New nurse in LTC & Overwhelmed (long)

BerryHappy · Feb 5, 2009

Poor thing! I am sorry for you. It sounds like you work in a really crappy place. 54 pts??? That's unimaginable! I graduated in June '08 and I've had a much better experience.

Yes, it is all overwhelming. Yes, I still find it hard to believe what I do is called "nursing". Yes, sometimes I feel like a med cart monkey. But I LOVE my facility. I respect our management. I admire my coworkers.

I really think if I was given 54 pts, I would contact the DON and tell her I refuse to risk my license. Start standing up for yourself. With so many pts all you CAN DO is make mistakes! They need you more than you need them so don't let them kill you for the sake of a few dollars! There are better LTC's to work at you just have to search. Start by going online to your state website and find out which LTC's in your area get 5 stars from the state. If they get good reports it is more likely they take better care of their staff and residents.

Good luck and I hope you find a better place to work.:flowersfo

ANnot4me · Feb 5, 2009

Sorry to hear that you have to deal with this and I hope you will learn from your experience. You have said yourself that you feel unsafe and that you are making mistakes. You are jeopradizing your future and I doubt that what little money you are making now is worth that. Once that registration is gone, what will you do?

The situation is sad and has been going on for years and years. You did not cause it, you can not fix it and there is nothing wrong with you. Unfortunately, other nurses have had years to learn how to justify this neglect and how to emotionally manipulate other nurses into doing the dirty work while they position themselves safely behind a desk. It is like brainwashing: you are abused, but made to feel that it is all your fault and you are not worth of better.

travel50 · Feb 5, 2009

I know exactly what you mean. I worked at my LTC facility for 6 yrs before I became the DON, so was well aware of the struggles of my staff. First thing I did was to insist that their pay be increased. Second thing was to point out to the office staff that when it is really bad out on the floor, I expect all hands on deck. Then I redistributed duties. For example, when a resident develops an ulcer, it is the MDS coordinator who fills out all that paperwork. My floor nurses do not have time for that. Legally, you have 24 hrs to get those papers done. And if the area is discovered on the weekend, or when the MDS coordinator is on vacation, any one of the RNs can do them. My LPNs never do them. Not b/c they can't, but b/c they just do not have time. During the daytime, there are plenty of office staff to answer the phone. I have a treatment nurse on the floor also, and she can help field phone calls for the nurses, say when a family member just wants to talk to a nurse on the floor about their loved one. Then I have an RN from 7P-7A. She fields phone calls when the evening nurses are doing meds, and when the nite nurses are doing their 6A med pass. My ADON does not come in until 11A, so she can stay until the nite RN gets there at 7P. The purpose is so my floor nurses do not feel overwhelmed. We have appx 60 residents, and always have 2 med nurses. We have a small number of residents who have trachs. The RNs and the treatment nurse take care of those. The treatment nurse does day treatments, and the nite RN does the evening ones. Our MARS are a mess as well. PRNs and routines are not separated. What my nurses do is to color code the times, so at a quick glance they can see what they are supposed to give...no searching. A brand new nurse at my facility also gets a full 2 week orientation if needed. I wonder how much you got. Now, my facility is absolutely not perfect. Matter of fact, I called an emergency meeting of all nurses today and...well...it was not pleasant. I found one mistake too many. But those meetings are actually rare. I try very hard to make a good work environment for my nursing staff. I need them to take time with the residents, to get to know them, have time to assess them, time to give hugs. Have you talked to your DON about how you are feeling? I hate for you to feel so frustrated.

Divemaster · Feb 5, 2009

That does not sound like a good place to work. I'm working at a place like "Travel50" runs.. Love it.

LogCabinMom · Feb 5, 2009

thank you all for sending me such nice kind thoughts. Travel50 - I AM an RN, and we are treated exactly the same as the LPNs; we do med passes, etc- I feel we are there so the facility can simply say, "see, we do have RNs on staff"... I was on "orientation" for about 1 week; then I was put onto the cart -there was another nurse on at the same time I was, but she had her pts and I had mine.

I like the idea of having the MDS coord doing the paperwork. We do not have a separate tx nurse. We are all expected to do our own tx, pts paperwork, help with serving lunch (which completely blows my mind) etc. It's not that I don't want to help; but if I am forced (and we have been told in no uncertain terms that we are supposed to) to pass a tray instead of writing up the paperwork, when will everything get done? There are days I feel more like a waitress than a nurse.

And assessments/charting of the skilled pts - which is the real reason we are there, right? If there is a Charge nurse (also a LPN) on days, she is usually pulled onto the cart too.

Thanks again for everyone's input. I am currently looking for a hospital position; I'm just going to hang in there and do my best until I find one.

mykrosphere · Feb 6, 2009

long term care was the hardest thing ive ever done.

we took vent patients, also, who were not stable whatsoever and the place was a sh*thole.

lasted there a year.

now im at an ltac and having 5 patients is like having 30 ltc patients.

i must have been out of my mind to take on that job, but it taught me a lot.

and with experience, you will definetly know whos going bad when, and who takes what when and how.

theyll let you know (the patients)

i feel your pain.

ltc can only make you stronger

:nurse:

mykrosphere · Feb 6, 2009

and good luck on your finding a hospital job.

!!