another new nurse swimming in ltc

[rj2011]

My first job was on a behavioral/medical floor. Loved it, facility was great, patient ratio was under 10. Aides were great, and then the hospital closed :-( I took the first thing, in a ltc and subacute facility, I float between. I like the work, I really like the pts even the difficult ones ;-) PROBLEM is I rarely feel safe.Working 11-7 I float between several floors with between 40-20 pts, this makes it impossible to know their complete history. I feel like I am just doing a dusting every night , not a good clean i.e. I am just getting the pst to the next day, not really able to do great nursing :-( half the time I cry driving home. Also there are these procedures for all the paperwork that no one has really explained so I think I did something and it turns out I didn't really finish. There are some great aides, and then there are MANY that sleep/hide, don't even try? Granted there are some very hardworking ones, some work 2 CNA jobs, coming straight from another job, so they are pulling 80-100hrs a week, they work and send the money home, which is admirable, but they often fall asleep and miss call lights, while I am trying to pass meds, do treatments and document document ....ALso they often don't have equipment, supplies, etc

There is a high turnaround there :-( I imagine they know why. Any words of advice?I want to leave, can I leave? I have been there about 3 months. I don't want to have a scattered work experience, but I don't want to jeopardize my license or harm anyone,

thanks for any words !!!!

[CapeCodMermaid, RN]

You don't really need to know someone's entire history to take care of them. 20-40 on an 11-7 is very doable. You do, however, need to make sure your CNAs are awake and doing what they are being paid to do. LTC is not easy and it doesn't look like it will be getting easier with the Medicare waivers and the sicker patients we're getting. Prioritize and do the best you can.

[benegesserit]

A single job that you leave quickly with good justification is unlikely to be a problem. If you have a pattern of staying at jobs for only a short time, it could be. If the facility is within the same general area as you plan to work, it probably already has a reputation, and other facilities are likely to be understanding.

[spiderslap]

This is pretty much the norm for LTC. It took me a while to get used to the ridiculous workload and I spent many rides home crying. The only advice I've received from the DON, supervisors, and other nurses i asked is to simply "do your best." Sounds like worthless advice at first, but just translate it into "prioritize." You'll rarely leave on time and feel like you did everything you were supposed to do, but as time goes on you'll have a better idea of what is necessary to keep all your patients safe and sound, and not drowning in the many different issues that fight for your attention. The system is clearly understaffed and that wont change. Prioritize the patients' needs and use your best judgement, but look after yourself and dont let this job get you down. If anything, you'll end up a master of time management and I'm sure you'll benefit in the future at any job having developed the ability to stay calm under extremely disorganized and stressful conditions. Learning the proper documentation and paperwork procedures is tough. All I can say, as a new grad who has been floated around and hired as per diem, my fallback plan is always document it somewhere (nurse notes, chart) and include every detail you can think of so that you can use this later if there is additional paperwork to complete. Good luck! I know it sucks, but all nurses seem to eventually develop their own style that gets them through and I'm sure we will too.