Tell me about your first job!

Mandylpn · Nov 30, 2005

Started out in LTC, it is not for everyone, loved the residents but very hard work, if you are young maybe you can handle it! :lol_hitti

Simba&NalasMom, LPN · Nov 30, 2005

OK I apologize in advance for the "book" I'm about to present:

My first job was pretty much a nightmare (I'm sure other nurses have had it much, much worse than I did lol). I took a position in a LTC facility that was desperate for nurses. They gave me two weeks of orientation during which I trained with different nurses with different styles every day (red flag number one).

Once I was off orientation, I was put to work on day shift as a floor nurse. I was responsible for passing all my meds, all the treatments, and all the documentation for 35 patients; we had a charge nurse who was responsible for calling the docs, writing phone orders, calling the pharmacy, and that sort of thing.

It was a very unpleasant experience for several reasons: Passing all those meds took 95% of my time, so my treatments and charting suffered. The level of acuity was higher than the norm for LTC...I had around 10 diabetics, a couple of tube-feeders, and sometimes up to 10 residents on skilled care/medicare charting (even though the unit was technically LTC, we would get the overflow from the skilled/rehab unit). Skilled charting means a full head-to-toe assessment and the appropriate documentation.

The daytime charge nurse was another problem. As a new grad, I needed strong support but she was such a loose cannon and got so stressed over her own duties that when I would approach her with questions she would get snippy with me and tell me to figure it out for myself or she didn't have time. The worst it got was when the DNS went on vacation, leaving the unit manager and ADNS in charge. Instead of addressing the obvious issues of staffing and morale, they took it upon themselves to nitpick at every little thing that they thought the nurses were doing wrong; of course, the CNAs had performance issues as well but they were left alone. I kid you not: during the time that the DNS was on vacation, the facility lost NINE NURSES: 5 of them staff, and 4 of them new hires that worked a couple of shifts and quit without notice. The worst was when I finally coudn't take it any longer and gave two weeks notice. The ADNS and unit manager called me into the office and basically tag-teamed me into staying by guilt-tripping me, telling me that a lot of time and money had gone into training me as a new grad and I OWED it to them. I caved and stayed on another month; I also discussed these issues with the DNS when she returned. She was sympathetic but did not make any changes to how things were done.

It did help for awhile when I moved to evening shift...I had an awesome charge nurse who was a great mentor; unfortunately, the damage had already been done and the facility was still a bad place to work despite changing shifts and having a good charge nurse. I wound up quitting without notice because I could not take another day. I worked a total of three months at that facility.

Here is what I would have done differently:

1)Stuck to my guns. When management told me that LTC is the same wherever you go and the grass is not greener, I was naiive enough to believe them. Sometimes the grass IS greener. If I had stood my ground with these two bullies, I would have been able to get through the next two weeks and leave on good terms with the corporation and been able to use them as a reference; but I stuck it out another month just because I let myself be bullied into it. Now, when a potential employer calls, they will say I'm not eligible for re-hire, which is a black mark on my job history.

2)Not settled for the first job offer that came my way. It was easy to do, cause I had been in school for the past year and I needed to start making money. I would have done better to take a bit more time and really check out several different facilities and found one with a training program specifically for new grads, instead of taking a job at a place that was desperate for warm bodies.

3)Taken some time, during the tour, to observe the staff and what their work habits and attitudes are. Good CNAs are true gems to find and can make the difference between what makes a job great and what makes it suck rocks. It's amazing how their knowledge about a resident's habits, behaviors, and general conditions enable the nurses to give the best care they can. I absolutely love the aides I have in my current facility; they are so tireless and pay very close attention to changes in condition and communicate with the nurse like true members of a team. I try to help them as much as I can and I only wish I could do more.

I'm still a new nurse with about 6 months experience. I have continued to work in LTC but have found a great company that is willing to work with me to make sure I get adequate training. Yes, there are negative elements to LTC that will be similar no matter where you work: staffing is pretty skimpy, profit is always the bottom line, it's hard to watch people deteriorate, and people dying is a given. But I've found that with good CNAs and good management, it can also be quite rewarding. It's nice getting to know your residents as people and not as the "CABG in room 6"; also, working with the same people every day (as long as they're good people) strengthens the team spirit which means we are able to give awesome care to the residents we come to know and love.

The best advice I can give you is to not force yourself to rush. You will feel pressure to get things done fast, but please realize that as a new grad you are not going to be as fast as a nurse who has been doing the same thing for 20 years.

Question, question, question! Even if you feel it's a stupid question. If you feel that you are given more to do than you can handle, speak up. I learned this the hard way a few weeks ago when I was overwhelmed but felt that I had something to prove so I kept quiet. Fortunately, nothing horrible happened to any of my patients that night and I have an understanding management team who was willing to give me additional training.

Most importantly: we work in a profession where human life is at stake and every day that we take report we are undertaking an awesome responsibility; but find a way to make it fun! Despite the challenges that my first year of nursing has brought, I wouldn't change my decision to go into nursing for the world. No career for me has been more rewarding.

Welcome to the forum and the profession...you're gonna be awesome!!!

:balloons:

JazzyLPN · Nov 30, 2005

Thank you SO much for the wonderful advice. I too am a new grad, and I haven't had a job as a nurse yet. A lot of it has been due to fear. You gave me some good insight as well, thank you!

JazzyLPN · Nov 30, 2005

Thank you SO much for the wonderful advice. I too am a new grad, and I haven't had a job as a nurse yet. A lot of it has been due to fear. You gave me some good insight as well, thank you!