Orientation-not enough

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:o

I figure this is a frequent problem but I need to rant! When I accepted the job at my nursing home I told them I had not worked in 11 years and said I wanted a thourough orientation. "No problem you can have as long as you need." Well apparently 3 days was enough. I went in yesterday and found I was charge for the facility and was responsible for the large unit. It has the skilled patients and a chronic hall. Their are 78 patients here and the number of medications is astronomical. I had not passed all the meds to pts. yet and it took me almost 2 hours. Luckily all the aides had shown up and were helpful in finding the residents and knew how most took their meds. I had 3 med passes to do. Blood sugars and insulin, vitals and assessments on the 11 hot charts-those with immeadiate health issues and answering the phones. There are about 20 keys, with only 3 marked, and finding the right one took for ever. I had never given report and was told from the night shift that nothing was different except one patient went to the hospital. I work only weekends so I didn't have a clue as what had happened during the week. I also didn't know what was normal on patients so if there was something that concerned me I had to dig to find out if this was "normal" for this patient. I had treatments to do and the lpn at the other station is one who does her work, poorly, and didn't like having to help an rn with questions. :angryfire There isn't a sheet that has all the residents name and rm numbers on it so if I wanted to find them I had to search through the med books, there are 3.

I work on Tuesday and I am the rn charge again. Things are different during the week with labs, dr. visits and such. I am telling the don that I need help and more orientation. I have no idea why they think I should know everything after 3 days. At first I was panicking but told myself to slow down and prioritize. getting the right med to the right patient, etc. My legs and back were killing me from running back and forth between the halls. Thanks for letting me rant. :rotfl:

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I think that this is totally unacceptable. You are putting your nursing license at risk. I would speak to the DON immedaitely and get some changes made, or resign. It is not worth losing everything because they are doing things wrong. If you agree to be a part of it, then you are also responsible for it.

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You passed meds to 78 patients!?!??:uhoh21:

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Specializes in Geriatrics/Oncology/Psych/College Health.

I've said this here before but it bears repeating, this is very common in LTC's. They are generally so short-staffed that they just want to get a warm body up and running. This is NOT to disparage the many fine and hard-working nurses here who do long-term care and have no control over this type of situation.

Be prepared when you talk to the DON for something like, "Everyone said you were doing so well that we decided you were ready to fly solo." Even facilities that spell out a longer orientation will often drop you into the fire if someone calls off.

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:o

I figure this is a frequent problem but I need to rant! When I accepted the job at my nursing home I told them I had not worked in 11 years and said I wanted a thourough orientation. "No problem you can have as long as you need." Well apparently 3 days was enough. I went in yesterday and found I was charge for the facility and was responsible for the large unit. It has the skilled patients and a chronic hall. Their are 78 patients here and the number of medications is astronomical. I had not passed all the meds to pts. yet and it took me almost 2 hours. Luckily all the aides had shown up and were helpful in finding the residents and knew how most took their meds. I had 3 med passes to do. Blood sugars and insulin, vitals and assessments on the 11 hot charts-those with immeadiate health issues and answering the phones. There are about 20 keys, with only 3 marked, and finding the right one took for ever. I had never given report and was told from the night shift that nothing was different except one patient went to the hospital. I work only weekends so I didn't have a clue as what had happened during the week. I also didn't know what was normal on patients so if there was something that concerned me I had to dig to find out if this was "normal" for this patient. I had treatments to do and the lpn at the other station is one who does her work, poorly, and didn't like having to help an rn with questions. :angryfire There isn't a sheet that has all the residents name and rm numbers on it so if I wanted to find them I had to search through the med books, there are 3.

I work on Tuesday and I am the rn charge again. Things are different during the week with labs, dr. visits and such. I am telling the don that I need help and more orientation. I have no idea why they think I should know everything after 3 days. At first I was panicking but told myself to slow down and prioritize. getting the right med to the right patient, etc. My legs and back were killing me from running back and forth between the halls. Thanks for letting me rant. :rotfl:

How in the world did you give meds for 78 patients? I am an RN who also has been out for 10 years. I found out that unless I had a refresher course, I could not be hired in any hospital. I was told by one nurse recruiter that a job in a skilled LTC would help, not just LTC. However, I have been placed on the LTC unit after being told I would be on the skilled unit. The first time was 39 patients, meds, assessments, tons of redundant charting for medicare, no time to know the patients diagnosis, no report. I don't know how I am going to do it. I am going to try to hang in there. I just part-time so I could take my refresher course. I have never worked LTC before and was totally clueless what they throw at you. Many other issues too regarding policies.

I just can't believe you handled 78 PATIENTS! Did the other lpn have part of them? Are you working fulltime? See my post on BAIT AND SWITCH on the general nursing discussion.

I am going in at 3 today. God knows what I will be facing. Please let me know how you do Tuesday. I would wish you good luck but it seems kind of lame. My thoughts are with you. Oh, yes, the CNA's were great. Maybe we will still survive. I would imagine you best bet would be to get into the skilled area and get enough experience to get into other types of nursing.

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Do not agree to work like that again. Call the DON before your shift starts and let her know. I work in a small facility where the RN is resposible for 24 residents. I would never agree to work like you did. YOu did a great job. Heck it takes me 2 hrs to do 5 pm meds on a weekend!

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I had the 78 patients she had 53. I am telling the DON on tuesday. I couldn't find half the paperwork that needed done. I was shown how to fill out lab requests and ect. but until you actually do it it is hard to remember it. I must have done what needed to be done cuz no one called me to say I had forgotten something or ask questions. I like to be a thorough nurse and spend a couple of minutes with each patient a day. They have omt's but none were scheduled that day. GRRRR. Thanks for showing me I wasn't wrong in thinking this was not acceptable. Lukily I am a positive person and handle stress well. :p

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I have worked in LTC for > 10 years and have never passed meds to 78 residents. It sounds dangerous. We run for approx 100 residents 5 nurses on the day shift and 3 on the evening shift and we do 12 hour shifts.

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I passed about 50 in my other home but I knew everyone and had a good orientation. We only have 2 nurses on evenings and days and 1 on nights.

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I was wondering as well how you were able to go back after 10+ years without a refresher course. Up here we are required to work a minimum number of hours every three to five years to maintain an active license. No hours = no license without going back to school.

Three days is pretty much the norm for a nurse with an active license. Five-8hours shifts are given at most facilities to new hires, but with 12's it's usually three.

Can you take a refresher course while working just to make you comfortable? Because part of me says if you've been away for a decade its reallly not up to an employer to re-train you....

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Check you state staffing requirements. 78 sounds like alot to me for a 3-11..even a 11-7 shift.

This is a first for many years. We hired a new nurse (not new to nursing, but she's been doing psych for many years)...our DON has her on orientation for 4 weeks!! She will be getting trained on each shift. Hopefully this one will stick.

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Specializes in MS Home Health.

I interviewed at a facility that told me, I have never worked as an employee of a LTC/SNF before, only as a wound/ostomy consultant, that I would get a whole, drum roll................................6 hours, 2 per unit. I say good bye.

I am sorry and yes it is WRONG.

renerian

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