Employed as an LPN, but unhappy.

[NurseDaddy2006]

Hey everyone.

I completed my 3rd of a 3 week orientation at a geriatric facility... nursing home. I will be assigned to provide meds and "treatments" (wound care, etc) to 25 residents (patients). I spent this past week just doing meds. I start at 7AM. 10 patients have 7:30's. My 7:30's are not done by 8. My 8's wind up being included with my 9's. Put it this way: At around noon, I'm getting done with my AM meds. My residents are all over the place, I have to go looking for them, I have to wheel them someplace other than the dining room to give meds. I have to take vitals on those with cardiac meds. Then there are the ladies who roll up to the med cart like it's a drive-thru and line up waiting for me to give meds while I'm pulling them for others.

Oy vey.

I'm on a 7-3 shift. Everyone there has told me that I should never plan on being out of there before 4:30 or so. I have to go get my son from his preschool by 5. This is not good. My nearest relative is 75 miles away. No friends or others can go get him. Other shifts won't work for me, I've already considered that.

I am not sure I'm having problems with time management per-se, I'm having problems with the amount of tasks and amount of residents I am assigned to. It's too much. I am discouraged by the approaches other LPNs there take, the shortcuts they encourage, and just how much everything that entails goes against the utopia that school tries to teach.

I know now first-hand the difference between school's idealistic criteria and the "real world" of nursing. Sad. Put it this way: I was written up for a med error in school, because I gave a med two hours before it's due. That's a regular occurence in this place.

I am concerned that if I do what other nurses there say needs to be done to get the job done, I am going to put myself at risk, put the residents at risk, my license, and my future. If I pick up bad habits and do something wrong when I return to school, I'm screwed. Not good.

I think I am going to resign. If I did not have to go get my son, I would not worry about when I get done, but the boy is dropped off at 7:45AM and he'd need to stay until 5PM, and that's a long day for him. Me too. In the last week I took no breaks other than 10 minutes to eat lunch, and then when I got back all I got was grilled with questions about how much I'd gotten done. It's got me very unhappy.

I told a supervisor. She said it'd be a shame if I didnt stay on, since she thinks I look like I know what I'm doing. I told the nursing director too, and she asked me if would resign now. I told her I want to try to stick it out, but now I'm not sure. The more she said she thought I was "overwhelmed" the more I wanted to stay and prove that's not it at all. I don't think that it's me being overwhelmed in the sense that I get frazzled and think I can't do it. Alright, in some ways maybe I am, but mostly it feels like what needs to be done in the time frame given - 7 to 3 - is way more than one person can do - correctly - in that amount of time. And the nursing director said this is a well-staffed facility, that you get more patients in other places. And less pay. Sheesh.

Meds, treatments, documentation, etc, for 25 patients. Seems like too much to me. If I was done with school, and did not have to worry about how I am going to perform in front of the critical eyes of an instructor, then maybe picking up real-world habits would not be as big a deal for me. Right now I am finding every error on the MARs that everyone else is overlooking, and seeing other things that I've been trained to see, and if I begin to overlook any of that, I'll lose what I need to have in me in order to retake that last semester.

I know I'm rambling a lot here, but I'm pretty torn up about this. It's not what I thought it'd be. I thought I'd get some good experience that'll help me feel confident in school, but now I'm feeling the opposite. Not to mention that one of the LPNs - let's call her Sally - who has been there for 20 years is currently in her last semester in the very same program I got booted from, and one of her instructors is riding Sally and telling her and other students and professors that she cant figure out how Sally made it that far in the program and in nursing because she does not know what she's doing. Imagine that. A 20 year veteran of nursing. The program is brutal, and she says they're dropping people left and right that have one week to go.

So not only do I have the prospect of being without an income again because I want to resign, but I am reminded of just how messed up the retaking of the last semester will likely be. At least the three weeks of pay will help fund Christmas.

I think I'm going to find a family with money that needs me to take care of an elder person and try to do that for a while. I've got to do something. Just not this, I think.

Thanks for reading.

ND

[tatgirl]

I am so sorry that you are having a hard time. 3 weeks isnt long enough to find your "groove" in LTC. I too started out in LTC back in May, and it took me a while to get my system in place. I have 25 residents that I pass meds too, do tx, and whatever may arise on my shift ( I work 3-11). My system is pass the meds to the residents that go to the dining room to eat first, pass meds to the ones that come up to my cart. At my facility,we have a 2 hr window to pass meds. One hour before and one hour after. I start passing meds at 4, do my accu-checks, and finish the first med pass by 6 or so. I take dinner at 630pm, and do my treatments by 7pm. Then it is time for more accu-checks, and pass the 9pm meds. Hang in there. It will get to a point where you find your zone

Wendy

[Mulan]

How about a hospital job? It would be better than that.

They can and do talk about time management until the cows come home, but that is not the problem, you are not the problem. A nurse is expected to do the work of two people, not one, that is the problem. The whole system is screwed up, everywhere, and they try to make the nurse think that there is something wrong with them, not the system.

Good luck.

[NurseDaddy2006]

How about a hospital job? It would be better than that.

They can and do talk about time management until the cows come home, but that is not the problem, you are not the problem. A nurse is expected to do the work of two people, not one, that is the problem. The whole system is screwed up, everywhere, and they try to make the nurse think that there is something wrong with them, not the system.

Good luck.

I agree with what you said. The facility is affiliated with a hospital, so I sent the nursing director over there a letter saying I'd like to work there. There's nothing available for me there at the moment, but the nursing director said she'd keep my name on her desk. I've got a feeling that a hospital setting would be better, but most other hospitals around here only hire RNs.

I'm going to explore other options.

ND

[Tweety, BSN, RN]

Good luck in whatever you do. It's a tough and demanding life as a nurse and the "reality shock" hits us all.

It really sounds like to me you are having the experience any new grad would have and you sound entirely normal. All of us feel the way you do. If you resign, you're going to find the same experience wherever you go. Sounds like your manager has confidence in you.

Howver, don't ever do anything you're not comfortable with. But, be gentle with yourself.

[NurseDaddy2006]

Good luck in whatever you do. It's a tough and demanding life as a nurse and the "reality shock" hits us all.

It really sounds like to me you are having the experience any new grad would have and you sound entirely normal. All of us feel the way you do. If you resign, you're going to find the same experience wherever you go. Sounds like your manager has confidence in you.

Howver, don't ever do anything you're not comfortable with. But, be gentle with yourself.

Thanks Tweety,

This would be a lot easier if I was a new grad, of my RN program. Then I'd be adjusting to the reality shock, as you put it. And moving on with my career. This LPN thing I did, in an attempt to gain valuable experience, is turning out to be something different than I thought it'd be. I am afraid it's going to de-tune me for school, if they ever give me a seat. I'm hoping they do for January, in which case in about two months I'd be either taking leave or cutting my hours down to 2 days a week because I don't plan on working much while in school. I don't want to get into any bad habits needed to work in the real world, for fear it'll undo my goal of graduating. I hope I'm making myself understood here. I can't for the life of me see how doing everything exactly the way school expects me to do it could possibly work given the 25 resident assignment. Nobody checks meds for the 5 rights. I've found med errors galore. I point them out to my supervisor. She corrects the MAR and chuckes. I've seen meds signed for that have not been in the cart for 3 days. Can't give it if it's not there.

I get that there's reality, and there's the utopian nurse that school tries to beat out of you. I've got to keep the utopian way of doing things alive in me so I can do well enough to graduate. I'm not sure I'd be able to do that if I continue working at this place.

ND

[glynda916]

This is my first post. I understand how you feel. I got my Lvn license last year. I've changed so many jobs. I can't stand working as a Lvn because the only job I can find is in nursing homes. My first job I had 36 patients and I didn't last long. How do they expect one to finish all their work on time with so many patients. I feel like i'm risking my license. I can see how mistakes happen easily cause of having so many patients and trying to hurry. I'll be applying for the Lvn to Rn program next year. I'm wondering if I'll be able to do that program because I don't have too much experience as a Lvn. I'm wondering maybe I should do the whole Rn program from scratch.

[augigi, CNS]

First of all, three weeks is not long enough to get comfortable with this. If you check out all the other posts by new PNs or RNs, they ALL feel the same, after 3 months!

I don't mean to be critical, but part (not all) of the problem likely IS your time management skills. I worked as an aide during school and then as the only RN for 30 patients in the same nursing home, requiring meds, wound care etc. But I had been there for a while, knew the residents, knew the routines. It still took me WAY longer than the other RNs, but I did it properly and got faster.

There is a difference in real world and school. However, whatever program you do, and whatever job you have, you will have similar problems. Some are definitely worse than others, but there is always the issue of getting everything done in the time allotted.

You do learn what can slide, and what cannot. For instance, with what you described, I would probably go and do all the vitals for the patients I knew had cardiac meds (while they are still in their rooms and easy to find - it's MUCH harder when you don't know the residents AND can't find them!!). Then I would get around and do the meds. I would group the 07:30's and 08:00's in the same list, and then give all their meds, then the 09:00's. You can ask your aides to help you out in terms of who needs to be where, when.

I think it sounds like you'll be a great nurse - you're questioning yourself, and that is completely natural and reassuring (if you weren't, I'd worry!). But it also sounds like it has all overwhelmed you a bit - this is not a reflection of you or your skills, but of the "culture shock" we all get in our first job! Sounds like your bosses have confidence in you, so perhaps you could ask them how THEY do it. You do not need to be there after your shift (in my facility, if we were off the clock, we weren't covered by insurance).

Good luck, and I'd say give it some time before you move on.