New LPN in LTC. Time mgmt tips/tricks? Med pass advice? etc....

[LPNKY2012]

Hi everyone,

I'm a new grad, new LPN, on my very first job, at a LTC facility. I love the people, like the facility, but I feel so unorganized & after my first stab at the med pass I am terrified.

I know it's going to take some time to get familiar with the names & faces of my residents & get to know who is up first, whose meds I can knock out quickly, & who I will have trouble tracking down or getting to cooperate, etc.

I'll be on day shift 7am to 7pm, with about 20 residents. My very first preceptor has been a LTC nurse for a really long time. She is great - she makes everything look so easy, she's so light on her feet, such a bubbly, positive attitude, great with all of the residents & all of the other nurses & CNAs. I call her the "people whisperer." She is so efficient, she seems to whiz through her morning med pass, do some treatments, takes time to stop & interact with her residents, helps other nurses when needed, & even has time for breaks & lunch.

I guess all of this comes with her many years of experience. I'm learning a great deal from her, but after my first test on the car myself, I felt like an utter failure. Like I was spinning my wheels & ended up 2+ hours into my med pass, missed some treatments, & two other nurses ended up helping me. Thank God for them!

Would any of you have any advice/experience to offer on time mgmt, tricks to help a new nurse be more efficient, etc? I feel like I just can't hurry any more than I already am or I'll risk med errors. Any advice for taking/giving report? I don't seem to know enough about my residents to give a full report & not just read off of their chart, but the oncoming nurse seems to look at me like I'm a moron if I tell her there were no changes, vitals were WNL, a certain issue has been resolved, or just report the MD orders that were given during my shift & changes to care plan.

Also, any tips for dealing with CNAs who are testing to see how little they can get away with while the "new nurse" is on?

Thanks!

[LPNKY2012]

WOW...I realize how completely horribly insensitive & moronic my comment about my CNAs sounded. I really did not mean they "only" turn, change, bathe, feed, etc, etc. That is terrible, & I really did not mean it that way. What I meant was I was not expecting to spend my day rushing & running, & my expectations of what the CNAs do was different than what it turned out to be at that facility.

I have worked as a CNA in a LTC facility, briefly, & my job was different - perhaps because it was on a different shift, or just a difference in facility policy. I had a list of patients & got routine vitals for my nurse, helped out with certain treatments, etc. Our jobs were a little more geared toward helping the nurse - maybe because it was a small facility, maybe because everyone there just felt like kissing ***, or who knows why. That's just the way we were trained.

My point is, I absolutely respect CNAs. They have a back-breaking job, believe me I know - the stress & strenuous work I did as a CNA threw me into early labor.

[BrandonLPN, LPN]

I think new nurses go into LTC expecting more help and obedience from their CNAs than they wind up getting. This is understandable, considering what they tell us in school and considering the actual job title. The reality is, once they hit the floor, they realize that the nurse has his job and the CNAs have theirs and neither has much time for anything else either way. That's why doing little things to help goes such a long way. Help pass trays or put someone down to bed when you have the time. The CNAs will respond to that. They'll be more willing to help when asked, rather than rolling their eyes or giving attitude. (I'm not implying the OP doesn't already do this, just offering it up as general advice)

[TheLiberation, ASN, BSN, RN]

It may be half and half. Half of your preceptor's abilities might be her personality and the other half is definitely the fact that she is a regular there and probably tries to stick to the same routine day in and day out. This is a right of passage for all new LPNs. We can all argue about who have more patients but at the end of the day we are all different and all situations that we encounter depend on the critical thinking skills of the person responsible for that particular situation in that time and that location. Even if you feel like you're being judged, and even if you are, plenty have been in your shoes and plenty will be soon. So don't fret, EVER. :)

[Elladora]

I created a cheat sheet. It had each client's name on it. Behind each client's name was a notation such as "crushed in pudding" or "cream bid". This helped me keep track of anyone that had anything extra/different.

Before you start each med pass, be sure you have everything stocked (med cups, applesauce, pens, sleeves for your med crusher, etc). Having to stop med pass to go find things is annoying and really can disrupt your groove.

As for CNAs, I've found that if you help them a little, they will help you a lot. Don't ever think anything is beneath you. If you discover a code brown and you aren't busy, handle it. If a CNA sees you are willing to help, they tend to appreciate that.

Take your time now (while you are still learning). You will be amazed at how quickly this becomes routine for you. Soon you will be flying through med pass.

[jagged777]

Thank you all for the info

[yupthischickanurse]

Thanks guys this was helpful.