I hate being a LPN in LTC. The horror!

lisamc1RN, LPN · Sep 3, 2009

I'm sorry your orientation is not going as it should. Don't give up, though. Even if, after giving this job a bit more time (be very upfront about what you need. Ask for help as much as you need to) you are finding that this is just not working out, find another place to go. There is the right LPN job for you. It may be in LTC or home health, or wherever. Just don't give up too easily. The first year of nursing is very tough and you are going to feel overwhelmed a lot. The key is a good support system in your other nurses and management. Speak up for yourself and let them know what you need. Hopefully, they will help you through this.

Ihoplover · Sep 3, 2009

Dear Plaqueis-

Hey I feel your pain - I'm a new RN and there are days I feel I'm drowning too! Big difference is I have an AWESOME group of nurses that answer all my simple and complex questions and are very good to me. It's still hard and I've cried over my patient's suffering and stress out over my lack of knowledge at times but honestly if they're not going to support you - you need to find another job. You CAN find another LPN job even though new grad - let them know you'll have to give your notice if you can't have more time WITH a preceptor. God's peace to you!

ItsTheDude · Sep 3, 2009

a new job with poor training can be tough, add to the factor it's ltc (no most ppl's cup of tea, can't believe u liked being a cna n ltc better, good for u though). sounds like u've done ltc for awhile now as a cna, so u should get the hang of it n time, stick with it.

SuesquatchRN, BSN, RN · Sep 3, 2009

Honey, forget learning anything but the med cart for now. The reason they're not teaching you the other stuff is because they want you where you are. SO focus on it. When people tell you things that you know in your heart are wrong just nod and smile and say uh huh. And concentrate on the 5 rights and your meds. That's it for now.

Hang tough.

:)

Need2Wings · Sep 3, 2009

Plagueis,

I too am a new LPN and feel your pain, I was just started a LTC job not quite 2 months ago, all of what you detailed I am seeing also.. Perhaps we work at the same facility. LOL. About Borrowing meds, recently this came to a not so nice FRONT at our facility, it is considered insurance fraud and you should not do it.. WE do put n/a well at least I do, if we dont have it for that resident and its not in the backup drug box, then that is exactly what I write. The facility may not like it but you have a license to protect and if they dont allow that well then they are asking you to commit fraud? (seriously) I sure wish there was another option out there besides LTC for LPN's its truly unreal what we go through on a daily basis. I too was "thrown under the bus" and while on orientation my "nurse" was out on smoking breaks etc the majority of one of my orienting days, which I was supposed to get 14 days since I had not ever been a CNA but after 9 days, I was on my own. There is still a lot I feel that I do not know. I find myself checking the schedule to see which nurses are also working, some of them are great, I can ask questions and get treated with respect while others, well I may not be young but I've been eaten more than once.

I want to thank you for posting exactly how I have been feeling but I am sorry to know that you are experiencing this unpleasantness too. I purchased Liability Insurance shortly after being thrown under the bus, its only a small percentage of peice of mind but if you continue working there I would suggest you get it too.. I found the information on this fabulous site. I wish I had some ingenious advice to give you but I too struggle with this, feel free to IM me if you need to vent some more.. I can take it. Hugs to you to help ease the stress, but please remember to do what you must to protect your license. ((hard to know all those boundries right out of school though)) thats how I feel.

nurse_mo1986 · Sep 3, 2009

I put up with such conditions for one year after graduating pn school. I worked in a nrsg home that sounds exactly like you describe, and nurses did all of these same things. After one year, I decided that my job and mental health were more important than the money. I took a pay cut and went to work in a hospital. Miracle of miracles, I now work in the ICU at my hospital as an LPN and they are paying 100% of my BSN while i work there. Things can work out for you. Just hang in there and keep your head up.

Margie LPN · Sep 3, 2009

If you can hang in there it gets better. You dont have to do any of those things you mentioned, as far as unavailable meds and stuff. I usually make a list of what is missing and when I can I call the pharmacy. You can circle a med and chart on the back that you called it in. If you are going to have your own hall all the time, you can call and get some of the times of the meds changed so there is not such a heavy med pass at night for those ones that do not want to or will not wake up and take pills. You do not need to do what others do. Sounds like the person who is orienting you has some issues. I wish you could orient with me a few days. There is a way of doing things the right way and getting it done. You just have to find your groove. The paperwork will take some time getting used to and you wont get the hang of it until you actually have to fill it out. Don't be afraid to ask even if there are bad attitudes. There is a lot to do but trust me you will get the hang of things. It was the same thing when I was a new nurse, I felt thrown to the wolves, wanted to quit and cry everyday. I couldn't even sleep, had nightmares of pouring pills in my sleep. Don't give up. Talk to your supervisor, and don't compromise your work ethic. Treat your patients like you would want you mother or father to be treated, even if they are mean. You can do it.

Plagueis · Sep 4, 2009

Thanks to all of you who responded. :) I'm trying to stick around, but I'm still worn out from work.

Need2Wings, I have purchased Liability Insurance. Not taking any chances. Sorry to hear you were thrown under the bus, too. Unfortunately, this seems to be a common trend in LTC.

As far as not having the med available to give, I've been told that writing "med not available" is considered a med error, and that a facility could be cited for that, not to mention the nurse getting written up. Nurses I know who work in other LTCFs tell me that their employers have a similar "rule." Hence, the borrowing. I don't see how it all falls on the nurse, especially if the pharmacy fails to deliver a med in a timely fashion.

SuesquatchRN, I'll guess I'll be saying "uh huh" quite a bit when I'm with particular nurses!

ItsTheDude, at least as a CNA, I didn't go home and stay awake for hours wondering if I missed something, or didn't fill out some sort of summary/form, or whether I missed signing one spot on a MAR/TAR. :banghead:

kappykatlpn · Sep 6, 2009

In addition, I've been told about some of the "interesting" habits that I've read about on this site, which I'm told is nursing-home gospel, such as:combining meds from different times into one pass ("you won't get done, otherwise")borrowing meds ("everybody does it; you can get in trouble if you don't give the med")no supervisor, except on dayshift ("there are hardly any emergencies on 3-11 or 11-7")signing that a med was given, when it wasn't even available, and couldn't be borrowed ("you can't write 'not available'")

Hello! don't give up! I have been a LPN in LTC for 8 years, I agree its is a LOT of info and work, but I love it. Just takes time. And for the "interesting habits" you do what is right remember it is your liscense that is on the line! If a drug is not available and not in our back up box, I call our pharmacy and they will call the med into a local "back up pharmacy" and then we get it from there. I don't combine meds, even though it take me forever to do the 8am med pass! I am almost always done after the one hour window. And I have seen nurses fired at my facility for signing for something that wasn't done, that is fraud! My DON would freak if she saw this post.

Maybe another facility would work out better. There are good ones and bad ones. You just have to find the right place. I worked in a couple of LTC places before finding the one I am at now, its not perfect, but one of the better places I have worked at, I have been here for 9 years.

Good luck!

)

SuesquatchRN, BSN, RN · Sep 6, 2009

As far as not having the med available to give, I've been told that writing "med not available" is considered a med error, and that a facility could be cited for that, not to mention the nurse getting written up. Nurses I know who work in other LTCFs tell me that their employers have a similar "rule." Hence, the borrowing. I don't see how it all falls on the nurse, especially if the pharmacy fails to deliver a med in a timely fashion.

I would borrow the meds, personally, and replace those of the borrowed resident when the borrowing resident's meds come in.

The facility can be cited for not having meds available. Of course, rather than figure out the system breakdown that is causing the need to borrow meds they'll just borrow, but don't get yourself written up. You don't borrow and the surveyor cites them because of your MAR entries you'll see how high your butt bounces when it hits the pavement. No one will charge you with insurance fraud.

dotherightthing · Sep 10, 2009

i'm a lpn, and i'm conflicted about whether to leave the ltcf i work at, even though i'm still on "orientation." i loved working in ltc as a cna, but ever since i've been on orientation as a lpn, i hate it!
although i'm still supposed to be on orientation, i've been on the med cart by myself a few times without warning, as there is usually a call out. i was told that i should be able to "figure things out" myself, as i'm a lpn (though a recent grad!). the other times, the lpn i was supposed to be with would take breaks away from the facility, leaving me panicked. i still don't have a clue about 90 percent of the paperwork/forms that i'm supposed to fill out as a lpn, because it has never been explained to me; i've been thrown on the cart to "improve my speed." my requests to learn more paperwork have been ignored. i feel overwhelmed and stresed out.
in addition, i've been told about some of the "interesting" habits that i've read about on this site, which i'm told is nursing-home gospel, such as:
combining meds from different times into one pass ("you won't get done, otherwise")
borrowing meds ("everybody does it; you can get in trouble if you don't give the med")
no supervisor, except on dayshift ("there are hardly any emergencies on 3-11 or 11-7")
signing that a med was given, when it wasn't even available, and couldn't be borrowed ("you can't write 'not available'")
i know there's more to list, but based on my experience, i seriously long for the days when i was a cna. i wanted to be a nurse, but after this, i need to get away to another place where i have a better breaking-in period. i don't think i can last another day at this place, and i'm scared for my license, to be honest. i want to quit, but some of my friends think i should just tolerate the madness because i make more money. i can always work as a cna until something better comes along, but i am still struggling with what to do. any ideas, thoughts, or other horror stories would be appreciated. i apologize for the length.

i'm an lpn also, i tried ltc because the money is good but the facilities are a mess in the inner city and nearby suburbs. in ltc, it's all about billing it seems, and throwing pills at people really fast - not about health care. i don't want to be too negative because i know some really like it but it's not for me. i've tried but it didn't work out.

the facility where i worked had a large population of filipino nurses and the language issues are difficult not only for the patients but for the other staff as well. the culture there is very interesting, they've very honestly shared that they don't allow their elderly to go to places like that. i get the feeling that they don't really respect the patients that are there or the families of the patients. this was my only real experienc with a facility that was straight ltc. i've worked part-time at facilities that had sub-acute care and assisted living and the culture was definitely different.

i'm trying to find my way back to ambulatory care or school nursing with a part-time weekend job in supportive living or assisted living. i like to see a positive result through good care and education, that's a rarity in ltc.

so, hang for a minute or use your cna to hold you while you find your niche. the job market for lpns is really limited these days so it's tough. i'm still trying to find my spot too.