Hello. I am a new LPN in LTC. I am SO discouraged. I recieved 4 days of training. There were no hours open, so I actually didn't get to work on my own until several weeks after training. My night was AWFUL. My shift is 4hrs on a hall of about 20, including a tube feed, 4 diabetics and 4 skilled rsdts. I didn't finish my 4p med pass until after 5p. I didn't finish my 8p med pass until about 1030p. I wanted to cry right there at the med cart, and leave! But, I knew that I could not, so somehow, I pulled it together. A supervisor came in to do an IV, and asked how it was going. I told her..well, I am SO late. She said "oh, honey I could not do all that in 4 hours either. Its ok." This made me feel somewhat better. I left SO paranoid that I forgot someone, or something. I asked the nurse following me, "did you notice anything stupid I did? Or didnt do?" She said.no, that I did great.
I understand that this is the norm for LTC, and that it takes time to get your routine, etc. But, this has gotten me downright depressed I am SO scares if I go back that I will end up losing my nursing liscense. It's too rushed! I asked how I was suppose to do my 3checks of the 5 rights and was told that I would not have time. What?! What about treatments? If I want to do everything correctly and CAREFULLY then I feel I need 8 hrs..not 4!! I am on call, so not scheduled. I had signed up to work a few days, but got someone to cover it because the thought of doing that again just gives me SUCH anxiety. I can't eat, sleep, or relax. I NEED to work. And I WANT to be a nurse. I hate to think I wasted all that time and money. I am scheduled a few more data this month, I KNOW I just need to grow up and go do my job. But, that thought makes me want to cry!!! Can anyone else relate? Or am I being overly anxious? Thanks!
Specializes in Gerontology, Med surg, Home Health.
I was an R.N. for 10 years and took a job in LTC when I moved to a new city and didn't have the "connections" to the hospitals yet. For 6 months I vomited on my way t work, cried on the way home and suffered panic attacks, unable to breathe during every shift there. Seriously I thought I would be a patient there myself before I was done. The only nurses who got lunch breaks and didn't go fruitcakes were the ones who charted untruthfully and signed off meds and treatments that weren't done. They had just sunk into "survival mode." Long term care is the worst nightmare ever inflicted on the nursing profession. It's not you.
I am going to wholeheartedly disagree with you Pixie. My facility has reasonable work loads and no one is working or living in a nightmare. Our resident to CNA ratio is 6:1. Nurses have plenty of time to pass meds since it is not our focus that the meds are the be all and end all. So what if the colace is late. No one in LTC, or home, or probably most other places ever died or had a bad outcome from a med that was a bit late. We are working every day to get rid of un-needed meds and will be changing our med pass time to "take in the morning" or "take in the evening".
I'm LTC as well, and I couldn't imagine a 4 hour shift. I ALREADY hate an 8 hour shift, because I think that it crams too much in a short time. The 12 hour shifts, over the weekend, are much better... plus the weekenders are better nurses to work with (in this case, anyway).
I don't even think I'd come in for a 4 hour shift, honestly. I'm glad we do not have them here.
You have gone from being a nursing assistant to being the nurse-the one that the na's come to if something is wrong. It takes awhile to get your head around the change in responsibility. As other posters said, once you get your routine down, you'll do fine. But as with anything else, repition is the key. You need to work MORE hours to reach your comfort zone and become more proficient, not LESS. My first job was in LTC-3 days orientation, then 50 patients. Utilize the resources around you-your nursing assistants can be your greatest resources. Since you were an aide there previously, you have a leg up on other new nurses. Hang in there...it's worth it.
The only nurses who got lunch breaks and didn't go fruitcakes were the ones who charted untruthfully and signed off meds and treatments that weren't done. They had just sunk into "survival mode." Long term care is the worst nightmare ever inflicted on the nursing profession. It's not you.
I hope you are speaking for the nurses at YOUR facility and not ALL LTC nurses! Because I am able to get my med passes done (and on time), get ALL my treatments done AND chart truthfully...I developed a routine, learned my residents ways/quirks, and was able to come up with a plan that works. Everything that I sign off has been given, has been done, I do not pre-pour meds, I do not sign meds off until I have actually witnessed the patient take them.
LTC is not everyone. It may not be your fit, but its a great fit for many of us. I personally LOVE my residents and for the most part enjoy my job in LTC. I can't say 100% of the time I'm just in love with my job, I have my bad days, at times things occur that thows me way behind, stress happens just like any position but for the most part..as I said I am where I want to be. And for what its worth, I am not "stuck" in LTC, I have been offered several positions outside of LTC, I just happen to enjoy working with the elderly.
I was an R.N. for 10 years and took a job in LTC when I moved to a new city and didn't have the "connections" to the hospitals yet. For 6 months I vomited on my way t work, cried on the way home and suffered panic attacks, unable to breathe during every shift there. Seriously I thought I would be a patient there myself before I was done. The only nurses who got lunch breaks and didn't go fruitcakes were the ones who charted untruthfully and signed off meds and treatments that weren't done. They had just sunk into "survival mode." Long term care is the worst nightmare ever inflicted on the nursing profession. It's not you.
Whoa, I think we must have worked in the same LTC facility!! It was the worst job I ever had. I cried every night before I had to go to work.
If I had had a coworker like the OP I think I could have survived there though. Hang in there. I am so glad to hear you really care about doing a good job. LTC aresidents need people like you. Also, when I reported some of our facility's infractions to the state, and they sent staff out to observe, the previously non-existent med pass turned into something like four hours (??!!) when one of the LPN's had to follow the rules for that day, and she passed the inspection. It burned me up and I quit shortly after that. Takeaway for you - it must be ok (as in not losing your new license!) to take long on the med pass if you are following the 5 rights etc.
Specializes in LTC/ TCC/Hospice/Clinic Supervisor/Med-Surg.
1st off shame on that Facility for giving a New Nurse 4 days of Orientation!!!!!!! Wow!!! This has alot to do with how you're feeling! Ask for more orientation don't jeopardize your license!!! 2nd you're NOT a failure!!! You made it!!!!! And like the others stated above you'll get into the swing of things, everything comes with time & patience a little Faith and of Course Prayer!!!! Good Luck with everything and I wish you the best. You'll get it, it just takes times.
I know how you feel. I just started in nursing too, and I recieved 3 days of shotty orientation (by the nurse leaving after I was trained!!) then put off on my own. I am only PRN, but worked 7 straight days. I was scared and almost didn't go. You will get it down. The 1st few days I didn't get all treaments done and my unit manager helped me. After the 4th day I got through it all. Last day new admit, a fall, and still got out only 30 minutes late. It gets easier, but never comfortable. I assume that is a good thing! Chin up. One thing I tried was doing the slower people 1st just in case a problem popped up. Lean on your Aide's for the tasks they can help with, and return the favor to them when you can. Great Aide's can make your day easier when mutual respect is shared!
I am SO scares if I go back that I will end up losing my nursing liscense. It's too rushed! I asked how I was suppose to do my 3checks of the 5 rights and was told that I would not have time. What?! What about treatments? If I want to do everything correctly and CAREFULLY then I feel I need 8 hrs..not 4!! I am on call, so not scheduled. I had signed up to work a few days, but got someone to cover it because the thought of doing that again just gives me SUCH anxiety. 
CapeCodMermaid, RN
6,092 Posts
I am going to wholeheartedly disagree with you Pixie. My facility has reasonable work loads and no one is working or living in a nightmare. Our resident to CNA ratio is 6:1. Nurses have plenty of time to pass meds since it is not our focus that the meds are the be all and end all. So what if the colace is late. No one in LTC, or home, or probably most other places ever died or had a bad outcome from a med that was a bit late. We are working every day to get rid of un-needed meds and will be changing our med pass time to "take in the morning" or "take in the evening".