I just started my first nursing job at a LTC facility on the night shift for a 52 bed unit (well 52 current residents).
I feel like I am a living contradiction. When I graduated Sept 2010 I was told I would hate LTC (I love it).
I was told since I was new it was unlikely I would get a night position (Out of 55 applications put out only offer I got was my current position 11p-7a).
I was told I would not have to worry about charge nurse duties at first (after 5 days of orientating on days and eves I found myself alone on nights as charge).
I was told I would have trouble with my aides..and this is a half truth as my aides are a mixed bag of great wonderful workers and a few that hide from me after shift start and I have to hunt down in breakrooms, on other units visiting friends, or out on the parking lot.
I had never worked (tbch I had never worked as a nurse so this may not be that great a revelation) with QMA's before and God bless each and every one of them. I did not know how much I appreciated them until I came in one night and I was paired with another nurse and no QMA. I swear the next time I worked and I saw I had a Q working with me I wanted to buy them flowers cookies and coffee.
My main problem is (and please no snickering from you more experienced LTC nurses) it was stressed that I had to be out of the building after about 10 minutes or so after shift end...
Well when I was orientating that was not a problem...but I noticed the rest of the nurses would just start charting as I was leaving. Once I started working I saw why. They have med passes, tx's, plus a ton of other stuff to do, and at shift end getting the last of the blood sugars, temps, vitals, etc. That doesnt include the fact that the next shift of nurses seem to show up when they feel like it (anywhere from 15 minutes to an hour after shift end). So Im waiting around to do narc counts, give report, and to pass on any other info.
First "real" shift I worked by myself I ran about 40 minutes over shift..I told myself I was new and I suppose that was to be expected. The next time we were short aides and so I helped with AM adls, I worked an hour past shift playing catch up. Then next night I had a hell night (again no snickering..this may be a walk in the park to some of you but for me it was pure chaos). Had a resident fall, spent time looking for every form i needed that were scattered around the station, calling Dr, DON, family members, and doing 15 min Neuro checks plus full skin assesment. Was at work hour and a half past shift end. I was positive I would come in to at minimum a written warning or verbal warning. Nope...Unit manager I spoke with just chuckled and said "Welcome to LTC".
I am really torn over this. I am trying to find ways to have better time management, I ask every other nurse I come into contact with how they do it (and they all say for the most part they still work over shift). I've made todo list for myself with times I should have x amount of things done..I budget time for emergencies such as falls, change of status events, short staffing of aides, etc...but nothing seems to help much.
Some of the aides have insinuated that the RN's work over on purpose for OT..I just don't see that.
So am I being naive?
Should I just accept that my shift ends when I have finished all tasked and not what my clock out time is supposed to be? - and I refuse to work "off-clock" in anyway if I may be expected to actually do patient care in my finishing up tasks.
Looking for advice, suggestions, or at least encouragement that it is possible to squeeze an 8 hr shift into 8 actual hrs.
Specializes in Gerontology, Med surg, Home Health.
Do I wish all the nurses could/would get out on time? Yes because if they don't, I hear about it from the administrator who hears about it from corporate. Do I write people up for getting out late? Not usually. I've been there...I know how a fall or a late visit from the MD or an afternoon admission can screw up your day. I know that the nurses who stay late aren't doing it to get overtime. They are doing it to finish their work and make sure everything is done...partly because they want the residents to get the best care and partly because they don't always trust the next shift to follow through. I'm up on the floors enough during the day to see that the nurses aren't sitting around doing nothing. (of course there is always the exception who is sitting most of the day reading a magazine...she didn't last long in the building).
You'll be late some days...cut yourself some slack...you're still new. Don't take shortcuts (flame away). If the med pass is too heavy or you have to take the cart out too many times, talk to the pharmacy consultant and get him/her to help rearrange the hours the meds are given. Don't give up. We need good new nurses.
CapeCodMermaid, RN
6,092 Posts
Do I wish all the nurses could/would get out on time? Yes because if they don't, I hear about it from the administrator who hears about it from corporate. Do I write people up for getting out late? Not usually. I've been there...I know how a fall or a late visit from the MD or an afternoon admission can screw up your day. I know that the nurses who stay late aren't doing it to get overtime. They are doing it to finish their work and make sure everything is done...partly because they want the residents to get the best care and partly because they don't always trust the next shift to follow through. I'm up on the floors enough during the day to see that the nurses aren't sitting around doing nothing. (of course there is always the exception who is sitting most of the day reading a magazine...she didn't last long in the building).
You'll be late some days...cut yourself some slack...you're still new. Don't take shortcuts (flame away). If the med pass is too heavy or you have to take the cart out too many times, talk to the pharmacy consultant and get him/her to help rearrange the hours the meds are given. Don't give up. We need good new nurses.