I am a new nurse working in a busy LTC facility. This was not my first choice to begin my career, however I had been out of college for 2 years prior to my passing NCLEX (due to unforseen circumstances) and I did not feel confident enough to begin in a hospital, so I decided to start out a bit, "slower" to advance my skills. I applied to several facilities and hospitals and this was one of the call backs I recieved. I am working full time on the 11-7 shift and I have to say...I absolutely hate it. There is nothing worse than going to work every day feeling absolutely miserable, however I know millions of people do it everyday, I just don't want to be one of them! Some of the CNA and Nursing staff are great, however a majority, are not so great. I see things I do not want to see (use your imagination) staffs attitudes are very poor and negative, and I get the "you've got 10 heads" look when I give report the next morning to the nurse and she's upset with me because I refused to do a certain task without an order from the physician. "Just do it" I've been told. Just do it? Really? I understand I have to stick this out because I do not want it to look poor on a resume to see I've only worked at a certain job for a few months, however, I absolutely dred going in every night and feel it may not be worth it. I'm not naive, I do realize that there is bad practice out there but I did not realize it would be this bad, some things that go on in this facility are enough to have ones license taken away. No exaggeration, it is that bad. The only thing I can say is that I am learning along the way, it is everything else involved that is making it very difficult for me to have a good experience.
So my question is this: Has anyone else experienced a similiar situation starting out? If so how did you manage and how long did you remain there? I appreciate any responses!
Mar 10, '12
Do not perform any task beyond your scope of practice without an MD order. Period. If the you know what hits the fan for ANY reason, You WILL be held accountable, and no one is going to stick their neck out for you.
Don't quit without getting another job. See if you can get into a registry or travel position....
I am sorry you are going through this. Nothing worse. Been there.
Mar 10, '12
My very first job out of nursing school was like this. I lasted 3 1/2 months. The administrator seemed to think that because she'd had to go through a CNA class while she was in training, she knew what floor duty was all about. WRONG!! I remember having to chase my wanderers back inside the building repeatedly while passing meds, answering the phone, and getting people up and dressed because the CNAs could have only 10 residents each, and we had only 2 CNAs but 28 residents. Then this silly woman ran up to me one day and pulled me into an empty room to show me a Betadine stain in a nightstand drawer, yelling at me to get it cleaned up before the state survey team came in. "Um, excuse me, did you just mistake me for the housekeeper?" I wanted to yell back, but of course I didn't, because one of my skilled patients fell in the hallway and my new admit with Alzheimer's chose that moment to bolt. The next day she punished me by making me work as an aide while a different nurse took my charge position.
I went out the day after that and landed my next job, where I worked for almost two years making almost $5 an hour more and in a much nicer facility to boot. Sometimes, living well really IS the best revenge. Go for it!
Mar 10, '12
I absolutely do not do anything without an order and I don't care about the odd looks I get in the morning, but to me, it's common sense, Don't - do - without - an - order. But to these people, it's FOREIGN. For example, say we have an incontinent patient whom the doctor asks for a urine spec on, the first question I ask is, "Do they have a straight cath order?" most don't, so then I say, "well I'm not going to do it without an order and I'm not calling a doctor at 2am for that.." man does that go up their butt sideways. I have already spoke with the director of nursing about this and she is behind me 100%. Other things that I've run into are like the other evening, a PT had come back after having a stent replaced (kidney), had clear blood in his urine and at first denied pain but as the night went on complained of it. So I went to to check his MAR and the only thing he had ordered was oxycodone 8a and 1p, his oxy PRN order was dc'd, now did anyone else think to ask the doctor, hmm, I see nothing PRN for this pt can we get something on board? Of course not. So I spent a majority of the shift calling and calling the doctor (who did not return my call until 6:55 am 5 min before I'm supposed to leave) thankfully this PT's pain must not have been that bad because I checked him several times and he had been sleeping, otherwise I would have sent him out. The point is, this is common sense things and it is just swept under the table here, I have never seen anything like it before in my life. It is awful.
Mar 10, '12
@Viva, I really think you are right, I mean I literally was sobbing one night before going in because I just did not want to be there, my fiancee said, "It's not worth it." I need to go to a job where I have fulfilled, and this place is just not doing it for me.
Mar 11, '12
Nursing home 11-7 was my first job too. I have worked at several now and they are all different. Lately I have been working 3-11.....i take back anything bad I ever said about 11-7.
Mar 11, '12
1. Don't do anything without a proper order. If you need an order, get one. I have seldom seen an LTC facility without standing orders for a straight cath.
2. You set your limitations: "Not feel comfortable." Where do you feel comfortable? It's your job. You have three choices.
Leave, do this job and be miserable, or just do this job. Most people are about as happy as they intend to be.
Mar 13, '12
@ Dixie, perhaps at the facilities you have been around there were standing orders for straight caths, however at this facility, there are none. I'm not calling a doctor at 2am for just a routine urine spec, unless its a stat order, it can wait unti the morning.
In regards to feeling comfortable and doing my job, I do do my job and I do it to the best of my ability every night that I am on. I am not an irresponsible person, so just "leaving" my job because I'm unhappy without something to fall back on would not be the right move. Not only that, but I am getting married in less than 3 months, it would not be in my best interest to do that obviously.
I posted on this forum simply for some feedback and advice from other nurses who have possibly experienced similiar situations. Isn't that what we are all here for?
Thanks for your response......
Jan 22, '13
I hear you. I'm working a job I loved at first but hate now. Not LTC but chronic case management with difficult coworkers. Terrified of the hospital but couldn't get hired anyway with no acute care experience. I'm looking for an LTC job to try and get more clinical skills but I'm hating every shift now. Hang in there. I can only get better right? Good luck.
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