Day 5 of orientation, want to quit

tyvin, BSN, RN · Oct 8, 2012

If it's LTC you're lucky to even have gotten 5 days of orientation. Most times it's only 3 days and then you sink or swim. It's ruthless in some situations and you need to develop your own plan and stick with it. Also, depending on the personality of the nurses showing you the ropes it sounds about right. When I first started I worked with some pretty harsh types. I didn't stay long but learned many things.

Know that not all LTC places are like that but it's pretty rare to get in one where the med pass is doable. It's physically impossible to do some of the med passes I've seen in the time allotted. The nurses have to make shortcuts somewhere. Figure out a plan, set up your cart right. Your best weapon is to know your med pass inside and out and where the clients are going to be when you are ready to give them their meds. As for the other nurses...just smile and go with the flow.

Anne36, LPN · Oct 8, 2012

Thanks for the input. Im still getting to know who the clients are and have the CNAs assist me with identification. I have only been able to memorize a few of their names and faces so far.

bubblymom373 · Oct 8, 2012

Make yourself a little cheat sheet for the med pass. Does the resident take the meds whole, crushed, or one at a time? In pudding, applesauce, ice cream etc. Do they get special house supplements? Do they have medications kept in another place on the med cart? or in the refrigerator that need to be pulled. Little things that will help make the med pass smoother.

As for how the other nurse does her med pass, well thats her med pass it doesn't have to be how you do it. You always need to do the 5 rights thats a given. With the med passes that I have done, I have always needed to skip around in the med book when giving meds. I mark the resident that got skipped with a straw or pulled a tab on the plastic divider to remind me to go back and give those meds. It does get easier. Just hang in there.

rndaniela16 · Oct 8, 2012

I really need someone to talk to. I am on day 5 as a brand new Grad at orientation. I was doing fine the first couple days with the Nurses who precepted me. They let me help them with med pass and tried to show me the ropes. The last 2 days I have had a Nurse who does not come close to doing anything by the book. Fine, I get that in extended care you need to take short cuts. But, she has asked me to sign things I didnt do, and she has signed the MAR 3 days late, etc. She asks me to put meds in the cart that are already pulled and just put someone name on them while I pass to some other resident that just wheeled up to the med cart and wants their meds now. She skips back and forth all over the MAR, suggests that I will not succeed in med pass if I do the 5 rights, etc. I could go on and on.
Last night she let me help her with med pass. Tonight she stood back and stared at me all night but it took me a few hours to figure out she was not going to help with med pass at all. It was never made clear to me because she was still throwing in her 2 cents and having me do med pass her way. Well, I did not finish med pass by 11. She let me fail at med pass and then just told me to go home at 11pm when my shift was over. Does that sound right? Should she not have told me I was on my own from the begining or at least stepped in when she knew I would not get it all done in time? She was the Nurse on duty and I was listed as an orientee.

First, I'm sorry you are in this position. Second, get out of it. Is there anyone at your facility responsible for education of new hires? Discuss this issue with them. Your "preceptor's" actions are in direct violation of every nursing standard and your state's nurse practice act. She is every attorney's dream and every family's nightmare. If you value your license, find a facility that hires new grads...a larger facility usually has a structured orientation program with preceptors who are also evaluated and your progress is monitored. Get yourself Liability Insurance...because if you stay there, you are going to need it. I'm a legal nurse consultant who reviews medical records for medical malpractice suits and I and was a clinical educator... and being on orientation with a preceptor who "makes" you do things her way will not hold up in a malpractice suit. As a new grad you are still held to the same standards as a seasoned nurse. It's apparent that you know what's going on is VERY WRONG. It is your responsibility to advocate for patients. Many years ago, when I first became a nurse, I adopted this standard to keep my actions in check: I asked myself "if this were my family member, would these actions be acceptable?". Obtain training in a facility that will provide you with a good foundation; don't start your career by adopting the attitude that taking short cuts and not following policies and procedures is acceptable...IT's NOT!

Google this: lawsuit nurse failed to.... and look at all the nurses who were found to be negligent for not following policies and procedures or being in violation of the nurse practice act.

I wish you lots of luck.

I hope you get out of that situation. I'm sure you'll agree that you put way too much of your blood, sweat and tears into finally becoming a nurse. Don't risk throwing all that away...listen to your conscience:)

bborcyk · Oct 8, 2012

Long Term Care is difficult. It helps if you had previous CNA or HHA experience, which it sounds like you didn't. There are two ways to play this game: 1. Talk to someone in human resources about the possibility of another preceptor. You will have to explain why you are requesting this. 2. Play her game her way, then when you're done being "trained," play the game YOUR way.

Nobody likes to admit it, but work is a game, in a way. You have to be aware of it, and you have to know how to play by the rules. A lot of preceptors do what that one is doing, because they can get away with it. However, if you know your rules, which it sounds like you do, make sure you cover your butt the whole way.

As for the ins and outs of LTC, med passes take time to get used to. You have to be effective at managing your time. The first thing I do after getting report and counting narcs is go through my MAR to make sure which residents get their meds first. I flag everyone who gets early meds. Then, I go around and talk to the residents on my assignment and know where they all are. It's important to know where your residents are located at all times. Then I check and make sure my med cart is fully stocked. I mean FULLY, including water pitcher, spoons, straws, apple sauced, pudding, all stock meds, pill crusher, etc. That way you don't need to make unnecessary trips to supply areas.

For med pass, make sure you start at a reasonable time. If you start your am or pm med pass (depending on your shift) too late, you won't be done on time. Start as early as you are allowed to (things may be different per state), and make sure you have heard everything the outgoing nurse said during report. That may give you hints as to which residents are usually sticklers for getting their meds at which times.

The best advice, though, is ASK QUESTIONS. Find someone in the facility who is positive about answering questions, and make sure you ask. If you don't ask, chances are, you will probably make a mistake. Nobody will think you're stupid for asking questions. They know you're new.

I hope this helped a little. Good luck with your job. You will make friends, you will end up fitting in, but it will take time. If you hate it, don't outright quit. Look for an office position first. Being an LPN isn't bad, but it is work...