Help !! .........

[NursieGirl199]

I am crushed tonight. I will start at square one. I passed my boards August 1, 2008. I have been working now this is my start of my 3rd week which is one full one one 3 day week. I have had Orientation from 5 different people all on different shift. This is Assisted Living and the meds really are given out in a hap hazzard way. (I think) There seems to be no rules adhered to. I know there is an hr before and an hr after time frame that is law. Well, a lady in this Asst. Living had a b/p of 91 which was under perameters on the MAR. I was not sure which 4 pills were the HTN meds so I brought them back. In the meantime, i get side tracked by a hospice nurse waiting for me due to a woman getting ready to pass. She is telling me about the Ativan and morphine ok to give together. The sister of this dying woman shows up upset and wants to know why the daughter is refusing to allow the dying woman to have the morphine. Mind you I am new on here 2 wks. Time gets away and the meds not checked within the time frame. I had sent the med tech back to recheck the blood pressure to see if it was any higher 40 min after the time line elapsed. She went right to the Director of nursing on me. The director of nursing comes back and tells me that she has to write me up. This same med tech then comes down 2 nights ago and says she know nothing of the 1st floor and can not help me. Am I right to think she has it in for me or is jealous? I was wrong yes. But I erred in the saftey of the patient. I was told that I could not have full time hrs as this was a private facility and 3 residents have just left. I was hired at $21.00 an hr and I know this med tech probably gets half that. She also does not want me take hrs away from her. I was on my own for 3 days with no other problems with my rotation and I was called in for a talk by the Director of Nursing. She says I have had more than enough OT and that all her nurses had no Orientation. All but 1 came from other facilities and have had long histories of prior work experience. I did on med pass in school on 4 patients in clinical and passed. I really had no MAR experience. Is this all about money here? I am so crushed. I really enjoy the residents and have just gotten to where I am feeling confident and she tells me I am on probation and she does not want to loose her license. ???? The one LPN that started a year ago clains she had no orientation and was giving out meds with no problem at all. She did not need orientation. I find that hard to believe myself. I am an ex preschool teacher and it took at least 2 weeks for a new student to settle in. Why do they claim I do not need orientation. And I have to sifer through 6 different nursing styles. Oh .. and.. The daytime gentleman a single LPN brings donuts in every morning for the residents and hands them out with the meds. Can you believe this? So they really don't warm up to me. All the other meds given out are not adhered to and given out when the client feels like they are good and ready to take them. I had mentioned that there is no time from on most of the meds. This one particular woman says the b/p cuff was wrong and her b/p is never 91. I told her I called the dr and dr told me to hold the meds. But I still got written up. Please someone what is going on here?

[3sodapop]

Well, if I were you I'd try not to get too worked up about it. You're new, a recent grad. Mistakes are bound to happen, and it's good you erred on the side of caution. Sometimes it's hard for the CNA's not to feel superior to the newbie LPNs because they have more experience. Try not to take it too personally. The DON was probably trying to cover her a**. Just do your job as well as you can, try to be organized, learn from your mistakes and you'll be fine. If you're worried about making a mistake, are there any nurses there who can answer your questions?

Suggestions: Some LTC's have a mentor program. Also, you should review if you're not 100% familiar with the most commonly given meds; or carry around a little nurse's pocket guide or a cheat sheet.

I know it stinks to get written up but chalk it up to experience and move on. We all have good days and bad days.

You'll be fine & good luck!

[NursieGirl199]

Thank you Soda Pop for your kind words. I was thrown about a bit but I have been counseled also by my sister today. She has been a nurse for years and tells me the EMT and the Med Tech that complained have their noses out of joint. She said it sounds like I am being treated as a new kid on the block. I did tell the aid who opts as a Med tech not to give out the meds I pour. This is state law. She was indignant that I had the nerve to tell her that. The DON asked about time management too. I pour my meds on time and have had not had any incidents other than this one production, so I am wracking my brain. I get there 15 min. early to get report, then go count the narcs and start pouring the 7AM meds. Isnt that time management too? I was told that I had way to much orientation with 2 wks training. I have had 5 give me their take on how to pour meds and I have taken a little from each of them. Mentoring program? That is not an option. Well, The male nurse who works comes back from vacation Monday and works for 7AM till 7PM and hands out donuts. I kinda feel used. I was hired to take up the male LPN's rotation and now that he is coming back I am written up and there are no hours for me. I was not told up front I was only coverage for him. After the fact I see this. I was working 64 hrs the last two weeks. The DON yesterday said there is no hours for me and 4 residents have left this past week from death or needing skilled care. The censes is really low now so money is a factor I fear too. I am slated to work the 10:30 to 6 AM night shift for a few nights the next two weeks. I will do it. In the interim, I am getting my needed 1 year's experience needed to move on. I will look around eventually for something that can give me more hours.

I feel squished out in my profession, in this area, as the hospital work has CNAs to do vitals and RNs to do the needed nursing work. LTC has the CNAs and now I am finding Med Tech's to pass meds. WOW ..... I thought nurses were desperately needed.

Also, I do have an up to date PDA always on me and have all the necessary info on it. I had to explain to the LPN coming on after me yesterday that a new med script was for a loop diuretic. They took the Lasix from the packs and extra packet of meds was replaced.

This nursing is hard to fit in. I must tell you that I am 60 and am very active. I am in excellent health and do not look my age. These kids are really trying to take advantge of me so it seems. Ha ha and fussy like teenagers. This is no picnic.

Thank you again for your kind words. I will keep truckin on ......

nursiegirl199

[kiszi, RN]

:icon_hug:Welcome to the board!! Sounds like you had a really tough shift. And a write up, too? Don't worry about that. Virtually everyone gets written up one time or another. And meds don't always get given on time. It happens. It does sound like you would be better off somewhere else. Hope you find a place that treats new nurses better! All facilities are definitely not like that one.

[NursieGirl199]

Thank you KISZI. I am gonna try and stick it out for now. I need the backround years of experience. I will definitely look around too and see what is out there for an LPN here in my area. In the meantime, I am gaining experience and learning how to give my meds timely and very very efficiently. I just can't see how I can gain experience on nights when everyone is sleeping. No patient or resident interaction going on. ;(