Terrified and Humiliated New Grad in LTC

[Super Ultra]

I just graduated in May from an ADN program. I was hired prn at a local LTC facility. The job market is scarce and I am desperate to take whatever I can get. 5 new grad/new hires including myself got a whole 4 days of orientation and only 2 of those out on the floor. One has already been hired as a 11p to 7a full time charge nurse, one got a full time 3p to 11p shift, and the other got a full time weekend shift. My supervisor tells me, after only TWO DAYS in a new nursing environment that my skills are not up to par, so I got none of the promotions and am still PRN, which really is fine, I guess, because clearly I'm not ready to be tossed to the wolves with no oversight for 30 patients with 20 medications apiece as well as peg tubes, wound care, feedings, etc. However, my boss made me feel like I was 1/2 an inch tall. He made me feel as if I was a substandard nurse and not nearly as good as the others I was hired with. I am somewhat sensitive and I began to tear up, but I did NOT cry. He said "are you tearing up?" with incredulous disgust. I said I was simply tired and I am no crybaby. I graduated with honors and externed at a large hospital. Something about this boss makes me nervous and when he watches me I make stupid mistakes. I don't know how to shake this, and show this guy that I can be a good and capable nurse. I also think it's a bit much to ask anyone to go out on a floor and handle 30 patients after 2 days on the floor. What do you guys think?

P.S. I thought I loved nursing but this experience is making me feel as if I've made a terrible mistake.

[malamud69, BSN, RN]

A veteran ER nurse friend of mine gave some great advice to anybody starting out in most health care jobs: If you can afford to do it, work more than one Per Diem job...you can find the fit that works for both sides...no B.S., you are not tied to something if it doesn't work out etc...makes common sense. You may also get to practice a variety of skills in different settings.

[malamud69, BSN, RN]

Hi I have been an LPN for 16 years and you are probably a lot younger then me but nursing is one of the hardest jobs you'll ever do. I guess my skin is thick in one way but in another I am so so so sick and tired of the abuse that goes on in nursing. I would love to tell you the grass is greener on the other side but most of the time it is not. I am always asking questions when I do not know something and it does take time to catch on how to manage all those patients. It is an exhausting job. You are always learning and things are always changing. I agree with the other writer he is making you feel small so that he can control you, it does happen to nurses all the time. You see there aren't any laws that protect nurses like the biggest problem patient ratio. But the truth is the amount of patients that is given to one nurse is really impossible to do everything that is asked. Your boss knows that. You will always be told that the facility can't get more nurses or they will have to shut down which is a bold face lie. Someone is making good money off of our backs big time. So you are made to feel inadequate so you will take on the responsibility and work you fingers to the bone to fulfill their unrealistic expectations. I wish you the best!

Seems like a perfect reason to support unions.

[CherylRNBSN]

The best way to deal with this? STAY.

And I mean for the short term. If you let this a** run you off, your confidence will take an even greater hit. He cannot make any meaningful judgement after two days! Period. (Unless you were clearly unsafe. And then he should have fired you. You need/deserve time to DEVELOP.)

Time to step up your game, Missy.(Spoken maternally) Take this as a challenge! Because it surely is. Do not let him undermine your confidence. You are a NEW nurse, and shame on him for not giving you concrete, helpful advice and NURTURING you.

I consider it very important to be able to lead, as well as to be led. This guy is not leading you! But I think, if you have faith in yourself and just SHOW UP (a great part of life is about just showing up), you will develop your skills and your confidence.

Please consider fighting thru this difficult experience. If you give up, you'll never know TRIUMPH.

And their are some fantastic nurse leaders/managers out there! Show this guy what your made of, while you search for another job. BUT DON"T QUIT THIS ONE! YOU CAN DO IT! Avoid the gap on resume! (And I know of what I speak).

Good luck! It will get better.

[BrandonLPN, LPN]

Probably the only reason this guy could rise to a management position is because this place apparently has such a high turnover.

[proud nurse, BSN, RN]

I've worked in LTC for the past 7 years as a night shift charge nurse (LPN). Working in LTC is stressful and overwhelming, even when you develop your own routine. Don't let this person get into your head and doubt your abilities. He doesn't sound like someone I'd want to work for or with. There's usually a reason why that door revolves. You'll know when it's time to move on.

[CapeCodMermaid, RN]

Your story reminds me of an experience I had when I was new. I was on orientation working 3-11. The supervisor who was orienting me spent most of the evening elsewhere. Most of the patients didn't have name bracelets so it wasn't easy to tell who was who. There was one resident who lookedlike she was in her 30's but according to the MAR she was 100. The meds included Stelazine and Thorazine....the supervisor screamed down the hall "you are too SLOW". I told her I didn't intend to give medications to someone I couldn't identify and then I added "if THAT woman is 100, I'm going to start taking thorazine!"I finished the shift and resigned. That was in 1982. Since then I've worked in many different places....some good some bad. I am the director now of a large facility. I do not allow any one treat a new or not so nurse badly.Don't give up. There are good places WITHOUT unions with reasonable, respectful bosses.

[Isitpossible, LPN, LVN]

superultra! dont you dare for one second that the problem is you-- i too am a NEW grad in a LTC.. i am receiving FIVE weeks of orientation...five weeks i repeat... two days is ludricous, and like someone else mentioned that fact that they have that many openings and promoting new nurses to charge already says alot about that company... thank God you are Per diem only! relax and try and learn as much as you can...refuse to let him or anyone else make you feel incompetent... seek suport from any experienced RNs who are understanding of us newbies...

[Super Ultra]

I went back today for a 12 hour shift and I will say that the great majority of my coworkers are extremely understanding and helpful. That's a bright spot at least!

[suanna]

My God- what new grads skills are "up to par" to work a position in LTC? It took me 6mos before I was marginal in my nursing skills. After almost 30 years I'm quite certain my skills are not "up to par" for LTC. I know I'm just not organized enough for some types of nursing care. I'm a good nurse-just not a good multitasker. I don't think at this point in your career you have any idea what your skills are. My first job I was turfed back to orientation after 8 weeks on the floor-I chose to resign. I was devastated at the time, but now I see it as the hand of God. I hated the job and figured all nursing was the same. It isn't. My next employer has lasted almost 30 years. I don't know where to direct you for a new position but an RN is rarely out of work in my area(Ohio). Wish I had better guidance for you- try again. After all, they didn't fire you- just want your skills to be more developed. That is something I can say about my skills.

[hotflashion, BSN, RN]

CapeCodMermaid said: "Don't give up. There are good places WITHOUT unions with reasonable, respectful bosses."

Unfortunately, there aren't enough; that's why there ARE unions. The best jobs I ever had were non-union; jobs where employees were valued and not treated like human fodder. But I've also worked a few places where "UNION" was front and center in my mind.

[NurseCard, ADN]

Your story reminds me of an experience I had when I was new. I was on orientation working 3-11. The supervisor who was orienting me spent most of the evening elsewhere. Most of the patients didn't have name bracelets so it wasn't easy to tell who was who. There was one resident who lookedlike she was in her 30's but according to the MAR she was 100. The meds included Stelazine and Thorazine....the supervisor screamed down the hall "you are too SLOW". I told her I didn't intend to give medications to someone I couldn't identify and then I added "if THAT woman is 100, I'm going to start taking thorazine!"I finished the shift and resigned. That was in 1982. Since then I've worked in many different places....some good some bad. I am the director now of a large facility. I do not allow any one treat a new or not so nurse badly.Don't give up. There are good places WITHOUT unions with reasonable, respectful bosses.

You know, this is something interesting that I've noticed in my new job. This place where I'm working now is crappy enough but... the residents don't wear bracelets!!!!! NO ONE has a bracelet; I don't even think that they are ever assigned. Sure is hard to pass meds, come and draw labs, etc., when you don't have a clue who anyone is.

I mean, myself, I've learned all 54 residents of my glorious new unit, but I got pulled to the alzheimer's unit last night. You should have seen me trying to pass meds in the morning to a group of walkie talkie dementia patients sitting in the day room. We are lousily staffed, so I kept having to go fetch the one CNA that always works that unit to tell me who was who. I unfortunately can't just rely on asking ALL of those residents who they are.

[hotflashion, BSN, RN]

Re: identification. In assisted living, it is a residence not a medical facility, so there are no bracelets. We have photos. The charts all have photos onthe front cover, the notebooks that hold the MARs have photos, and on the dementia unit, all the entries to the rooms have photos. (I thought that was standard in any dementia unit, as it helps the person whose room it is, identify it as such).