First nursing job = Nursing shock! Need advice please.

Nurses LPN/LVN

Published

Hey everyone, so I'm new at this and I would really appreciate some feedback that could possibly save my career as a nurse...

My first job as a LVN is working at a skilled nursing home and the moment I had gotten hired on the spot, was the BEST feeling in the world!!! But the moment I started working, in which they only trained me for six short days, I was also being taught wrongfully by some nurses... Everything was being fabricated, and things just got real! Finding out this place did not pass the state 4-5 times earlier this year and almost shut down said a lot by how some of these nurses trained me... Like assuming a patients BP was within the range to give BP meds, and documenting that meds were consumed by patients when it was really refused... I was in shock, but as a new grad and a new nurse, I stuck to what I believed was ethically right for my patients. A part of me is afraid to work in a place like this, and the first time I had to stay over additional 6 hours after my shift ended to finish orders, and documentation I had my first mental breakdown. Got me thinking and questioning myself if I had gotten myself into the wrong profession, I cried for days. I've been working there for just about a month now and I know that eventually things will get better, for now I just have to stay paddling. It's also been hard to get my routine down since I'm a floater, it's always a challenge being switched between 3 different stations with 30+ patients.

I'm slowly starting to get numb and comfortable to all the craziness and hectic days, but I'm still questioning myself if, maybe skilled nursing home isn't for me? or could it mean that nursing overall isn't for me?! I'm the first nurse in my family so I don't really have a lot of people to relate with, there's a few people at my work who tells me that it's always going to be tough in the beginning and that's kind of expected, but I want to think that maybe it's this place that I'm working for that is ALL WRONG and not ME?!

I feel like an emotional wreck. I want to be a great nurse! But it's hard to maintain that mentality working for a place that feels so disorganized and almost wrong. I have no comparison since this is my first nursing job. I don't know if it's like this everywhere else?

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I understand where you are coming from ... I am also in the same situation..I was so excited the first week but now I'm going on 4 months and I don't feel so enthused to go to work .. I think it's the facility.. I still feel ambitious and like an advocate for my patients. so I honestly think it boils down to what kind of facility you are working for. Mine is a 2/5 stars lol I'm hoping I can finish my RN or land a different job working for a better organization. Don't give up on nursing, this is just your first experience.

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Irene it will get better. I was in your shoes once , new grad at a facility with only 3 day orientation facing the same problems. Was floated around dif floors with 40 pts only I as charge nurse and an RN supervisor who was gone most of the time on other floors. After 6 weeks you should be getting your routine down pack , buy a notepad to plan out the day and when to do your finger sticks , med pass , treatments ect. By the time you know it everything is done with time to document. The issues you described bothered me as well and I applied to a better facility and was hired having obtained experience. Protecting your license is important gain your 6 months experience and look elsewhere , these places have high turnover and don't care for retaining quality nurses just having someone to cover their short staffing.

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I also wanted to add that to use your cnas to your advantage. They are your eyes and ears on the floor , help them and they will return the favor. It's impossible to check all the v/s while doing med pass , that's why you can delegate these task to your cna but make sure they are competent in checking v/s first. They will apply the creams and lotions for you if they feel you are a team player and not just a pushy nurse. Best of luck in your career and it gets better.

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Great to hear that I'm not the only one feeling this way... and your right, and thanks for the advice, it REALLY means a lot to me, and I'm really just going to try and give myself 6 months in this place and I'm going to hope and pray I find a better job. It's just so disorganized and fabricated it's insane. I'm going for my RN too, and getting ready to apply this semester so I'm going to cross my fingers! Goodluck to you! and I hope you land a better job opportunity in the near future!

Thanks for the great advices!

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Since many of you have had a new grad bad experience. How long do you think a new grad job training should be? or what could be helpful for the new grads. I work at a pediatric office and I'm trying to encourage the CEO to open up a new grad program. She has asked me to come up with a job description and training plan for new grads. I would really love you guy's input and ideas in what would be helpful. How long do you think the training should be, would having a mentor help. The new grads would be placed in a clinic setting ordering routine immunizations, giving oral meds, minor wound tx, a breathing tx. Your ideas would be helpful.

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Keep on keeping on. Make sure that you don't fabricate, that you are on top of documenting accordingly, protect your licesnse. How others choose to practice is not your issue, only how you choose to practice. Give it long enough to get the experience you need to move on.

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I'm kind of in the same boat. I have been working at a LTC/skilled facility for 2 month. I'm the charge nurse of 26 patients (10 are skilled), 1 CMA and 2 CNAs. I had 2 days of orientation and that was just passing meds before we got a med aide. I wasn't told what all I was supposed to do or what the guidelines were for labs, emergencies or anything else. Then when things weren't done I would get yelled at or written up. Being a new nurse and the only one working the shift I would have to call my DON and ask what to do if something came up. I get so frustrated when I come on to my shift and supplies are not ordered or we don't have to right things to do my job. Some days I just feel like crying and others I think about quitting. Sometimes I think that things are getting documented that they were done on the other shifts but they aren't really done. The facility pays way more then anywhere else around but they have lost 4 nurse and 5 aides since I started working there. The amount of work per nurse and the stress doesn't seem worth the money.

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I am very lucky to have started in a facility that really took pride in their nursing staff and low turn over. I had 3-4 weeks of orientation. Same thing with the next facility I went to.. I orientated for almost a month! I had a week of orientation on each wing and another week to learn the computer system, order entry, documentation, ect ect.. They did not take anyone off orientation until they were comfortable to working the wing independently. The last place I worked?? New staff members were lucky if they got a full week of orientation! And usually their orientation period was cut short when a nurse called in and the orientee would be thrown out on the floor by themselves! I think orientation periods should be at least 3-4 weeks.. The orientee should be comfortable working each hall they may be assigned to as well as know how to transcribe orders and be able to do their daily documentation comfortably before their orientation period ends.

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Specializes in Emergency Nursing.

I started writing a 2 paragraphs and got too personally involved... so let me say this...

Become an RN. LPNs get the sloppy seconds RNs don't want to deal with. LPNs aren't even allowed in the American Nurse's Association for Goodness Sake. What you are experiencing is a LTC thing most frequented by / through LPN/LVNs.

I just wrote two more paragraphs but rambled far too much......... Nursing is not a hard nor overly difficult profession if your facility supports you. Please find another job or become an RN where you will encounter more job offers with better respect for nurses.

::edit::

someone once told me on AllNurses that if a nurse can't make it in the slowed pace of LTC then they couldn't make it anywhere. I'm telling you, as a nurse who works the ER, if a nurse CAN make it in LTC, then they can make it anywhere! That other person on AN didn't know what they were talking about and obviously didn't have a generic LTC experience.

... begin shortened version of rant.... After several months of working the ED, I was informed I was chosen not just for my interview skills and job experience, but the ED was looking for an LPN who worked outside of LTC (ie my Corrections experience). So essentially, those LTC nurses become boxed in b/c so many hiring managers feel that LTC nurses do/know nothing pertinent.

This is how reality in my area is. I pray you can find a different reality before it is too late.

Good luck....

/ end edit

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Specializes in Emergency Nursing.

oh another thing.... did you know... where I work... the nurses in a non-trauma setting, freak out when they have 3 patients at one time and there are 2 of whom have orders at once.

So as a LTC nurse... you have 30+ pts. All 30 have a minimum of 6 PO meds (talking minimum). The Average patient probably has around 10. 8 pts have wound care to be completed. All need to be showered, toileted, cleaned, and fed. 4 are total care/feeds. 20 of those patients are on BP medications and need daily VS and at least half of which need daily weights. Another 12 are accuchecks. That is just the morning basics.... Do you know how hard the morning acute care RNs would LOSE their stuff if they had to take care of those same 30 pts with just 2 UAPs to help them..... the RNs wouldn't stand for it. So why does it stand in LTC? RARRRRRRR I'm so angry about this.

Several other of my LPN cohorts plant to become MSN RNs of various types and create our own nursing homes to help those poor geriatric patients get the care they deserve and encourage proper care by the nursing staff with standardized nurse (LPN or RN) to pt ratio.

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I totally felt exactly the same when I first started in LTC. I had three days training and felt completely thrown to the wolves. I was a new graduate, it was my first job, it was horrifying.

My first few weeks I was there at least two hours over every night.

And on top of that, everyone around me had atrocious nursing habits. No one wore gloves, things weren't clean, paper charting was a mess. Well, most of those things are still going on.

But the job had gotten easier. I found a routine, got to know the people there, and just pushed through.

It'll get better, just keep going :)

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