Spoke with the manager and feeling less confident with care..

[sn543]

I started working as a new grad RN at an LTC/SNF facility for about 22 days. It has been about a full week after my orientation, and I believe that I am progressing. But after talking with my DON today, I felt less confident and disappointed with my progression.

The DON came by today to talk about the reason why I have been clocking out later than expected. "What's going on?", "What are you doing wrong?", "What is it that you need help with?". The work day is 8 hours long, but on average, even the more experienced nurses clock out 1-2 hours after 8 hours. For me, I have been clocking out around that time also.

I understand that working overtime is bad for the financial part of the facility. However, I believe it says a lot knowing that even the more experienced nurses clock out 2 hours later. Maybe its a facility issue that should be worked on?

After the talk I felt so unworthy and useless. I have been working so hard to keep up the pace with this line of work. To my understanding, I was going along just fine. After the talk, I am thinking twice about this line of work and whether or not I am capable of working at that facility. I replied back saying that "I tried my best and was safe as possible". I also mentioned that there was a last minute discharge and some medications that I physically could not find, but was located in the other medication cart. But even then, it seemed as if my DON did not understand the situation today.

Boy it felt good to let all that out...

I plan on talking to my DON and mentioning to her what I typed here. Would this be a good idea? Any recommendations?

[LTCangel, ADN, BSN, LPN]

The company I work for also wants us to ty and clock out no later than 7 minutes past our sceduled time. So did the hospital I worked for before this facility. It's management's way of trying to cut back on the bottom line. I am usually out on time or maybe a few minutes past their "golden limit", but occasionally things happen at the last minute that just can't be passed on to the next shift. For instance, the last shift I worked, I was passed a new admission that had come in just before shift change, around dinner time. I was not passing meds on that hall from 7-11 but I work night shift and at 11pm I pick up both halls. The nurse who was working that hall did absolutely nothing for the new admission, she is agency but has worked in the facility enough that she has done admissions and could have worked on it, but it was passed on to me. So at 1130 at night I am trying to finish his admission, do his Nursing assessment,and his skin assessment which turned out to be extensive d/t multiple skin issues. I also had to do my Midnight meds on both halls and all the other routine things that needed to be done. Well at 330 am this new patient falls out of bed! Thank God he didn't get hurt but I had another stack of paper work to do on top of his admission. We also have to do computer charting along with the paper charting. Well needless to say when dayshift arrived I was finished with all of my med pass and care that needed provided but had had no time to do any charting. So I sat right there til 825am until i was finished! Some things can be passed on and some things just can't. I am the only one who could chart the fall and the assessment, no one else could do that. If someone says anything to me about it, that will be my answer. give yourself time to get things down and realize that Management will always want you out as soon as possible, it's what headquarters is telling them. They don't want to pay out more if they don't have to. I have also seen Nurses who have been there way longer than me, have to stay a little while to finish things that just HAVE to be finished. I just passed my 90 days and I would like to think that my DON is more interested in things getting charted in a timely and correct manner than whether they have to pay me another 45 minutes. I am NOT one of those who is able to get my 9pm med pass done in an hour because I give ALL the meds that are ordered. Don't take that stupid advice about doing it the wrong way, form good habits and keep them and eventually things will fall into place and you will find yourself leaving on time most of the time. Unfortunately in Nursing, things happen unexpectantly and we don't always get to get up and just walk out. We have to see it through til the end. Good Luck and God Bless:loveya:

[sn543]

Thank you everyone for your input and sharing your experiences. I am grateful that there are others out there who support me and understand what I am going through. SNF/LTC is very hard work. I have decided that I am not going to talk to my DON just yet, but rather work on some goals to improve my timing on the clock while NOT compromising patient care/ethics. If I do not reach my goals, then I will talk to the DON to discuss ways to improve.

Again, thanks guys!

[baseballmama]

Tyvin,

Thanks for the feedback. The DON was actually the one who wanted me to "amend" my charting. I never did. My poor co-workers rewrote their charting three different times and each time I kept entering the same entry!!! I think she finally gave up.

On a side note, I do carry my own malpractice insurance (the maximum amount). I don't trust anyone above me to "have my back" when it comes down to the wire. I can't imagine a MD, Administrator or DON saying "Yeah, I did 'xyz'." Human nature sadly would lead me to believe most people will save their own butt first...even if it means wrongfully throwing someone else in front of the proverbial bus.

I ended up giving my two weeks notice soon after the charting incident. The stress of it was more than I could bear. I would go to work on the verge of tears and come home and cry in the bathtub. It was not a healthy environment. I was blessed to find a much healthier working environment 5 months later. Sadly we moved out of state and now I am working under similar circumstances as before. Again I feel myself preparing to take a stand...it may not be pretty, but I trust God to take care of me.

[LaRN]

I don't think I would press the matter any further, because She doesn't seem to be very open to reality.

sometimes I think the more worried we are and the more we seek approval, the harder they are on us. killjoys are everywhere.