So, I have to be a bad nurse to be a good nurse?

Specialties Geriatric

Published

I'm a new grad in LTC. I have 40 residents and I have to do EVERYTHING within my 8 hour shift. At first I tried to tell myself "It's ok if I take my time passing meds" and "It's alright if I stay longer to finish my paperwork", but now I realized things can't always be like that. I feel like in order for me to finish on time, I have to cut corners (haven't taken any short cuts yet). I hate that this job is highly based on rushing from start to finish. Every minute counts and management is constantly down my back about speed. I guess in LTC, good nurses finish last.

Specializes in Pediatrics, Geriatrics, LTC.

I know what you mean. At first it took me all of my shift and another two hours to complete everything, now after 5 months I'm pretty much done on time. Pretty much. That's if something doesn't happen at the last minute like a fall. Each med pass went faster than the last, you will get faster at your jobs. Once you learn the systems and can do them without thinking you will get faster. Don't give up.

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I have worked LTC for the past six years, and i very Rarely leave on time. I used to punch out and continue to work on charting (not a good idea) I stay punched in now. I figure, I am lucky IF i get a lunch break in 10 hour day. I would love to leave on time some days! But there is usually always something to finish up on, charting, labs, fax orders, treatments, etc. In my facility staying an hour late, is quite typical for many nurses. I just hate leaving extra work for the on-coming shift, and I prefer to finish all of my charting. Overall, I have been told I am quite organized at work. Time management isn't always the issue here. Without a unit secretary or nurse manager on my unit, I have all the appt's to make, rides to schedule, fax's to follow up on, orders, (medicare unit=lots of new orders) besides passing meds, doing treatments, assisting CNA's. Don't be too hard on yourself, you are just starting out...but don't plan on leaving everyday on time either, that is just reality

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We in long term care are always chasing the clock. Or should I say the clock is chasing us. You don't have to be a bad nurse to survive. I consider my self a good nurse and I survive. You have to be willing to delegate. Don't try to carry the weight of your world on your shoulders. If you have a cream that is to be applied to someone who isn't in bed well ask them to be put into bed. If it is not reasonable for them to go then, well give the aide the cream and tell them where it goes. I f you are willing to help them as needed they will help you. The CNA's can make you or break you. If you show them that you are not afraid to get your hands dirty they will help you in everyway. Teamwork in LTC is the key. If you see yourself as separate you will be separate and behind leaving late.

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Specializes in LPN.

I have worked LTC both on sub acute and long term for quite a few years, and in different facilities. I find how the beginning of my shift goes - is in direct relation to how the person worked the shift before me. It make take four hours to calm residents and pass pain meds, if I am following someone who is not as hard working. Or, I may sprint ahead and get a lot of work done, - if I am following someone who is a little more on the ball, (so to speak). There are many times I see who I am following and give and inward groan. I then just start out by asking the most painful people, if they are feeling ok, usually they need a pain med, once that is done,and all the ruffles feathers smoothed, I can then start my day. It usually puts me about an hour behind, but then it speeds up the rest of my day. So, a lot of times it is not your fault you are struggling, but the person who preceeds you on the cart. Once you get to understand who is gives you trouble by not passing meds, or fininshing orders, or calling in labs, ect, then you can deal directly with that person.

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Specializes in ICU, School Nurse, Med/Surg, Psych.

I think that seasoned nurses take more short cuts than new nurses - it is the increased comfort level with tasks (like driving a car, I pull on my seat belt while backing out and adjusting the heat or a/c as I go unlike the 16 yr old who sits for 1/2 a second to get their bearings before starting out). I started in LTC and didn't take lunch and stayed late for the first couple of months then I got faster and more familiar with the routine and took lunch and then I finally was leaving on time too; in a realtivly short time I was helping others with their work as well as getting mine done. you can do it - just give it time and keep trying.

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Specializes in LTAC, Telemetry, Thoracic Surgery, ED.

this is the key reason that I only spent 2 months in LTC...as a new nurse you can always talk to your nurse manager/ADON and as the legit question of "how do I get this all done (correctly) in 8 hrs" if you hear that you need better time management and they offer nothing else...have them (or nurse educator) to follow you for a day for feedback....the reason why....it can't be done legit.....if they are truely invested in you doing well and they truely feel it can all be done in 8 hours I'm sure they will be able to give you good constructive feedback....otherwise they realize it can't be done but still expect you "document" that it has been done....Be very careful

Some of my very good friends are in LTC for years and cannot do it all by the book. Don't feel bad about it.....

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Specializes in Geriatrics, LTC.
the time management skills of a nurse are different, you learn to rush without..........rushing. its a difficult concept and its also very zen'ish in nature. i can't give examples of how one nurse does it and another does not. there is no way to write a guide on how to do it. it just happens. experience combined with a drive and desire to do better make it happen.

thanks so much for articulating this concept. it is the very essence of what makes a "good enough" nurse :)

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Specializes in Long Term Care.

I've been nursing for 6 months. I will say, everyday I am more comfortable with how to handle situations that arise. I used to work 3-11 and had one unit, in which in two to three weeks I was able to pass my meds on time and get my work done without any shortcuts. That in itself gave me more confidence. About 4 weeks ago, I took a day position but it's a floater position. 3 of the halls that I am normally assigned to I can pass my meds, chart and finsih all work on time without a problem and no shortcuts. Recently, I have been assigned to the other unit. I don't know these people or their habbits and they tend to be more needy. the first time, I finished an hour and half late. I've only been over there twice and the second time it was an hour late. So, with time I think you get to know where they will be and how they take their meds and the time management will come. You may have to try different ways and starts for your pass.

Good luck and hang in there!!!

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Hang in there, I'm trying too, and I feel like I'm being a huge pain but I'm comfortable at the end of the day that everyone is safe, and I don't feel like I've made a mistake even if I dont get a break and I have to stay a few minutes.

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