Quote from missdeevah
i just graduated as an lvn a little over a month ago and haven't started working . i have been offered a position at a nursing home but have since learned the following: i will be working in the "heavy load" hall, i.e the medicare ward. there is a med-aide, but no admission nurse. i am told that the shift i will be working is when the most admits take place. they gave me an example of the current condition: there are 8 wounds, i would be doing the breathing tx, skin tx, 3 g-tubes (currently). i'd have to assess all the patient's skin nightly and chart on all of them nightly as well. however they said it would be a good learning opportunity (hmm...) for me as i go through excelsior for my rn as i will be trained on iv's and something else (can't remember). i was told these will be patients who have just come in from the hospitals. also the families can be very demanding (aren't they all), but that families are very involved at this facility.
i'm due for orientation on monday and i am just so unsure as to whether to take this or not. there's a certain thrill that comes with the idea of a challenge, but at the same time, being a new grad, i don't want to chew off more than i can bite. any advise? is this what is normal for an ltc? they did say that they will try to get one of their more experienced nurses to take the floor, but they doubt that she would .
how many patients? sounds normal. the typical medicare unit in my state has about 30. i've got 60. how may cnas. they will make you or break you with the families. say, if there are 15 patients, you, a cma, and one aid, and you get 3 admissions and 2 discharges on your shift, it is not possible. those new patients families will have them discharging an hour after they arrive. new families want 100% attention from someone at all times, plus admission assessments, ordering meds, clarifying orders. they will want you to get bed rails or a tv at that moment, but then they at the same time will want a new order for pain medication for someone who is so recently out of surgery that they just took them off of that morphine drip for a triple bypass but didn't even send with an order for tylenol. they will come to you for toilet paper and malfunctioning heater vents. no matter what you do it will not be good enough. waiting 5 minutes for a call light or a fresh towel or a second roll of toilet paper will translate to a week, and as they tell you that you run this facility so poorly and they have just waited a week for a second roll of toilet paper that they asked for five minutes ago, their family will say i think she's in pain and she needs her oxygen right now, when she has come with no orders for oxygen and her spo2 is 99% with a pulse of 62 and yours is 92% with a pulse of 178 from running around trying to get this stuff these people want that you do not have access to because it sounds like you are on second shift. meanwhile your second admission comes in and the family is there to pick up one of your discharges in which no one has done any paperwork on, but social services told them everything would be ready to go when they got there. so they want you to fill out a complaint form right then and there, but no one has even written discharge orders. and it is all your fault because the nurse is the middle man and gets the blame for everyone. good luck getting an ltc doctor to call you back. god forbid there is an emergency or fall with someone. then when someone is bleeding on the floor with 15 people standing around and no one will do anything without the nurse. then they will be screaming your name to hurry up while you are administering someone's tube feeding or doing cpr and then report to the don that you wouldn't come get this person off of the floor for 2 minutes, and as you are running down the hall to get this person off of the floor a resident will yell after you "will you push me to my room?, i have to go to the bathroom." you yell back i'm sorry i can't i have an emergency, i will tell your aid." they mumble ya right and then report you to state for refusing to take them to the bathroom. your superiors will not back you up, because they were there all along and would not answer your pages for help, but their butts are covered because they had that many people in the building who were supposedly providing direct care. typically in the midst of all of this, they will come yell at you because one of your people has not been moved in their chair for 2 hours and they want you to locate the cna and have you assist in moving them. or "why has this person not had pain meds?" ok sorry, but this is how it is. i had a housekeeping person try to give me their mop today and tell me to go find the other housekeeper they had borrowed it from. this was in the midst of a situation like the above. i paged the other housekeeper who gave this guy a dirty look when she came and he said "it's not my fault. i tried to delegate the responsibility but this girl wouldn't do it. :trout:
the nurses are the lowest of the low despite the fact that we are the one's taking care of everything and cooridinating all of the departments. all each department sees is themselves.