Advice needed for PD LPN

caliotter3 · Jan 18, 2014

Limit to no more than two shifts each week, if that, and concentrate more on school. That is my advice.

mluvsgnc · Jan 19, 2014

All families are different- you may not be as unhappy at the next home. If you stay, you can show continued employment on your resume, which looks better than 6 months. Also, if you accept another assignment, tell your employer that you only want 1 or 2 shifts per week like pp suggested. That way, you can continue to focus on your studies while maintaining employment.

I'm 6 months into PDN and one of the perks, for me, is that it allows me to go to school while getting that seemingly required "one year experience" that will (hopefully) help me get an RN job elsewhere. The family I work for doesn't ask me to do household chores or make unreasonable demands. They know and accept that I won't give a med or tx without an order. So there are decent families out there. My advice would be to give it another go, and take it from there.

SDALPN · Jan 19, 2014

PDN isn't for new grads. Next, get used to being let go for anything by a family. They will complain that you're breathing if they think they can complain about it. You crossed boundaries that shouldn't have been crossed.

There are plenty of threads on all the problems you encountered if you look through them.

Oldfashion · Jan 20, 2014

I'll stick it out and throw my lines out. I actually have six months of CNA experience in a hospital before this, but the hospitals in the area do not hire LPNs.

Thanks for the advice.

Oldfashion · Jan 20, 2014

Pretty much should've looked through this board before starting, but live and learn I suppose.

mluvsgnc · Jan 20, 2014

SDALPN-

I've read repeatedly your stance that "PDN isn't for new grads." It is such a blanket statement and seems unfair and judgmental. I know you are entitled to your opinion, as we all are, but, as a new grad in PDN, where it is working out quite well, I bristle a bit every time I see it. Normally I wouldn't bother with saying something, but it is so often stated by you that I feel compelled. I am an example that contradicts your opinion. I think it depends on the person and is not a black and white issue. I don't want to argue back and forth, it just feels really disrespectful from where I stand. That's all. No hard feelings.

CloudySue · Jan 20, 2014

Mluvsgnc, please don't take it personally. We're not trying to annoy or belittle anyone here. We offer our warnings because we care, both about you and your clients. We consistently try to protect new nurses from the fact that they don't know what they don't know. Many agencies do not care one bit about your license. They know that 99.99 percent of the time, the shift will go just peachy and everyone gets paid. They also know that that 0.01% of the time if something goes wrong, they can either sweep it under the rug, or else blame the nurse and throw him/her under the bus. They have nothing to lose, but we nurses have everything to lose: our livelihood, our family's security, our homes, even our freedom. Yeah, you'll probably be fine, I'll concede that. For myself, the odds still give me pause, because when things go wrong, they really go wrong.

One thing to note, working alone in PDN keeps you isolated from nurse and health facility culture. If you spent a year in nursing amongst other nurses in person (and I mean working as a practicing nurse, as their peer and not their subordinate aide), you'll know that we on AllNurses are comparatively very kind and helpful here, albeit frank and VERY too-the-point.

CloudySue · Jan 20, 2014

I've thought on this more, and I've come up w a good analogy. Remember when we were all in high school and we thought we understood what the opposite sex was all about, and we all knew how to drive just fine, and we thought we could all stay out late no matter what mom and dad said to the contrary of all of this? And we thought our folks had no clue what they were talking about, we knew what we were doing? And then most teens grew up and did successful things w their lives, but then some others went down other roads leading to drug/alcohol usage, failed out of school, teenage pregnancy, etc? No teenager really knows as much as they think, and yet most come out of their teen years largely unscathed. But some do not.

Yeah, it's kinda like that.

JustBeachyNurse, LPN · Jan 20, 2014

In my experience found that 75% or more of professional boundary crossing is done by new grads who don't know any better. They are "bored" and do household tasks that are above and beyond what should be done and increase the expectations of the family which makes the case more difficult for other nurses on the case who follow the rules & company policy. They are not crossing boundaries to be malicious but they want to be in good favor and are trying to be "helpful". They want to be liked by the family and as new grads don't realize the impact on other nurses. New grads are often eager to work, take the "difficult" cases, work extra shifts that can lead to rapid burn out. They may do "favors" such as purchase gifts or supplies out of their own money thinking they are helping the family rather than discuss family needs with their clinical manager.

We had a family in my agency that the nurse was buying supplies & other items to "help out" the family just trying to be nice. She called out and another nurse filled in last minute. When the child was out of something, parent informed fill in nurse that last time other nurse got it for her. Fill in nurse alerted the agency. Our clinical manager was not aware of the situation but was able to contact insurance to ensure adequate supplies were sent each month (it was difficult as the regular "helpful" nurse never let anyone know that more supplies were needed & just bought them herself) and was able to make an agency referral to help the family with the other needs they were struggling with such as no gifts for the holiday and insufficient food.

This is not to say that all new grad nurses cross boundaries but in MY experience it's most common as they are eager to help and don't realize what is happening and how it effects others. (The famous last words "well the other nurse does_________________"). There are also experienced nurses that are comfortable with a case and regularly cross boundaries/go outside case expectations so they can be favorited and keep their coveted shifts.

In addition to clinical inexperience most new grads don't have special needs pediatric experience and might think suctioning as an EMT will cross over to medically complex/fragile pediatrics. I've met a new nurse that thought her 90 hours riding volunteer as an EMT was more than sufficient to work with medically fragile children. Not realizing that an O2 sat of 85% does not warrant a 911 call in a child with a congenital cardiopulmonary defect. Or another child is safe to sleep on his belly when the usual recommendation is back to sleep and argue with parents. They don't realize that two 4-hour shifts are insufficient orientation and don't know how to ask for more. Very few agencies will ask if more orientation is needed.

There are new grads that have had exposure to medically complex/fragile pediatrics and have a good base to start off in pediatric PDN with proper orientation and training but this is individualized.

When experienced nurses state that new grads generally don't belong in pediatric PDN it's based upon experience and wanting to forewarn new grads of the potential challenges without protection.

SDALPN · Jan 20, 2014

SDALPN-
I've read repeatedly your stance that "PDN isn't for new grads." It is such a blanket statement and seems unfair and judgmental. I know you are entitled to your opinion, as we all are, but, as a new grad in PDN, where it is working out quite well, I bristle a bit every time I see it. Normally I wouldn't bother with saying something, but it is so often stated by you that I feel compelled. I am an example that contradicts your opinion. I think it depends on the person and is not a black and white issue. I don't want to argue back and forth, it just feels really disrespectful from where I stand. That's all. No hard feelings.

Not taken the wrong way at all. Honesty is appreciated.

You may not have been put into a situation over your experience. You may just have missed something and not realized it. Hard to say. Maybe you've been lucky. But there is a reason even most insurances require a year of experience for PDN. Those of us on this side of the fence have seen things that you wouldn't understand (due to experience, you and the others are certainly intelligent! Hoping that comes across right) It's just like when a parent thinks they know everything about vents and trachs just because of the little bit of info given to them at the hospital. Or the "google medical expert" that knows as much as the drs because they looked up one little part of an illness. Then add the fact that agencies lie and the new grads and new to agency nurses believe the crap they are told.

SDALPN · Jan 20, 2014

I've thought on this more, and I've come up w a good analogy. Remember when we were all in high school and we thought we understood what the opposite sex was all about, and we all knew how to drive just fine, and we thought we could all stay out late no matter what mom and dad said to the contrary of all of this? And we thought our folks had no clue what they were talking about, we knew what we were doing? And then most teens grew up and did successful things w their lives, but then some others went down other roads leading to drug/alcohol usage, failed out of school, teenage pregnancy, etc? No teenager really knows as much as they think, and yet most come out of their teen years largely unscathed. But some do not.
Yeah, it's kinda like that.

Yeah, that!