Feeling uneasy about first nursing job.

Cola89 · Feb 2, 2016

I think this is normal with alfs. these residents should require less care than ones at any given ltc. all 3 alfs in my area dont staff rns (except the don). just remember- you can always send em out (to the ed, with an order), but yeah, these patients should be pretty stable.

%D#2 · Feb 2, 2016

My post may give you insight

https://allnurses.com/general-nursing-discussion/vent-rant-about-1034537.html

I work at a LTC that's mostly AL but has a small skilled unit. It's not uncommon for there to not be an RN and ALFs are accepting more complex patients without adequate staff. I have one resident who needs to be sent out like once a month or be on hospice but his family won't accept him being in our sub acute unit cause it has hospital beds.

This is a good start but I'll be looking for other jobs while in school for my RN

%D#2 · Feb 2, 2016

Sorry if I scared you though, but you should know what it's gonna be like. The more you know the less it may stress you. At least you have other nurses on your shift.. If I had that I think I'd feel much better.

Cardiacluv · Feb 2, 2016

Sorry if I scared you though, but you should know what it's gonna be like. The more you know the less it may stress you. At least you have other nurses on your shift.. If I had that I think I'd feel much better.

Thanks, you didn't scare me. I like being realistic. I've worked in assisted livings as a CNA so I've encountered patients that shouldn't have been their from an acuity standpoint, but I didn't pay it too much mind because hey, I was a CNA! As a nurse though, it worries me, because while yes you can send them out, it seems like I wouldn't have to be sending so many out or having lots of incidents if there were more licensed staff and we had more time to actually do rounds on our patients............ And sadly I dont think our manager is an RN! (I believe she's just an administrator!)

I'm going to stay positive and hope that all goes well because I do want to obtain at least 6months of experience, to better my chances in the job hunt.

%D#2 · Feb 2, 2016

Thanks, you didn't scare me. I like being realistic. I've worked in assisted livings as a CNA so I've encountered patients that shouldn't have been their from an acuity standpoint, but I didn't pay it too much mind because hey, I was a CNA! As a nurse though, it worries me, because while yes you can send them out, it seems like I wouldn't have to be sending so many out or having lots of incidents if there were more licensed staff and we had more time to actually do rounds on our patients............ And sadly I dont think our manager is an RN! (I believe she's just an administrator!)
I'm going to stay positive and hope that all goes well because I do want to obtain at least 6months of experience, to better my chances in the job hunt.

Yes definitely stay positive! My positive attitude and drive to do good for others is what keeps me going. One thing I love about LTC is the elderly residents. You're gonna have all these new grandmas and grandpas who love you and you're gonna love them!

Even if you have an RN there, you'll still have to send people out in emergencies because there are limited resources. But a really good thing this job has taught me is how to work independently, aside from needing orders from doctors of course.

I rely on my instincts and my own assessments all the time. And it's hard, and I am still new, been here for 7 months. I had no nursing orientation at all.. I didn't shadow any nurse I went in on my first day and I was on my own and terrified. The Cnas were so helpful. So many times I do wish I had even another LPN working with me.. But most of these facilities are run by LPNs (in charge front line staff).

Another thing I learned is don't underestimate yourself as an LPN. You are a nurse who has great potential to take care of your patients with your nursing license. Confidence goes a long way! I'm still a work in progress. Never stop learning!

If you have any questions please let me know! I would be more than happy to help since we're kinda in the same boat here :)

Cardiacluv · Feb 2, 2016

Yes definitely stay positive! My positive attitude and drive to do good for others is what keeps me going. One thing I love about LTC is the elderly residents. You're gonna have all these new grandmas and grandpas who love you and you're gonna love them!
Even if you have an RN there, you'll still have to send people out in emergencies because there are limited resources. But a really good thing this job has taught me is how to work independently, aside from needing orders from doctors of course.
I rely on my instincts and my own assessments all the time. And it's hard, and I am still new, been here for 7 months. I had no nursing orientation at all.. I didn't shadow any nurse I went in on my first day and I was on my own and terrified. The Cnas were so helpful. So many times I do wish I had even another LPN working with me.. But most of these facilities are run by LPNs (in charge front line staff).
Another thing I learned is don't underestimate yourself as an LPN. You are a nurse who has great potential to take care of your patients with your nursing license. Confidence goes a long way! I'm still a work in progress. Never stop learning!
If you have any questions please let me know! I would be more than happy to help since we're kinda in the same boat here :)

Thank you so much. I guess you're right! Having an RN there would probably only lessen the send outs by so much!

I'm just used to working in hospitals where I can turn around and ask a physician, RN, respiratory therapist, speech pathologist, etc for assistance. But after reading your posts I see it can be manageable, I just have to realize that all those great minds to turn to for questions arent going to be their and I have to trust in my skills and knowledge and go from there. As for the CNAs, I barely see them, they're just as busy(if not more busy) as I am!( or as I will be!)

%D#2 · Feb 2, 2016

Thank you so much. I guess you're right! Having an RN there would probably only lessen the send outs by so much!
I'm just used to working in hospitals where I can turn around and ask a physician, RN, respiratory therapist, speech pathologist, etc for assistance. But after reading your posts I see it can be manageable, I just have to realize that all those great minds to turn to for questions arent going to be their and I have to trust in my skills and knowledge and go from there. As for the CNAs, I barely see them, they're just as busy(if not more busy) as I am!( or as I will be!)

Yeah I came from being a pct in a hospital too. It did feel more secure. But if you decide later on to transition to a different facility with more staff and more resources think of how this job will have already trained you to be so resourceful on your own. Like super nurse lol

If you need to call on your CNAs (like if you have an emergency) do it.. Just say "I need you to stay with this patient while I call 911 and prep the transfer paperwork" and I feel that having someone else there eases the nerves a bit.

Good luck and keep us posted!

Cardiacluv · Feb 2, 2016

You are so right! Thanks LupieNurse!

amoLucia · Feb 2, 2016

Another thing I learned is don't underestimate yourself as an LPN. You are a nurse who has great potential to take care of your patients with your nursing license. Confidence goes a long way! I'm still a work in progress. Never stop learning! :)

Lupie, this is a very gracious compliment. Too often, some LPNs low-ball themselves and that's just sad. Some are awesome! Likewise, CNAs are the secret gift to effective TEAM efforts. Underpaid and underappreciated.

To OP - just remember that your place is an ALF. Your pts SHOULD be in better health with better self-ADL skills, better cognitive skills (ie safety awareness) etc. HaHa!!! :roflmao: SHOULD be is the operative word. As it was said, AL pts are freq becoming more complex for AL, and their presence may be inappropriate for the level of care needed.

Just to tell you, there is a rule that an RN IS REQUIRED somewhere in the regulations for consultation. They don't have to be physically present but they have to be avail for contact. Make sure you know where your contact lists are, esp for administration, MDs, transportation, hospitals, dialysis, pharmacies, FAMILY, FAMILY, FAMILY for telephone numbers

ALs are unique critters in the healthcare continuum. The regulations have been developed but the facilities have morphed faster than the regs have.

Good luck.

littlelimabean01, LPN · Feb 2, 2016

I work in LTC and just until this weekend we had a RN supervisor. The facility which is privately owned decided to eliminate the RNs!! I was dismayed of course. I like learning from them, but I guess it was a cost saving decision. The facility decided to go with LPN supervisors that they felt were strong. Those LPNs do exist because experience does matter you do not have to have the degree to be a very competent nurse who knows their stuff. In a ALF that is very common the RN that they do have on staff is a day shift person and over night it will be just in your case one LPN to care for the whole facility. Try not to be nervous. Just develop a good relationship with the med techs, CNAs so that they report when they feel like something is amiss.

Cardiacluv · Feb 3, 2016

I work in LTC and just until this weekend we had a RN supervisor. The facility which is privately owned decided to eliminate the RNs!! I was dismayed of course. I like learning from them, but I guess it was a cost saving decision. The facility decided to go with LPN supervisors that they felt were strong. Those LPNs do exist because experience does matter you do not have to have the degree to be a very competent nurse who knows their stuff. In a ALF that is very common the RN that they do have on staff is a day shift person and over night it will be just in your case one LPN to care for the whole facility. Try not to be nervous. Just develop a good relationship with the med techs, CNAs so that they report when they feel like something is amiss.

Thanks, I won't be working overnight. They only have med techs at night and there is no RNs on staff at all. I do plan to get to develop my relationship with the aides, but I dont know if that will help any, I think I am just really partial to the hospital environment, where their is a plethora of supplies, staff, and newer, well functioning equipment!!

You are right, there are some very knowledgeable LPNs out there, that can be great resources. ðŸ˜Š