of things. Always remember to prioritize & even though a routine is helpful, everday can be unpredicitable. Know your residents & their meds. If something out of the ordinary comes up, prioritize! For probably the first couple months of starting my career as a nurse, I felt sick everday before work, simply due to nerves. I think you will feel better with experience. Good luck & be confident
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    So I finally counted my residents and i have about 60. I've been with the company for a month now and I've only worked for 7 days. Every time I'm about to go to work I feel like having a panic attack. I've been hit twice by a resident and now I am very scared. I don't know how long i can handle this feeling. People are telling me to hang on it will take time but, the fear, anxiety, and feeling helpless is taking a toll on me both physically and mentally. I actually spoke with my nursing director about turning my 2 week notice. She told me to hang on and that other places will be much more difficult. I seriously just want to quit. Is that too soon?

    Thanks!
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    Which shift are you on? Maybe someone would think 60 was O.K. for 3rd shift, but I can't see it being O.K. for days or evenings, when you usually have more meds and treatments and more emergencies happening. When I did AL, I had med technicians helping with a lot of the med pass; by no means did I have this big of a load to pass by myself.
    VivaLasViejas likes this.
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    how many days of orientation did you get.. i feel the like were on the same boat right now
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    Sixty residents are about 25 too many to pass meds to safely on the day or evening shifts, even in assisted living. Some ALF residents take as many pills as those in nursing homes; some even need them crushed up in pudding or applesauce, which slows the process of the pass considerably. And that doesn't even begin to take into account the paperwork, treatments, and diabetic cares......let alone the falls, pharmacy and physician calls/faxes, family questions, and other emergent situations that interrupt one countless times during the course of a shift.

    What, exactly, does your nursing director do? It seems to me that she should be handling at least some of the paperwork and dealing with the doctors in addition to whatever administrative work she's doing. I'm a DON for a 90-unit ALF and I can't even imagine forcing one med aide or an LPN to do all of that herself. We have two MAs per shift (except for nocs) and four resident assistants, plus a resident care coordinator and me, and NONE of us is too good to take a phone call from a concerned family member or do the AM fingersticks. It's a team effort all the way.

    How much orientation did you get, OP? Anything less than a full 5-7 days is criminal.......especially for a new nurse! And I have to wonder why there are combative residents living there; usually such residents are not appropriate for AL and we have to move them to a higher level of care, such as a dementia unit or a nursing facility.

    In short: Your workload is too heavy. Assisted living today is what nursing homes were 15-20 years ago, and the acuity of the residents is rising still. You need more help on that floor, and if you can't get it, you should probably consider walking. Life is far too short for bad jobs.
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    @conscientiousnurse 6 out of the 7 days i've been working nights 2:30pm-11pm. I don't finish my med pass until 10:30. Plus i have to do paperwork. So i end up going home around 12ish or 1ish. The facility only allows 1hrs worth of overtime. *sigh* i'm just ready to quit. Although, the pay is great, the feeling i'm experiencing is not worth it.
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    @racs09_RN I got 2 days worth of orientation. The orientation consists of reading protocols and other materials on a computer for 2 days. After that, I've received 3 days worth of training with a nurse. The 3 days of training i pretty much just shadowed the nurse. After that you're on your own. Getting this job totally changed my perception of nursing.
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    @vivalasviejas omg your 1st paragraph sums it all up!!! seriously i do all those things!!! honestly i don't know what the don does in our facility. the facility i work at is an assisted living but they have a locked dementia unit in which, if you are new you will be working there due to "seniority" i usually work pm's 2:30pm-11pm
    i got 2 days worth of orientation. the orientation consists of reading protocols and other materials on a computer for 2 days. after that, i've received 3 days worth of training with a nurse. the 3 days of training i pretty much just shadowed the nurse. after that you're on your own. getting this job totally changed my perception of nursing. i've only been with the company for a month. i am very thankful that the company gave me a chance as a new grad with no experience to work with them, but i just can't handle it anymore. is it too soon for me to quit?
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    Working into late hours to finish up on everything is common in LTC and ALF, but having 60 residents to pass meds to on evening shift doesn't seem common practice to me. If you feel unsafe doing so and it's causing you panic attacks, who's to say it's too soon to quit? If you feel you are being set up for a serious med error to happen, it seems reasonable to me to quit. Do what your gut says. There are other nursing homes and ALF looking for nurses, I can guarantee that, and some of them may have a more reasonable load.
    VivaLasViejas likes this.


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