Can someone please give me some advice, some direction. I feel like a failure.

[snazzy-jazzy, BSN, RN]

Hello fellow nurses I really need to discuss something with you. I need your help, support, advice please. I am a new grad RN, who just started working in an LTC 2 weeks ago, just started my 3rd week. During the interview I was told it was for 2 days a week while I was training, which as I told them that suited me fine as I was a single mum and still adjusting to a new situation and area. The place I work at has 160 residents, that is in low care, high care and a dementia unit. I did a total of 2 buddy shifts in high care (day shift), I was on a 3rd buddy shift in low care when the boss came and asked me to go home and get some sleep and come back and PLEASE HELP HER OUT and do night shift in the high care unit. I would be the only RN on in the whole facility but other than give DD's to low care with an AIN (CNA) there would be no other medication pass other than early morning. That shift went well, I was nervous but it was fine. Ofcourse there were things I could not do like prepare for the Dr's rounds etc as I had not been trained in that... oncomming nurse wasn't happy about that but oh well, I got through a shift on my own.

4th shift I'm starting what would be my 3rd buddy shift this time on the Dementia unit when a call comes through and I'm once again sent up to high care to fill in for the RN going home because they're sick. It is 2 hours into the shift already (shift: 2 to 10pm). I had to give meds to 50 residents at 5 and then again at 8 (although probably around 40 residents had meds at 8)... 4.30 I had accu checks and insulin and at 8 I had more accu checks and lantis to give. OK so by the time I got hand over, counted the DD's it was 4.30 and I did the insulins and accuchecks. I then started the med pass... It was so hard, as I didn't know the residents, I was terrified of making a med error. Our medications are pre packaged but some aren't and also they might need crushing and mixing, being high care some residents need a lot of prompting and kind support to take their meds. Or they won't open their eyes for drops etc... I took FOREVER. 3 hours to be exact.

I then had a quick coffee before I fainted, I took the insulin book into the staffroom with me so I could work out who needed lantis and accuchecks done at 8. Then went and did those and started the 8 oclock meds probably around 8.30. By the time the night shift RN came on I still had 10 residents that I hadn't given meds too, a resident who was on the EMS but I couldn't find her medication anywhere. I was exhausted, felt like bursting into tears and felt totally useless. I handed it all over to the RN and she was mad, she went on and on about how BAD that was, yeah I know, I know its bad. I got teary, as much as I tried to hold it in, I didn't bawl, but it hurt. I never wanted to be a bad nurse, and I felt like such a failure. I am crying now just thinking about it. I should mention that during this shift my boss rang me from her home twice, and the EN (LVN) from the low care called me to authorise some PRN's for her and I let them both know what was going on. That I was running behind and then latter that I was not going to finish. They both said ok, just hand it over.

Anyway, the next day I rang my boss and told her , although she already knew and was going to talk to me about it on my next shift. I told her I wanted to come in and speak to her about it. I packed up my uniform, my ID, and a book she lent me on aged care. I walked with just the book into her office and she said that she had given me that, I told her that I wasn't going to stay... so she got me a coffee and we discussed it. She told me it would take a while before I'd settle, 3 months at least. We talked about why it happened, I felt it was because I didn't know the residents, their likes and dislikes. I didn't know the routine, and I was thrown in unprepared. She agreed and she asked me to stay, so I did. THEN she gave me a buddy shift in the dementia unit (would be my proper 3rd one as the others got cut short), 2 days off, then 6 shifts in a row. 2 of them night shifts in the dementia ward, where once again I have no clue of that routine. I havn't been buddied there on that shift and have really only had 3 buddy shifts in the entire time. Then during the buddy shift my boss came to the office and asked if I would work one of my days off, I said no and she walked out in a hurry and slammed the door The EN (LVN) and I just looked at each other shocked.

So I'm home from that shift now, wondering if I should leave. I'm so dissapointed, I don't want my kids to see me be a quitter, and I hate being broke (poor), but I think they are just looking for anyone with a heartbeat and a licence to work shifts and at least have one RN on the facility. I am really upset!!! I have thought about leaving, I have thought about calling her and saying 'look, can I have a buddy shift before I do a night shift on my own in that unit'... because I was told by her 'oh its easy, I have carers that do that shift'.. But the carers know the routine, they know the residents, which ones are a high fall risk. I don't know which residents I can change myself at night or which ones to call someone from another unit in to help me with. I just don't get this. I think they need at least 2 people on that dementia ward (25 residents) during the nightshift, not one on their own.

I know this is probably a HUGE post, I hope someone managed to read it and can give me some direction.

[snazzy-jazzy, BSN, RN]

No replies? I've spent the day going over everything and I have decided that this isn't what I spent 4 years at uni working towards. While most of my friends say to stick it out, it will get better, well, I don't care because this is just a sad environment. I don't see myself as a quitter anymore, or as a failure. I feel that the system failed me. I refuse to put myself in a position where the residents could be harmed due to my lack of experience and orientation. I've asked for more but it obviously fell on deaf ears. They called me today to give me even more shifts. I know I'm doing the right thing. So I guess this just turned into a small vent for myself to work it out on my own.

[chrisrn24]

I think you are doing the right thing.

Working at a crappy place is no good. If a job interviewer asks, just explain that the place wasn't a good facility and you felt your license was at risk.

I got over a month of orientation in LTC so it's possible to find a good place!

[Blackcat99]

Your friends are right. Stick it out. Don't be a quitter. It will get better. It just takes time. It's not easy finding a new job these days especially if you are a new Grad.

[k.willow]

Snazzy-jazzy I'm not sure where you are, but it definitely sounds like a very unsafe place to work. If it were me, I would go to your boss/supervisor, ask for what you need (buddy shifts/actual orientation to your job or whatever). If s/he continues to tell you yes and then doesn't do it, leave. Not having a job sucks, but not having a license to get a job sucks even more.

[Not Your Nurse]

I would say document everything for yourself and try your best to last 1 year there (I know it sounds like a long time). If its truly unbearable and you feel like your license is at risk thats totally different and Id start looking for another job asap in that case

Otherwise the experience is good if you cant find something better and at least you can save up $

Best of luck!

[blugreeneyez]

RUN!!!!!! No need in putting your hard work and license on the line for it

[nursel56]

I think our temperament plays a role, too. At least in mine. Your boss has demonstrated her pattern of how she deals with being short-staffed and her attitude toward those who don't adapt to her standards (having a hissy) It drove me crazy to be constantly asked to fill in, "do the boss a big favor", "help out" at the last minute. Some people don't mind that, and they like working all the hours they can possibly get, perhaps not yet having family responsibilities or firm commitments to do other things.

"Know Thyself" has proved to be an excellent guidepost over the years when I've faced a "should I go or should I stay" dilemma. Sounds like you probably would've got the routines down pat in a few weeks, but your boss's personality would not change.

[snazzy-jazzy, BSN, RN]

Just wanted to post an update. I resigned. It was too much of a risk, and I felt I was being asked to work out of my scope of practice. I was down for the weekend doing a late on the dementia unit and told her I would do those shifts if she is short because I have been orientated to that shift and also I would have Nursing assistants to assist me with identifying the residents.

On my last day I ended up having a resident fall, split her head open and I wasn't happy with her pupil dilation, however she wouldn't look directly into the torch either. Sent her off to the hospital and she ended up with sutures, staples and they said possible concussion. After I did all the paperwork for it, I rang my manager... she answered the phone all happy then when she heard it was me she became very unproffessional, gave a huge sigh and repeated 'oh hello' but with a lot of tone and attitude. I just gave her the details of what occurred and she then came around. BUT it made me realise that I'm not a failure, I have the makings of a good RN (for a new grad) who makes the right decisions both clinically and professionally.

I also had nurses come up to me over the weekend shift and state that they felt I hadn't received the right training and that 'everyone thinks its bad that I had been thrown in the deepend like that' , one person said that management don't even like coming down to the dementia unit. Another offerred his own time to come in and give me extra orientation (I only had 3 days).

Thing is I really enjoyed working with the residents and especially had a good rapport with the dementia patients. Sad, everyone wants you to cut corners when you're new... and they don't want to fork out the extra bit of money to train. I really only would have required at least 2 more buddy shifts.

[snazzy-jazzy, BSN, RN]

Exactly and this was proven to me with that last phone call.. Gawd I wasn't calling her from work to have a friendly chat. It was a professional matter.

I think our temperament plays a role, too. At least in mine. Your boss has demonstrated her pattern of how she deals with being short-staffed and her attitude toward those who don't adapt to her standards (having a hissy) It drove me crazy to be constantly asked to fill in, "do the boss a big favor", "help out" at the last minute. Some people don't mind that, and they like working all the hours they can possibly get, perhaps not yet having family responsibilities or firm commitments to do other things.

"Know Thyself" has proved to be an excellent guidepost over the years when I've faced a "should I go or should I stay" dilemma. Sounds like you probably would've got the routines down pat in a few weeks, but your boss's personality would not change.

[nursel56]

Thanks for the update! I've always felt every job is of value from the standpoint of what you learn that you can take with you going forward. I couldn't work with that type because I was on pins and needles even when I wasn't at work worrying about what they might spring on me next.

I'm hoping for you to find that right fit - identifying that you work well with dementia patients is huge! There is such a need for nurses who have the ability and interest to work with that population. Best wishes to you!

[Davey Do]

I'm hoping for you to find that right fit

Sometimes, snazzy-jazzy, we have to kiss a lot of Worhols before we find our Rembrandt.

Your decision is supported by this one.

Dave