Feeling discouraged

[lorias]

Hello,

I work in a LTC facility and am in charge of 35-40 residents, which is my first job as a nurse. I have been off orientation for 2 1/2 months and last week found out that I am on a 2-week probation where another nurse has to follow me. The terms of the probation are that I have to improve in documentation, critical thinking, decision making and staff supervision. I have made five med errors since I started. Two were before I started orientation when I was asked to work as the med aide. My supervisor says that this was a training issue. Another was because I didn't write the order fast enough so the med aide gave a resident aspirin that should have been on hold. Another was when I answered an alarm and was interrupted in dispensing a resident's meds and still another was when a resident wanted something for pain and there wasn't anything to give her according to her eMAR, so I asked another nurse and she said "she gets a hydro." This nurse worked exclusively on this unit ans was very experienced. So, I gave this since the med card was still in the cart. I'm not making excuses for these med errors, just some background.

Then a few weeks ago, I found out that me and three other nurses were reported anonymously to the BON for med errors in which the complainant said I had 18 med errors, which is false. My supervisor also thinks this claim is bogus. I know I need to improve in certain areas, but I'm feeling like I didn't get the training that some other nurses have gotten. One nurse who works a different shift was told that since she will be working that shift exclusively, she was given almost a month of orientation on just that shift. I will be working evenings and got 5 days of orientation. My supervisor says that "you don't know what you don't know", but at the same time says "we can't teach you everything." I didn't think I was doing a bad job other than the med errors until I was put on probation. I thought that I would have time to grow and develop in my role.

Anyway, has anyone else felt discouraged early in their nursing career? And if so, what did you do about it? I sometimes feel like I want to get into my car and just drive far, far away from nursing and never look back! It was only after I was having problems that my supervisor gave me a mentor (just someone that I could ask questions to, but nothing like formal meetings or formal training) and told me that we have a training computer program. Anyway, I plan on writing down concrete goals and then keeping track of what I do each shift that shows I am developing in the areas I need to improve in.

[Nurse.Kelsey, BSN, RN]

Sounds like that place is bad news. I would leave. They are setting you up for failure and its your license on the line not theirs.

[Crash_Cart]

Staffing ratios like that and yet they wonder why there's problems.

[AnnieNP, MSN, NP]

Resign.

[JKL33]

@lorias, you have to start making some better decisions for own benefit, pronto. This is not primarily about med errors (all though the ones that are actually med errors are concerning). Yes, the staffing is awful and the supervisors there were willing to let someone try to hand out medications to all the residents with no orientation - so they have big problems, too. So maybe you should look for a better place, but that is not the whole story and if you don't make stronger decisions then you won't fare much better elsewhere even if you leave.

This is about just inviting risk upon yourself. Examples: agreeing to act as med aide when you are a new grad and haven't had any orientation to the facility whatsoever; administering a controlled substance when you know that either the patient isn't supposed to have it or that there is some problem with the order which should compel you to investigate.

I think you should reflect upon your own actions and rationales surrounding your decision-making, but don't be discouraged. If you can see the bigger picture you can see how to strengthen yourself for the future. ?

[lorias]

Yes you are right. This experience has opened my eyes to the fact that this is serious business and I have to look at everything as important. I need to take responsibility for myself and protect my license and my future. Thank you. I asked the DON where I work what happens after the two week probation if im still not performing up to their standards and she said lets nust wait and see. I didnt like that answer.

[JBMmom, MSN, NP]

Take a deep breath, this can be okay. I started out in long-term care as well and unfortunately, what you describe about the staffing and the pace of work is something you are likely to encounter in many of these facilities. You CAN be successful, but you feel like you're behind the 8-ball right now. For the remainder of this probation period try to approach every day like a new day. Don't dwell on what's happened in the past, but us this as additional "orientation" time. The nurse with you is someone that you can bounce things off of to show them that you're addressing the things that they are questioning. I understand your med errors, and you sound like you understand and own up to them, but you need to change the pattern behind them. As hard as it is with that workload, you can't rush. Things that need your immediate attention require ALL of your attention. It might take more time, but you don't have any wiggle room right now for another mistake. Better to have the next shift address a couple things than to rush through and get them wrong. Hope fully you have some good coworkers that will help. Good luck!!

[dportal2006, ASN, RN]

I would seriously consider leaving this place. You are putting your license at risk. It is simply not worth it. Start applying for local hospitals and get the first opportunity you can. Hospitals are usually more responsible in the way they train their nurses and you have more support along the way. Not to mention you are going to get paid more, get better experience and have more opportunities for advancements. Nursing homes offer limited opportunities and a lot of hospitals don't even consider it acute care experience. It is one of those jobs that you have for a few months while you look for something else. This is a blessing in disguise and should be a wake up call to move on. Good luck to you.

On 9/10/2019 at 1:42 PM, lorias said:

Yes you are right. This experience has opened my eyes to the fact that this is serious business and I have to look at everything as important. I need to take responsibility for myself and protect my license and my future. Thank you. I asked the DON where I work what happens after the two week probation if im still not performing up to their standards and she said lets nust wait and see. I didnt like that answer.

Don't beat yourself about what happened. Every nurse makes mistakes when they first start off. I know I made a few. The important thing is for you to recognize the mistakes and learn from them. The patient to nurse ratio in your facility is absolutely horrible.

[lorias]

To be fair, I usually have 5 CNAs to help me and most of the residents don't require my constant attention, but nevertheless I am responsible for 35+ residents. I do feel that I have been treated unfairly in that another co-worker of mine received 20 additional orientation days for the night shift because that was the shift she would be working on top of the four weeks we both received and she was not on a "written warning" probation, but rather just the usual 90-day probation that everyone is on when starting a job. I have worked night and evening and now will be just on evenings, but I didn't get additional orientation until they decided I wasn't performing up to par. The thing about applying to other jobs is that I live in a small town and the nearest other hospital to me is 45 miles, but that hospital has had problems. Otherwise, I'd have to travel 75 miles. And I'm under a 6 1/2 year contract because they paid for my schooling. I thought it would be a 5 year contract, but the cost ended up being more than originally told to me. I didn't think that was fair either.

[lorias]

We also have a med aide, but this person isn't a nurse so I'm responsible for that person in the same way I am for the CNA's. Why we can't have another nurse rather than a CMA is beyond me. Would be so much better. I guess it's cheaper to have a CMA rather than another nurse.

[RNfindingherway, BSN, RN]

Run! Grab your License and RUN as fas as you can.

[dportal2006, ASN, RN]

21 hours ago, lorias said:

To be fair, I usually have 5 CNAs to help me and most of the residents don't require my constant attention, but nevertheless I am responsible for 35+ residents. I do feel that I have been treated unfairly in that another co-worker of mine received 20 additional orientation days for the night shift because that was the shift she would be working on top of the four weeks we both received and she was not on a "written warning" probation, but rather just the usual 90-day probation that everyone is on when starting a job. I have worked night and evening and now will be just on evenings, but I didn't get additional orientation until they decided I wasn't performing up to par. The thing about applying to other jobs is that I live in a small town and the nearest other hospital to me is 45 miles, but that hospital has had problems. Otherwise, I'd have to travel 75 miles. And I'm under a 6 1/2 year contract because they paid for my schooling. I thought it would be a 5 year contract, but the cost ended up being more than originally told to me. I didn't think that was fair either.

You have 6 and a half year contract with who? The nursing home?? That is an outrageous amount of time.