I would look for a PRN job at another facility, if there are others in your area. I've been working overtime at my job, but the FICA tax eats all of it. Try to get on PRN in another discipline, get new experiences, then approach your supervisor about a rate increase.
You had three weeks orientation as a new grad to a med/surg with tele floor?!
Yes. It was supposed to be longer, and even as I was working as a staff RN, I was listed on the schedule as "orienting," but I had a full load (4-5 patients) and no preceptor. I've had to learn by immersion.
That I don't leave work and worry all night about what I forgot to do! I work on a VERY busy med-surg/Tele floor and I swear, I am running all day, and by the time for report, I'm a wreck. I use "brain" sheet, check orders constantly, can pretty much stay on time for meds, but I still feel behind ALL. THE. TIME. My orientation, which was supposed to be nine weeks, was cut to three. I got yelled at by one of the night nurses for letting a bag of LR run to gravity when my patient got back from a procedure, something I totally didn't know was a no-no. She was a total condescending b**** about it, when she could have told me in a nice way. I would have learned the lesson just as easily. I've lost whatever confidence I had, and I truly just want to take great care of my patients.
I started on a med-surg/tele unit in November and got three full weeks of orientation, as a new grad. I don't feel ready, as far as facility orientation goes, but the NUS is insisting that I take a full load. I don't really know what to do. I love the hospital where I work, but some of these people are really sick. For example, I had a patient last week with a potassium level of 2. I didn't know how to initiate the protocol that was in place, and I heard, second-hand, that the doctor was frustrated with me. I had never done anything like that before, and feel like I'm getting shorted in my education. I'm still listed as "orienting" on the schedule, but the charges are giving me four patients of my own each shift.
Thank you! Having worked in an SNF/LTC with 30+ residents/patients daily for 6 months, I learned how to manage time and prioritize, it may be the only thing I came away with that I will use in my new position, but I'm so happy to be in a hospital environment.
Hey! I just got a sparkly new job on a med-surg/TELE floor and I am STOKED! I graduated in May and have been working in LTC since June, but have had my heart set on a med-surg job since I started school. Any advice, or anything else to get me prepped for my job would be so appreciated, I start November 19th with orientation. Anyhoo, howdy and thanks!
I'm a new nurse, working in a busy LTC/SNF/rehab. I love the work. I love (most) of the residents. I love (most) of my peers, but the management really leaves something to be desired. Schedules are a nightmare, nurses are quitting left and right, and the DON and ADON don't seem to care. So I have this idea. . . I work in a non-union state. We, as nurses and aides, have very little to no leverage when it comes to negotiating with our managers at this facility. I know that everyone, (yes, everyone)who works under these specific managers is very upset every time schedules come out, to the point that it feels like blatant disrespect. Days off requests are flat-out ignored, etc. So here's my idea: for the staff (nurses/aides), create a totally anonymous survey and ask a few key questions about what they would like to change about scheduling. Have a drop box to put them in, then collect them and go to the facility administrator and propose a mediation meeting between staff and management. We all tend to get so angry and emotional that I really think a mediator, an objective person who could keep us all on track, would be essential. Is this a good way to initiate change? Like I said, I'm a new nurse. I haven't been at this facility for a year yet, I don't want to lose my job, but some predictability, some reasonable rhythm and flow to each month's schedule would make such a difference, not just for me, but for all of my peers too. I miss the days of CNA at the hospital, where we filled out our own schedules (for approval, of course) every month. Why is that such a taboo thing at other facilities? Help?
The challenges where I work (LTC/SNF/Rehab) are the same as those mentioned above. The SNF/rehab is relatively new, and used to be a locked Alzheimer's/dementia unit. They left the "farthest gone" residents there so that they wouldn't be totally messed up by moving to a new unit on the LTC side. Unfortunately for me (when I'm on that unit) and for the residents, there is only one RN (me) and 36 of them. I talked to my RCC about it the other day while gathering up supplies for med pass, about how I lament the fact that there isn't time to do more "nursey" stuff for the patients and residents, between PRN pain meds, keeping the dementia residents seated, fall charting, scheduled meds, coumadin orders, blood draws, and calling physicians. She said, "yeah, it's quantity, not quality." This was a rude awakening to me, for her to actually admit that. I'm a new grad, mind you, this is my first "real" job. I worked my a** off to get this degree, and not so I could be a glorified medication aide. I want to help make people better, I want to use and gain more skills. I'm afraid that by the time I get my year experience, any hospital will dismiss me. Like most others, I LOVE the residents. They're awesome and fiery and funny and keep me sane. But the institution itself, and the LTC system in this country need a serious overhaul, starting with GETTING RID OF PAPER MARS. I still can't wrap my brain around that little gem, and this is my fourth month at this job.
Adding, last week "State" was auditing our facility, I was off the day they came, one of the RCCs called me at home to come in and fill a couple holes in the MAR from the Monday prior, when I was the ONLY nurse (we had a med aide for 2 of the halls) to put in orders for 60+ residents, (coumadin, PT/INR, you know, Monday orders) then we had a meeting the last hour of the shift. So I had to rush through my EVERYTHING and jeez, didn't have time to go through the MAR and fill in the few holes. So I went, on MY time, and filled them in. Then, she called me again, the NEXT DAY, when I was off again, because I forgot one 72-hour paper charting on a resident who had fallen on a different shift. She wanted me to come in, again, on my day off, and falsify an assessment because state was there. She was there for the same shift, she's an RN, she could have easily just done the charting in the time it took to call me. I know these are my responsibilities, but when the work of 3 people is heaped on me, the odds are that I might forget to do 2 things. I love the residents where I work. But to manage through intimidation is, excuse my language, bullsh*t. Unless someone is dying and only I can save them, leave me alone on my day off. It'll keep until my next shift.
I just graduated, got my RN, and started in an LTC because hospital jobs are scarce here right now. My experience with the (very nice, very expensive) LTC where I am currently working has been excellent and awful, at the same time. The excellent comes from the residents. All of them have from mild dementia to late-stage Alzheimers, and have completely stolen my heart. The awful comes from the business end. Yesterday, I was the only RN in the entire facility, and I didn't even know it until the LPN orienting me let me know. Last week, on my fifth day of orientation, the RCC decided I needed to pass meds on two halls, for forty residents, for the AM med pass. That allowed me 3 minutes per resident, if you break it down evenly. Some of the residents have 15+ meds that have to be crushed. That, in itself, can take 10 minutes. I let my LPN orienter know that it wasn't safe for the residents, that I am protecting my license, and that I would gladly take one hall, but not both. Whatever kind of game the RCC thought she was playing to test my speed was totally inappropriate, and putting residents and ME at risk for med errors.
Forget quality of care or anything you learned in nursing school. I am now a glorified Medication Aide, hired because the RN after my name improves the facility's rating. The biggest travesty is that the residents are bored, sad, and confused, and I don't have time to properly nurse for them.
There is a rehab unit, that has short-term patients. I don't know if I'll be on that unit or not. Right now they have me orienting with the Alzheimer's/dementia unit with long term residents. I know the med pass in the hospital takes a lot of time, but you also do myriad other things, like patient education, complimentary therapies, and plan care. This is just. . . finding the residents and either spoon-feeding their meds to them crushed in some horrific concoction, or watching them swallow their pills. I'm proud of my clinical skills, I worked hard to earn them, and this job depresses me. Again, I love the residents. They're human beings in a very vulnerable place in their lives, and I treat them with the utmost dignity and respect. I just want to be in a place where there is hope of my patients getting better, and to know that there are things that I am equipped with to facilitate that healing.
Hi all,
I just graduated in May, and got my RN in June. The market here is saturated with new grads, so I took a job at a very nice LTC in my area. I've worked for exactly one week and I'm feeling really sad. I am basically working as a medication aide, not using ANY of my nursing skills, and feel like I was hired because they needed an RN on the unit to satisfy some sort of requirement. All my clinicals and preceptorship were hospital work, I am not used to not looking at vitals, labs, etc. They have PAPER MARs, which totally blows my mind. The residents are the only bright spot, they are delightful. But the autonomy that I expected from this profession is not there. I am pushing a huge med cart around a HUGE facility, medicating 25+ patients 3 times a day plus PRNs, and I'm really down about it. Please help, I really want to work in an acute care setting. Should I keep applying and leave (with notice) if I get an offer? Or should I stick it out for a year? Is this job going to be a stigma on my record? How do I keep my knowledge and skills current?
You know, nursing exams are hard, period. They're not like regular exams. I will be happy, when I re-take my course, to pass them! I met with the department chair yesterday and she was so nice and positive, and delighted with my positive attitude. Yes, it all happens for a reason, and I have a few CNA II interviews lined up. I've let go of feeling like a failure, because the only way I would be failing is if I gave up! I will also be re-taking the course with a friend, and we are working together on the practicum that we are required to pass for re-entry. We will be better nurses for this, just you wait and see!
I was enrolled in an Associate's degree program, and failed my final class with a grade of D. I worked for two years to get into the program, then two years of the actual program, and I'm grappling so much with this failure. I've always been a great student, both classroom-wise and clinically. I have such unresolved grief over failing this course and having to completely change my life plans. I can retake the course next year, and will be in a better position familially (my family didn't have a car the entire semester, my father became incredibly ill), and have a tremendous understanding of the material, it's just incredibly hard to suddenly stop all of your work because school is over and you didn't get that diploma. It's like having a stick thrown through your spokes. Good luck to you, I completely empathize with everything you're going through. I'm glad I stuck it out to the end, I put my whole heart and soul into passing, but there just wasn't any way.
I would look for a PRN job at another facility, if there are others in your area. I've been working overtime at my job, but the FICA tax eats all of it. Try to get on PRN in another discipline, get new experiences, then approach your supervisor about a rate increase.
That I don't leave work and worry all night about what I forgot to do! I work on a VERY busy med-surg/Tele floor and I swear, I am running all day, and by the time for report, I'm a wreck. I use "brain" sheet, check orders constantly, can pretty much stay on time for meds, but I still feel behind ALL. THE. TIME. My orientation, which was supposed to be nine weeks, was cut to three. I got yelled at by one of the night nurses for letting a bag of LR run to gravity when my patient got back from a procedure, something I totally didn't know was a no-no. She was a total condescending b**** about it, when she could have told me in a nice way. I would have learned the lesson just as easily. I've lost whatever confidence I had, and I truly just want to take great care of my patients.
I started on a med-surg/tele unit in November and got three full weeks of orientation, as a new grad. I don't feel ready, as far as facility orientation goes, but the NUS is insisting that I take a full load. I don't really know what to do. I love the hospital where I work, but some of these people are really sick. For example, I had a patient last week with a potassium level of 2. I didn't know how to initiate the protocol that was in place, and I heard, second-hand, that the doctor was frustrated with me. I had never done anything like that before, and feel like I'm getting shorted in my education. I'm still listed as "orienting" on the schedule, but the charges are giving me four patients of my own each shift.
Thank you! Having worked in an SNF/LTC with 30+ residents/patients daily for 6 months, I learned how to manage time and prioritize, it may be the only thing I came away with that I will use in my new position, but I'm so happy to be in a hospital environment.
Hey! I just got a sparkly new job on a med-surg/TELE floor and I am STOKED! I graduated in May and have been working in LTC since June, but have had my heart set on a med-surg job since I started school. Any advice, or anything else to get me prepped for my job would be so appreciated, I start November 19th with orientation. Anyhoo, howdy and thanks!
Crickets ... Tumbleweeds.... Maid running the vacuum cleaner lol
I'm a new nurse, working in a busy LTC/SNF/rehab. I love the work. I love (most) of the residents. I love (most) of my peers, but the management really leaves something to be desired. Schedules are a nightmare, nurses are quitting left and right, and the DON and ADON don't seem to care. So I have this idea. . . I work in a non-union state. We, as nurses and aides, have very little to no leverage when it comes to negotiating with our managers at this facility. I know that everyone, (yes, everyone)who works under these specific managers is very upset every time schedules come out, to the point that it feels like blatant disrespect. Days off requests are flat-out ignored, etc. So here's my idea: for the staff (nurses/aides), create a totally anonymous survey and ask a few key questions about what they would like to change about scheduling. Have a drop box to put them in, then collect them and go to the facility administrator and propose a mediation meeting between staff and management. We all tend to get so angry and emotional that I really think a mediator, an objective person who could keep us all on track, would be essential. Is this a good way to initiate change? Like I said, I'm a new nurse. I haven't been at this facility for a year yet, I don't want to lose my job, but some predictability, some reasonable rhythm and flow to each month's schedule would make such a difference, not just for me, but for all of my peers too. I miss the days of CNA at the hospital, where we filled out our own schedules (for approval, of course) every month. Why is that such a taboo thing at other facilities? Help?
The challenges where I work (LTC/SNF/Rehab) are the same as those mentioned above. The SNF/rehab is relatively new, and used to be a locked Alzheimer's/dementia unit. They left the "farthest gone" residents there so that they wouldn't be totally messed up by moving to a new unit on the LTC side. Unfortunately for me (when I'm on that unit) and for the residents, there is only one RN (me) and 36 of them. I talked to my RCC about it the other day while gathering up supplies for med pass, about how I lament the fact that there isn't time to do more "nursey" stuff for the patients and residents, between PRN pain meds, keeping the dementia residents seated, fall charting, scheduled meds, coumadin orders, blood draws, and calling physicians. She said, "yeah, it's quantity, not quality." This was a rude awakening to me, for her to actually admit that. I'm a new grad, mind you, this is my first "real" job. I worked my a** off to get this degree, and not so I could be a glorified medication aide. I want to help make people better, I want to use and gain more skills. I'm afraid that by the time I get my year experience, any hospital will dismiss me. Like most others, I LOVE the residents. They're awesome and fiery and funny and keep me sane. But the institution itself, and the LTC system in this country need a serious overhaul, starting with GETTING RID OF PAPER MARS. I still can't wrap my brain around that little gem, and this is my fourth month at this job.
Adding, last week "State" was auditing our facility, I was off the day they came, one of the RCCs called me at home to come in and fill a couple holes in the MAR from the Monday prior, when I was the ONLY nurse (we had a med aide for 2 of the halls) to put in orders for 60+ residents, (coumadin, PT/INR, you know, Monday orders) then we had a meeting the last hour of the shift. So I had to rush through my EVERYTHING and jeez, didn't have time to go through the MAR and fill in the few holes. So I went, on MY time, and filled them in. Then, she called me again, the NEXT DAY, when I was off again, because I forgot one 72-hour paper charting on a resident who had fallen on a different shift. She wanted me to come in, again, on my day off, and falsify an assessment because state was there. She was there for the same shift, she's an RN, she could have easily just done the charting in the time it took to call me. I know these are my responsibilities, but when the work of 3 people is heaped on me, the odds are that I might forget to do 2 things. I love the residents where I work. But to manage through intimidation is, excuse my language, bullsh*t. Unless someone is dying and only I can save them, leave me alone on my day off. It'll keep until my next shift.
I just graduated, got my RN, and started in an LTC because hospital jobs are scarce here right now. My experience with the (very nice, very expensive) LTC where I am currently working has been excellent and awful, at the same time. The excellent comes from the residents. All of them have from mild dementia to late-stage Alzheimers, and have completely stolen my heart. The awful comes from the business end. Yesterday, I was the only RN in the entire facility, and I didn't even know it until the LPN orienting me let me know. Last week, on my fifth day of orientation, the RCC decided I needed to pass meds on two halls, for forty residents, for the AM med pass. That allowed me 3 minutes per resident, if you break it down evenly. Some of the residents have 15+ meds that have to be crushed. That, in itself, can take 10 minutes. I let my LPN orienter know that it wasn't safe for the residents, that I am protecting my license, and that I would gladly take one hall, but not both. Whatever kind of game the RCC thought she was playing to test my speed was totally inappropriate, and putting residents and ME at risk for med errors.
Forget quality of care or anything you learned in nursing school. I am now a glorified Medication Aide, hired because the RN after my name improves the facility's rating. The biggest travesty is that the residents are bored, sad, and confused, and I don't have time to properly nurse for them.
There is a rehab unit, that has short-term patients. I don't know if I'll be on that unit or not. Right now they have me orienting with the Alzheimer's/dementia unit with long term residents. I know the med pass in the hospital takes a lot of time, but you also do myriad other things, like patient education, complimentary therapies, and plan care. This is just. . . finding the residents and either spoon-feeding their meds to them crushed in some horrific concoction, or watching them swallow their pills. I'm proud of my clinical skills, I worked hard to earn them, and this job depresses me. Again, I love the residents. They're human beings in a very vulnerable place in their lives, and I treat them with the utmost dignity and respect. I just want to be in a place where there is hope of my patients getting better, and to know that there are things that I am equipped with to facilitate that healing.
Hi all,
I just graduated in May, and got my RN in June. The market here is saturated with new grads, so I took a job at a very nice LTC in my area. I've worked for exactly one week and I'm feeling really sad. I am basically working as a medication aide, not using ANY of my nursing skills, and feel like I was hired because they needed an RN on the unit to satisfy some sort of requirement. All my clinicals and preceptorship were hospital work, I am not used to not looking at vitals, labs, etc. They have PAPER MARs, which totally blows my mind. The residents are the only bright spot, they are delightful. But the autonomy that I expected from this profession is not there. I am pushing a huge med cart around a HUGE facility, medicating 25+ patients 3 times a day plus PRNs, and I'm really down about it. Please help, I really want to work in an acute care setting. Should I keep applying and leave (with notice) if I get an offer? Or should I stick it out for a year? Is this job going to be a stigma on my record? How do I keep my knowledge and skills current?
You know, nursing exams are hard, period. They're not like regular exams. I will be happy, when I re-take my course, to pass them! I met with the department chair yesterday and she was so nice and positive, and delighted with my positive attitude. Yes, it all happens for a reason, and I have a few CNA II interviews lined up. I've let go of feeling like a failure, because the only way I would be failing is if I gave up! I will also be re-taking the course with a friend, and we are working together on the practicum that we are required to pass for re-entry. We will be better nurses for this, just you wait and see!
I was enrolled in an Associate's degree program, and failed my final class with a grade of D. I worked for two years to get into the program, then two years of the actual program, and I'm grappling so much with this failure. I've always been a great student, both classroom-wise and clinically. I have such unresolved grief over failing this course and having to completely change my life plans. I can retake the course next year, and will be in a better position familially (my family didn't have a car the entire semester, my father became incredibly ill), and have a tremendous understanding of the material, it's just incredibly hard to suddenly stop all of your work because school is over and you didn't get that diploma. It's like having a stick thrown through your spokes. Good luck to you, I completely empathize with everything you're going through. I'm glad I stuck it out to the end, I put my whole heart and soul into passing, but there just wasn't any way.