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Specialties Geriatric

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Hi all,

Hoping for some insight, support, advice. I have now been working LTC for 9 weeks. I am a new grad, had two weeks of training, and been on the floor on my own since then, hired as a charge nurse. The job has been challenging, to say the least. I have 24 residents I am responsible for, plus the challenge of Cna's who have been there for 15 to 20 years, and seem to have something against me from the start. NOT all of them, just a few. I was pulled into the DON's office today and told that as of today, she would not reccomend me for hiring at the end of my probation period. The DON is new, started 3 weeks ago. I was told that my proffesionalism was not good, (I was giving report and did not know that DHS was there, and my supervisor told me afterwards that it was not okay to complain in front of them, I was giving the usual report, what was and mostly what wasnt done, ect., ect., my fault, but I did not know she was there!) I also missed dressing changes on one patient, the last time her dressing for her peritonial cath was changed was on 10/01, she is gone for dialysis on Tues and thurs from 6 to 1, my shift ends at 3, the docs come in at 1 to give orders, anyway, bad excuses, I did mess up, but I work only 4 days a week, what about the other 3 days? When I told my supervisor I was feeling overwhelmed, Which I was, they never let me do anything, then they throw it at me and say, "Why dont you know how to do this by now?" Anyway,those are really no excuses for my mistakes, but to call my professionalism to task when I am still learning? And to be written up? I have been crying all day. I called in sick yesterday, I had vomiting and diarrhea in the morning, called in at 5am, my scheduling director called me at 8am to ask if I could cover Thursday, my husband answered the phone and relayed the message as I was vomiting at the time. I dragged by butt to work today, despite a fever, chills and sweats, sore throat and a headache that made me want to vomit more. I really should not have been in there, I wore a face mask so as not to kill a resident with this bug. I had confided in my supervisor about my personal problems, she acts like a friend, only to have this thrown in my face during my meeting with her and the DON. I feel so betrayed, so very stupid.

WHY? What are the expectations of a new grad? I have had one med error, it was a transcription error on my part, I have done my best to maintain my professionalism during harrowing times, (residents sister sobbing heartbrokenly beside me, dementia patient hitting me cause I had 'her' shirt on, constant yelling, sundowning which I only get the very first part of, I know, ) God I feel like such a dummy. If you cant tell, I am feeling so stupid, probably because I really thought I was doing a good job. Maybe not a great fantastic job, but a competent, safe one, as I learned how to become a really great nurse, you know? I feel like a failure.

I was written up for concerns about my professional demeanor, my inability to focus, and time management issues. I do understand the focusing issue, she told me I let to many things 'distract me', like residents screaming out "HELP, HELP". It has taken me some time to know which ones are really needing help, but while I am learning, and I dont know the residents that well, how am I supposed to know which "HELP" is real or not? The time management issue is because of the dressing change I missed.

The Cna's dont report to me, and last week I heard them commenting on a resident who was playing 'possum', and I dont know why, but I thought to myself, "Jeez, he always yells at them when they are mad", and I went to check on him, long story short, his blood sugar was 56, he was going into a diabetic coma, and they would have left him in bed. I ended up doing IM glucagon, his physician came in, I assisted him in doing IM dextrose, and he came out of it. The doctor told me he would have died. I feel like I have good instincts, if I am just given the chance. Now I am evaluating every thing I do and say, I am afraid to talk to anyone, and I am so discouraged I feel like I made the biggest mistake of my life. I am so sorry to ramble on to everyone, I am just so hurt and discouraged, insulted and I feel so stuck. Sure, move on and find another job, and be a job hopper. To top it all off, my husband just lost his job.

Sorry everyone. Thanks for letting me vent. Friday I have to meet with the DON and my supervisor and give them my list of 'goals to hellp me succed in my job'. Half of me wants to walk out and say the heck with you. I have put my all into this, I am not half-***** with anything I do, and your expectations are ridiculous. The other half is to proud to let anything or anybody say I cannot do this job. In the meantime, I still have to pay the bills. and they wonder why there is a nursing shortage.

sorry about the typos.

Thanks for being here.

Specializes in Community Health, Med-Surg, Home Health.
THANK YOU ALL SO MUCH FOR YOUR SUPPORT

Every single person who replied gave me something to think about, and most of all,the emotional support I needed.

UPDATE........After my written goals to succeed was given to the DON and my nurse manager, I was told they were very impressed. I have also made an effort to live by my words. I cannot learn it all in such a short time, but I can and will maintain my calm in the midst of chaos. :chair: I am also covering the weekend Baylor shift for 5 weeks, (the Baylor nurse is on military duty), and I cannot believe the difference on the weekend shift. First of all I have a wonderful experienced nurse, (she is Filipino, reminds me so much of my mother-in-law), friendly, and soooo calm and capable.) It is such a different atmosphere, it is like working in a completely different place. My last two weeks of probation period are up next week, if I am not hired full-time, well, SoBeIT. I know in my heart that I have given it my all. I have discussed this with my DON, and she has said to me that she is very impressed with my "change of attitude". I did let her know that MY attitude has not changed, she simply saw me on a very bad day, when Iwas overwhelmed and close to crying. In other words, the calm capable one is the real me, but jeez, we all have bad days, huh? I also let her know how shocked I was at her attitude that she was ready to give up on me without even getting to know the real me, and/or my accomplishments. She acknowledged that she had probably seen me at my worst, and basically stated that she has changed her position on keeping me. Despite the initial instinct to cut and run, I think I am going to continue with my position. The CNA's present a challenge that is going to probably be there in any facility I work with, correct? So it is up to me as the charge nurse to find my balance, and not let them knock me off my stride. It remains to be seen if my choice to stay is the right one. I do feel so much more confident, and i have three more weeks of working the weekend shift and learning from my co-worker. After that, if I must go back to the weekday chaos, (this is still up in the air, if the nurse with the baylor position is called to active duty, the baylor position is mine), but if I must go back to weekday chaos, then I will do so with more confidence in myself. It also helps that every day I am learning skills that will stay with me a lifetime.

Again, thanks so much for your support, emotionally I would have felt so alone without all your input. I have been actively recruiting friends of mine from nursing school to take advantage of this wonderful tool.

Thank you Thank You ALL!:thankya:

KristyBRN

:balloons: :balloons: :balloons: :balloons: :balloons: :balloons: :balloons:

An epithany!! You realize your talents!! And, that witch as able to better appreciate you!! I suspect that they thought of their error and had to cover their rear ends! Hooray for you!!!

Specializes in Med-Surg, LTC, Rehabiliation Nursing.

Dear DDooDopDuo,

You are so right about not not airing my frustrations nor trusting anyone with personal information. It was a hard lesson, but well learned, and i will Never make that mistake again.At this point I will trust no-one with my opinions, just stick to medical facts. This lesson I will carry with me forever.;

Thanks again.

I think it is fairly common in long term care to give a brand new nurse about 1 week or less orientation and then leave them in charge of up to 40 residents. It can take several months to feel completely comfortable with your new position. Until then ask your co workers for help and advice when you need it. such as how to prioritise The CNAs will try to test a new nurse, let them know what behavior you will not tolerate. I would look for another job. Maybe some of your former classmates can recomend a place that will offer you more support. Good luck and it does get better as you gain more experience. Sometimes it is a good idea when you are new to not air too much frustrations at work as it is difficult to know right away who to trust with yor opinions.
Specializes in Med-Surg, LTC, Rehabiliation Nursing.

Just one last comment, to all who told me to leave and now, I suspect you may be right, but (perhaps it is my pride), I am going to do my best. And if I do leave because it is not getting better,Iwill be able towalk away with my head held high, and not to be a total sap, (cuz I am starting to sound like one), but the support I have found here will be a huge part of that. I think I may be able to succeed here, and in a years time I will be better able to make the choice of where I want to focus my career. My wise mother always told me that every person you meet has something you need to learn, every situation (especially the really tough ones) is presented to you in order to test you, and allow you to learn and do the best you can. You know, the old lemons, lemonade thing? So at the risk of sounding like a kiss ~!!,

Thanks again everybody!

KristyBRN

Never let them see you sweat! (never again, at least, LOL)

I'm sorry for what you're going through. I've only been out of school for a little over a year myself and couldn't imagine being able to go through your situation right now. I hope everything works out whether you decide to leave or not. Just remember that your worth and dignity can only be stood up for by you alone in this profession. Stand up for yourself and demand respect as a human being and a nurse. The fact that you are a new nurse doesn't mean that others can get away with humiliating you. I hope you feel better! Keep us posted!

Specializes in MICU, ER, SICU, Home Health, Corrections.

Hi Kristy,

Just reading the thread here and thought I'd chime in...

It caught my attention because several LTC's in my local area came shopping for Charge and Manager nurses in our school just before graduation.

I believe they actually gleaned a few of us too.

The thing is, and the thing everyone seems to be 'leaning towards' but not saying outright is this...

You aren't stupid.

You aren't doing anything wrong.

The problem is that you're simply not qualified to fill the position you've taken.

Please don't take offense to that statement, as I mean none.

The fault isn't yours, it is the facility's, or those that chose to hire you.

As a fellow new grad in an ICU, I know how you feel. There's a lot to learn.

However; you should really do some critical thinking about your situation.

Consider that currently you're a college grad with a nursing degree, and/or license, and that's pretty much it. You did not learn to be a nurse in school.

Possibly the best thing right now is to consider that you would be better off to become a nurse before you try to tackle being a nurse manager.

It isn't a 'hang in there' situation. It's more like a 'do yourself [and anyone relying on your care/leadership position] a favor' situation... so that you don't find yourself either on the receiving end of an attorney, or crying in the hallway as they wheel the body out. Sure, It wasn't your fault, but you're in charge and should have known. [re: sign here, P/P manual read. sign here, trained and checked off, sign here, you give us the right to....]

Justice is blind my dear, and your wonderful facility or buddies in the system will serve you up with duck sauce when the fire's hot.

I would hope your license means more to you than does jumping line to a charge position.

Finally, I have to say, if one of my parents were in a LTC and I heard this story, I would carry them out on my back if I had to, just to get them out of that place. And again, it isn't about your drive to succeed and hang in there, it's about qualifications, experience, and ability, so please don't take offense.

Please do think about that though.... what would *you* do if you heard a 9week old nurse was now in charge at your loved ones facility?

Just some food for thought.

Good luck in whatever you pursue.

rb

Hi,

Doesn't the dialysis center change the dressing at dialysis? that would make sense to me. What is your homes policy? can you find that in writing? Alot of times LTC facilities hurry to write up new grads when they need to look internally and see where the orientation is lacking. They need to work with new grads instead of against them! Maybe this home isn't a good fit for you. There is one that is and with your skills so far (good call on the diabetic) you shouldn't have a problem. Good Luck this to shall pass!!!

I agree that a new grad should not be expected to do all those things, especially w/o proper orientation. This is the fault of the facility that you chose to work for. I believe that they are extremely incompetant, not you. Do not feel as though your whole nursing career will be determined by their abuse of power. We all learn by our mistakes, and I would put my resume out there, & see just what is available. Keep looking up, never look down, I am sure that perserverance will be in your favor.:balloons:

Specializes in Emergency.

Quit kicking yourself!!! I'd get out NOW!!! You can get a job at any hospital you want! There is such a nursing shortage; any hospital would be so glad to have you!!! Plus, orientation is longer; and you would have your peers to help you is you have questions! Don't make yourself sick and above all, don't sell yourself short!!! From reading your letter, I'm sure you're a great nurse! You just need a different setting!;)

Hi all,

Hoping for some insight, support, advice. I have now been working LTC for 9 weeks. I am a new grad, had two weeks of training, and been on the floor on my own since then, hired as a charge nurse. The job has been challenging, to say the least. I have 24 residents I am responsible for, plus the challenge of Cna's who have been there for 15 to 20 years, and seem to have something against me from the start. NOT all of them, just a few. I was pulled into the DON's office today and told that as of today, she would not reccomend me for hiring at the end of my probation period. The DON is new, started 3 weeks ago. I was told that my proffesionalism was not good, (I was giving report and did not know that DHS was there, and my supervisor told me afterwards that it was not okay to complain in front of them, I was giving the usual report, what was and mostly what wasnt done, ect., ect., my fault, but I did not know she was there!) I also missed dressing changes on one patient, the last time her dressing for her peritonial cath was changed was on 10/01, she is gone for dialysis on Tues and thurs from 6 to 1, my shift ends at 3, the docs come in at 1 to give orders, anyway, bad excuses, I did mess up, but I work only 4 days a week, what about the other 3 days? When I told my supervisor I was feeling overwhelmed, Which I was, they never let me do anything, then they throw it at me and say, "Why dont you know how to do this by now?" Anyway,those are really no excuses for my mistakes, but to call my professionalism to task when I am still learning? And to be written up? I have been crying all day. I called in sick yesterday, I had vomiting and diarrhea in the morning, called in at 5am, my scheduling director called me at 8am to ask if I could cover Thursday, my husband answered the phone and relayed the message as I was vomiting at the time. I dragged by butt to work today, despite a fever, chills and sweats, sore throat and a headache that made me want to vomit more. I really should not have been in there, I wore a face mask so as not to kill a resident with this bug. I had confided in my supervisor about my personal problems, she acts like a friend, only to have this thrown in my face during my meeting with her and the DON. I feel so betrayed, so very stupid.

WHY? What are the expectations of a new grad? I have had one med error, it was a transcription error on my part, I have done my best to maintain my professionalism during harrowing times, (residents sister sobbing heartbrokenly beside me, dementia patient hitting me cause I had 'her' shirt on, constant yelling, sundowning which I only get the very first part of, I know, ) God I feel like such a dummy. If you cant tell, I am feeling so stupid, probably because I really thought I was doing a good job. Maybe not a great fantastic job, but a competent, safe one, as I learned how to become a really great nurse, you know? I feel like a failure.

I was written up for concerns about my professional demeanor, my inability to focus, and time management issues. I do understand the focusing issue, she told me I let to many things 'distract me', like residents screaming out "HELP, HELP". It has taken me some time to know which ones are really needing help, but while I am learning, and I dont know the residents that well, how am I supposed to know which "HELP" is real or not? The time management issue is because of the dressing change I missed.

The Cna's dont report to me, and last week I heard them commenting on a resident who was playing 'possum', and I dont know why, but I thought to myself, "Jeez, he always yells at them when they are mad", and I went to check on him, long story short, his blood sugar was 56, he was going into a diabetic coma, and they would have left him in bed. I ended up doing IM glucagon, his physician came in, I assisted him in doing IM dextrose, and he came out of it. The doctor told me he would have died. I feel like I have good instincts, if I am just given the chance. Now I am evaluating every thing I do and say, I am afraid to talk to anyone, and I am so discouraged I feel like I made the biggest mistake of my life. I am so sorry to ramble on to everyone, I am just so hurt and discouraged, insulted and I feel so stuck. Sure, move on and find another job, and be a job hopper. To top it all off, my husband just lost his job.

Sorry everyone. Thanks for letting me vent. Friday I have to meet with the DON and my supervisor and give them my list of 'goals to hellp me succed in my job'. Half of me wants to walk out and say the heck with you. I have put my all into this, I am not half-***** with anything I do, and your expectations are ridiculous. The other half is to proud to let anything or anybody say I cannot do this job. In the meantime, I still have to pay the bills. and they wonder why there is a nursing shortage.

sorry about the typos.

Thanks for being here.

though i say you at least got 2 weeks ( the gals where i work have gotten 3 days if that - even the new grads) your "excuses" ARE valid. you are learning - they shoudl NOT be expecting you to get it all in a feew weeks - unfortunatley thats how it is in many many LTC settings - i encourage all new grads i meet to try med surge first to help getting skills organization etc as it seems hospitals are better with preceptorship - maybe not all but many. even better get into a state run facility as i hear the mandated orientations ( my friend has worked in the facility she just went back to, is an experienced nurse of maybe 15 yrs or 20 , i dont recall, and she oriented for THREE MONTHS!!! mandatory - even though she knew a lot of it due to working there prior.

your feelings are not unusuall - many of us feel the same way and we have been here for a while. i know we argue with the bosses about the orietation of grads who havent even passed boards yet but we get nowhere. its all about the mighhty buck.

we all have and will cont to make mistakes so dont beat yourself silly over it - learn from it. the things you describe like yelling for help - that is what ANY normal person would do if they dont know - they would check ( and if able ask a cna but they are hard to find they have to work short too and end up not being seen to often to be able to "ask them cause they knw" ) further more - personally - i dont just "let them tell me" ( nothing against cnas) i check for myself until i hjave been showed they can be trusted to report to me and are good at what they do ( some just float through the job and i wouldnt trust em with asking even a name )

the dressing - oh for heavens sake - it was probably not changed in eons anyhow- we can only do so much. i go in and manytimes dressings havent been changed in days and the nurse will report she never even had time to look, sad and i try to get to it but facts is facts - if they dont give staff the staff to get er done - it aint gettin done. and they dont get it..........

move on - you dont need to be where you cant get taught what you need. you can be a great nurse with guidence- hell - we are all learning daily that medical things change so quickly. go to a med surge in a hospital and get some skills ( physical ones like tube feeds, ngs, ivs,caths, the like ) and learn to get organized - once you get that you will feel much better about yourself.

so far no new grad has made it past a few months by us - some of us do the best we can to help them but we have our own issues on or wings to deal with and often cant get there soon enough - however - many may disagree - if only in lip service - but i do not know ANY nurse that i know personally who does not have quite a few shortcuts that are taken ( of course that is where experience comes - you learn what can be cut around and not hurt anyone to get the extrqa few min you need to get the really important stuff done) to get through the day and get done what needs to be - we hate taking these shortcuts - even though they dont physically harm our residents but they sure are emotionally hurt - and that is not fair - we are supposed to adress all areas and cant.

good luck hon and my prayrs for you and your family.

Kristy,

I am very impressed by your posts, and how you took action to improve your situation.

No matter how it works out at that particular job, you are doing your best.

I wish you much success in your nursing career!

I am so sorry you are going through this. If you research this forum a little bit you will see that many new grads have had this problem. And the problem is not you, but the facility that you work at. There are many places that try to take advantage of new grads. You need to run from this place. Carefully read what all the posters have to say, don't burn bridges, just put in your 2 week notice. You will have no trouble finding another job. I recommend med/surg at a local hospital with a nice/appropriate orientation. Keep us posted, we care.

i agree with dont burn your bridges too - i have seen to many nurses do that and end up worse off- i am one of em - hard to find a job in such small area as ours when you are on the "black list" of leaves nno notice, stirs up trouble in regards to staffing etc etc lol - give them 2 weeks if they ask why tell them you wish to go to a hospital ( even if you arent - none of thier business) where you can gain clinical skillls better so that you can come back to LTC ( doesnt mean youd ever go back there but they might think hmmm maybe she will come back even more experienced) this will keep your foot in the door so to speak and perhaps even spften thier view of you. make it look like its thier idea - tell them i was thinking about what you said and i see i need to work on my skills and i have found a job which i can gain those skills with a good preceptor program.

I would resign and look for another job.

One thing, you said you had confided in your supervisor about your personal problems and she threw it in your face in your meeting with the DON. I don't know what type of problems you are referring to, but in the future I would keep any personal problems to myself, what you described happens all too often. These people are coworkers, they are not your friends or family and they don't care about you. Keep your personal life to yourself.

Good luck.

yes if you can help it do not get into the pesonal life story with the bigwigs. they dont give a care - i made that mistake and foudn they use that against you whenever they can to control you. personally i dont even consider these folks coworkers- a coworker helps out and assissts - gives feedbackand such - at least at my place they do none of that - i have been tere 18 mo and yet to have even one eval........... i am sure there are some good ones - i have worked with one of the best D

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