Bad weekend in LTC, wondering why I am a nurse

Nurses LPN/LVN

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Sorry if this is long, but I just need to vent. First of all, I am a new LPN, just graduated in February and passed boards in March of this year. I have been working per diem on weekends in a LTC facility, plus still working my full time non-nursing job Monday thru Friday. I did not want to jump right into nursing full time until I became comfortable being a nurse. After this weekend, I don't know that I will ever be comfortable. The first clue that it was going to be a bad weekend was when I went into work and looked at the schedule and saw that they had scheduled me to work on a weekend that I specifically asked for OFF, because my family is going away on vacation. A vacation that was planned before I even started working there. I am per diem and had given them a list of my availability and told them I was not available on that weekend. It use to be that they would call me and go over my availability before they put me on schedule. Now they just automatically put me on every weekend. I left a message for the person that is charge of scheduling and hopefully things will get fixed.

The second clue was the hallway that I was assigned. This hallway has a high percentage of fall risks. I spent most of Saturday night with 4 or 5 residents moving up and down the hallway with me as I did my med pass, while waiting for the aides to put them to bed,so that I knew they were not climbing out of their chairs. So my med pass took a little longer than usual because I had chair alarms and bed alarms that were constantly going off. I was a little frazzled, but by the end of the shift, everyone was safe in bed and we had no falls.

Then Sunday night was a total nightmare. Again, I had the hallway with all of the fall risks, and 2 residents were persistently getting out of their chairs. Then, just as dinner began, I had a resident that was complaining of SOB. I took him back to his room,

assessed him to make sure that there was no major problem and put him to bed with O2 as per his prn order. This is something he goes through at least once a week, especially with the hot, humid weather. As I was taking care of his needs, one of my other residents, probably my most alert and mobile resident, bent over to pick up keys that someone had dropped, lost his balance and fell. I had spent all weekend trying to prevent falls and the one person I least expected if from, was the one who fell. As a new nurse, this was my first fall. So I am taking care of him, calling the doctor, calling his family, documenting and writing out an incident report, checking in on my SOB resident, keeping everyone else from falling, trying to pass meds and generally pulling my hair out. Then to top it off, the fire alarm goes off. I am just ready to quit.

I left the facility last night wondering if I am going to get a phone call today, telling me that I am fired. It was my first incident report, I hope that I filled it out appropriately. I would have liked to have had one of the other nurses look it over, but they were kind of busy with the fire alarm and had incidents of their own that they were dealing with. I documented on everything I did for my residents, but just feel like I did everything wrong. I feel like my documentation is not up to par and that the nurse manager will be looking at it under a microscope, looking for mistakes. I was up all night, running things through my mind, did I do this right or could I have handled this differently, did I forget anything? Right now, I feel like the worst nurse ever. I had wanted to look into an LPN-RN program for next year, but now I am not sure that I am cut out for this.

Someone, please tell me that it will get better with time and I am just over reacting. I try my best to make sure that my residents are safe and have everything that they need, but it just does not feel like enough right now. Maybe I just really need that vacation.

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Specializes in ASC, Infection Control.

just take a deep breath and try to relax...i sincerely doubt you will be fired for this single incident. maybe if it were something that consistenly occurred under your care, but that's not the case. sometimes the most mobile residents are the ones that are most apt to fall, and they need to be watched just as much as the other ones.

you do not sound, by any account, to be a bad nurse! you need to have confidence in yourself, first and foremost. you are a nurse, and i'm sure you are a good nurse. :wink2: as long as you documented everything that happened, you should be okay. it's not fair to yourself to expect that nothing is going to go wrong under your watch and then beat yourself up when something does happen. if you are proactive in your patient's care and protect them to the best of your abilities, that's what matters. you can't possibly be in two places at once - it's not as if you were sitting around, watching the resident as he bent down to scoop up keys and just waited for him to fall and then intervened. don't be upset at yourself in this situation.

we live, we learn, we grow. let this situation be a learning experience for you and you will be a smarter nurse for it. if you love nursing and truly want to help others, then you will be just fine. all you need is a little faith in yourself, and you'll be amazed at what you're capable of. :nurse: don't let this one occurrence scare you away from following your dreams!! good luck to you

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Specializes in LTC, assisted living, med-surg, psych.

Hmmmmm......sounds an awful lot like the weekend I had, and I've been in LTC for years!

Please, whatever you do, DO NOT BEAT YOURSELF UP OVER THIS. You did everything by the book, and you did your best. Even the best nurses have days like this, so please be gentler with yourself and give yourself a break!

Secondly: The only way you'll ever become "comfortable" as a nurse is to.....be a nurse! The more you practice, the faster you'll learn and the better your confidence will be. Please consider quitting the non-nursing job so you can work fulltime and sharpen up your time management and assessment skills.

Above all, realize that LTC is a hard, hard job and that bad things will happen to residents because they are so frail and vulnerable. No matter how much you watch them and try to protect them, you cannot possibly be in more than one place at once, and you can't rescue them all when they are determined to get up and go catch that bus to Albuquerque, or head to the job they've forgotten they retired from 20 years ago.

Best of luck to you, and please, stick with it! It does get better!!

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Thank you both for your words of encouragement. After getting a good nights sleep, I feel better today. I am hoping that my confidence in my nursing abilities will grow as I continue to survive weekends like this. Nursing school sure doesn't prepare you for the real world. Quitting my non-nursing job is not an option right now. The LTC facility does not have any full time openings at this time, and I really do not want to go elsewhere, since this is the best facility in my area. I am just glad that I am getting per diem work to get experience. I guess my biggest problem is that this facility is so much better than most and have very high standards. Sometimes I feel like I am not working up to standard because I am still a new nurse. But I guess I just need to live and learn. I am not afraid to ask questions and I would never do anything that would harm one of my residents. I guess I am not doing too bad since they keep putting me on the schedule. It helps to know that I can always come here to vent or to ask questions.

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Specializes in ASC, Infection Control.

I'm glad you are feeling better. It's good that you are working in such a high-standard place though, because as a new nurse, you will (hopefully) see things done the right way and will learn to work to the best of your abilities.

Look at it this way - if you weren't worried about being a good nurse and being "up to par", then there is something to worry about - obviously you care enough to worry and that is a GOOD thing!!

Keep positive and just remember every experience is a learning opportunity. Take care of yourself. Atleast we have all have a place like this for support and encouragement! :)

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Specializes in Mother-Baby, Rehab, Hospice, Memory Care.

Ok first of all take a deep breath... What you have described sounds like a fairly typical day in LTC. Residents will fall from time to time, you will have incident reports, there will be acute needs that you have to assess and intervene. That is why you are there as the nurse. By yourself you cannot prevent everything from happening. From what it sounds, you did everything correctly. Don't beat yourself up if you make a little mistake here and there, you are learning! If your documentation isn't up to par, management will let you know and should understand that you are new and should show you the correct way. Trust me, I experienced worse sounding days than that when I was a new nurse in LTC. I am stubborn and I kept at it, learning and gaining more cofidence. I might also recommend quitting your non nursing job and taking a full time position in nursing. That way you can gain more experience and confidence in yourself. I won't lie, it IS hard at first and there WILL be many times you want to quit but you have to give it time. Even if the first job you hold isn't your ideal job, just keep in mind that it is a starting point and not something you will have to do forever.

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No, this is not my ideal job, as much as I love the residents. That is why I am looking into LPN-RN bridge programs, so that I will have more options. I guess I was just looking for some

reassurance from others that have been through this and know what I am going through and I just needed to hear that someday it will get better. Hopefully, someday I will be the one giving

advice to the newbies.

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Specializes in Geriatrics.

Hang in there, I cant really tell you it gets better with time but the more experience you get the easier it is to deal with everything going on. I have been a nurse about 5 years and some days are easy peezy and other days are like the one you described bed alarms, falls, psycho family members and everything else in between. Hang in there!

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Specializes in LTC.

welcome to LTC! What you described is basically a daily thing...I dont think I can even remember a truly uneventful day that Ive had as a nurse in LTC. Its always something...falls, skin tears, bruises, breakdown, sob, chest pains, n/v/d, .....paperwork paperwork and more paperwork. Im not really sure if it gets "easier" but I think it gets easier to deal with as time goes on. Alarms dont prevent falls....and this is why....they just let someone know that 1) someone is moving or 2) they are already on the floor or up and moving around. I sometimes think they are worthless.....b/c half the time the batteries run down in a matter of days or the cords get stripped or my fave...when they figure out how to turn them off or lay stuff on them so they can get up without us knowing...til we find them on the floor. Our incident reports are outrageously long....about 6 pgs front and back. My DON wants us to fill out incident reports if we THINK someone MIGHT fall....which...nobody does that b/c you cant document what you think...has to be facts. craziness.

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