I just started at a LTC facility and like the previous one I worked at, it's very short staffed. The big concern I have is that I attempt to jot down things as I'm passing meds to address when I'm done, but due to all he!! breaking lose everyday, I don't seem to get those jotted down things done. Well last night on second shift I did go listen to some lungs and did some pulse ox's (had to borrow pulse ox from another unit, because heaven for bid if my unit had one of it's own). I found out one of the patients had an O2 of 90 at room air, one had mild crackles on expiration. I called and got new orders and ended up leaving way to late. There were more things I wanted to get done, but knew I had to work again to day and wanted to leave work somewhat on time. My question is, why is it that I work late everyday, whether it be first or second shift and yet when I walk in on second shift the nurse is reading a magazine and out the door by the time her shift even ends. What am I doing wrong? Or what are they doing? I'm a fairly new LPN, but I do put my heart and soul into trying to do everything I can to assist in the care of my residents (trying to do a mini assessment) while trying to pass meds, and all the other stuff. Charting is the last thing I do and I chart on everything that is out of the norm. I feel bad because I don't get everything done I would like to, but I also feel there are two other shifts, so why don't they pick up on some of this stuff? I had one nurse tell me last night that she will not do any CNA work. I do, because like I said otherwise I don't get to see their butts, periarea or do my mini assessment. No I don't have time to do CNA work, but because they are always short, I help, and it also helps me (assessments). Sorry this is long, but I'm just already getting tired of the short staffing and heavy workload, but I feel for my residents who are mostly helpless and need me to advocate for them in some way. I do find that I'm constantly saying I'll be right back, Give me five minutes, etc. Bless the residents hearts, because I do feel so sorry for them and try to give them all I have to give during my shift, but I am only one person. My big fear is that I'm going to get into trouble for missing something, yet I assessed and found 5 other things that day. I'm stretched to the max, and by the end of my shift I'm physically and emotionally drained. Any positive input would be greatly appreciated. I don't want to quit because I bond very easily with my residents. Some already know me by name and their little faces light up when they see me, I don't want to leave them, but fight for more help and better quality of care.
I was in long term care as a new LPN and lasted for 15 years before it was time to decide if it was gonna be me or them- alas they won, and I left for a new position where my nursing skills are sort of lost but it pays the bills for now. LTC is a crunch situation, you are either in trouble because of overtime or because you didnt get everything done. I got tired of working 12 hour shifts when I was only to be there for 8. The GNA staff were overworked and burn out was horrible there. Patient care went from something you were proud of to something that you didnt have time to do. I hear " oh its the same everyplace" but surely somewhere out there is a facility where smiles arent forced due to fear of losing your job, and the residents get the care they deserve. Hang in there, your residents are the most important thing - paperwork should go to office nurses that dont do hands on work any more.
I recently started a new job in a nursing home 3 months ago. I have had 25 years in Long term care so I know what to expect. I should have left this place while in orientation like I was told many of the new hires walk out and never return by some of the staff. ( Should have been in huge sign.) But instead I decided I would give it all I had and not make judgment. I have given it my best and can hardly think of going back there ever again. It is a very disorganized place to say the least and care is minimum to say the least.. I have brought things up to the unit manager several times and feel she herself is so overwhelmed and almost a new grad herself and just does not know how to make it better. As the new employee I feel like I might be labled the complainer. We all have basic things that we know should not be happening such as foley catheter bags not laying on the floor. Using foley catheter cover up bags when resident in in w/c. Its not appealing to see a resident in the dinning room with a full foley bag hanging for all to see .Really stimulates the appetite. Dirty linen is thrown on floor instead of using plastic bags to be put in. Hallways always have urine smell. They use cloth linen hampers in hallway that hold smelly dirty linen. Dirty incontinence barrel sits in hallways and when opened smells like the can has never been cleaned.. I work the PM shift and breakfast trays are still sitting around when I come on my shift. The hallways are cluttered with wheel chairs, lifts , walkers, tray tables, linen carts, ect. Most days between 13-14 items in each hallway. I can't even push my med cart down the hallway without blocking the hallway for residents to get through. I have a med cart that when I push the button to lock it will not always lock . I have written fix it notes and talked to unit manger several times. Still not fixed. The med cart is very old and so full of meds, the wheels don't turn right and makes it difficult causing my back to hurt all the time. The med room is always full of garbage bags ( Old med cards that they keep for the month and have someone pick up to burn) why I don't have a clue. They sort and save ensure cans or anything that come in a bottle like a recycling place but just leave in bags on the med room floor There is never an empty spot on the med room cupboard. Its full of junk that is never thrown away.
The floor in dayroom always has food and spilled things from lunch on it and housekeeping rarely cleans it. We have no treatment cart and every supply that you need has to be gotten out of this locked cupboard that you have to punch your number into to get even a insulin syringe or a chux pad, meaning your always running back to supply room for anything you need. This is so they can bill every item out. The nurses station is full of wipes, incontinence products, clothing, cups glasses and trays. They have little coolers called lab specimen coolers that have urine samples, hemmocults , and blood draws in . They are then left on the floor in front of nurses station for pick up by our local cab company to transport to the lab. I have Stated several times that residents' could get into theses coolers and be exposed to body fluids. It does not seem to matter to them. It just yucky having coolers with specs sitting out in front of nurses station. This company uses four different pool agency's for staffing and most days are still understaffed. I spend so much time looking for meds on my shift that are not in the med cart but are being signed out by previous workers. I end up having to order from pharmacy. Simple things such as a black pens for CAN's to do charting can not be found. They won't provide them.
I have a resident that gives his own insulin per insulin pen with nurses supervision .They allow him to put his own needle on and take off. When I started he would say to me when holding his insulin pen with the dirty needle on " should I play darts with you? How would you like me to hit you in the eye?. I went to my unit manger and told her this resident was not competent to do his own injections when he makes these comments and I did not feel safe and at risk. Her comment was " He would never hurt you " He is just joking". He just playing with you." He is still allowed to do own injections.
I think I am going to call and quit tomorrow without notice to save my sanity. How do I answer the question when looking for new work. Why did you leave your last place after only a short time?
I recently started a new job in a nursing home 3 months ago. I have had 25 years in Long term care so I know what to expect. I should have left this place while in orientation like I was told many of the new hires walk out and never return by some of the staff. ( Should have been in huge sign.) But instead I decided I would give it all I had and not make judgment. I have given it my best and can hardly think of going back there ever again. It is a very disorganized place to say the least and care is minimum to say the least.. I have brought things up to the unit manager several times and feel she herself is so overwhelmed and almost a new grad herself and just does not know how to make it better. As the new employee I feel like I might be labled the complainer. We all have basic things that we know should not be happening such as foley catheter bags not laying on the floor. Using foley catheter cover up bags when resident in in w/c. Its not appealing to see a resident in the dinning room with a full foley bag hanging for all to see .Really stimulates the appetite. Dirty linen is thrown on floor instead of using plastic bags to be put in. Hallways always have urine smell. They use cloth linen hampers in hallway that hold smelly dirty linen. Dirty incontinence barrel sits in hallways and when opened smells like the can has never been cleaned.. I work the PM shift and breakfast trays are still sitting around when I come on my shift. The hallways are cluttered with wheel chairs, lifts , walkers, tray tables, linen carts, ect. Most days between 13-14 items in each hallway. I can't even push my med cart down the hallway without blocking the hallway for residents to get through. I have a med cart that when I push the button to lock it will not always lock . I have written fix it notes and talked to unit manger several times. Still not fixed. The med cart is very old and so full of meds, the wheels don't turn right and makes it difficult causing my back to hurt all the time. The med room is always full of garbage bags ( Old med cards that they keep for the month and have someone pick up to burn) why I don't have a clue. They sort and save ensure cans or anything that come in a bottle like a recycling place but just leave in bags on the med room floor There is never an empty spot on the med room cupboard. Its full of junk that is never thrown away.
The floor in dayroom always has food and spilled things from lunch on it and housekeeping rarely cleans it. We have no treatment cart and every supply that you need has to be gotten out of this locked cupboard that you have to punch your number into to get even a insulin syringe or a chux pad, meaning your always running back to supply room for anything you need. This is so they can bill every item out. The nurses station is full of wipes, incontinence products, clothing, cups glasses and trays. They have little coolers called lab specimen coolers that have urine samples, hemmocults , and blood draws in . They are then left on the floor in front of nurses station for pick up by our local cab company to transport to the lab. I have Stated several times that residents' could get into theses coolers and be exposed to body fluids. It does not seem to matter to them. It just yucky having coolers with specs sitting out in front of nurses station. This company uses four different pool agency's for staffing and most days are still understaffed. I spend so much time looking for meds on my shift that are not in the med cart but are being signed out by previous workers. I end up having to order from pharmacy. Simple things such as a black pens for CAN's to do charting can not be found. They won't provide them.
I have a resident that gives his own insulin per insulin pen with nurses supervision .They allow him to put his own needle on and take off. When I started he would say to me when holding his insulin pen with the dirty needle on " should I play darts with you? How would you like me to hit you in the eye?. I went to my unit manger and told her this resident was not competent to do his own injections when he makes these comments and I did not feel safe and at risk. Her comment was " He would never hurt you " He is just joking". He just playing with you." He is still allowed to do own injections.
I think I am going to call and quit tomorrow without notice to save my sanity. How do I answer the question when looking for new work. Why did you leave your last place after only a short time?
I turned in a 2 page list of things that I've witnessed that are not being done on a daily basis on the unit I work on yesterday. I gave one to the Adminstrator and one to the ADON. Some of the items were, no showers being given, no water being passed (UTI's out of control on this unit), dirty linin on beds, no oral care being given, residents not being changed to the point of the diaper leaking onto their clothes, hoyer transfers with one aide, and the list went on. But as I told the people I gave the list to, there are 30 residents on my units, 2 CNA's, 11 hoyers, atleast 12-13 two assist transfers with total care, 3 tubefeeders, 8 diabetics, 3 cathed residents, and 5 of the residents that are hoyer lifts are over 400 lbs and are very demanding and obviously heavy to work with. So how in the heck can 3 people do it all in an 8 hours shift? This is the 6:30-1500 shift and the medpass alone is an 8 hour job. I never get out on time because I'm not only doing my job, but trying to help the CNA's. My theory has become if they get a one time a day med, they'll get before the end of my shift. Sad, but I feel nourishment, being dry, being hydrated, just in general being taken care of is more important than a lot of the non beneficial meds these residents are on. I give them their meds, but like I said, my priorities are the residents as a whole, not just being a pill pusher to wet, dirty, hungry residents. I won't quit right away, I'll raise a stink before I bail on the residents. I do know that when I come home after working 3 days, I'm mentally, physically and emotionally drained. I give my all everyday, which is far from enough, but I figure maybe I'm making just a small difference in these peoples lives. All I know is that if society (cooperate America)continue to take care of our geriatric poplulation the way we do, I hope I go fast in my sleep before my children have to faced with the choice of putting me in LTC. I know not all LTC facilities are bad, but most are understaffed due to money or lack there of, but hopefully all the good nurses don't give up easy and atleast leave knowing they tried to make a change and that is all that we can do. God bless the geriatric population.
dcnballmom, ASN, RN
50 Posts
I was in long term care as a new LPN and lasted for 15 years before it was time to decide if it was gonna be me or them- alas they won, and I left for a new position where my nursing skills are sort of lost but it pays the bills for now. LTC is a crunch situation, you are either in trouble because of overtime or because you didnt get everything done. I got tired of working 12 hour shifts when I was only to be there for 8. The GNA staff were overworked and burn out was horrible there. Patient care went from something you were proud of to something that you didnt have time to do. I hear " oh its the same everyplace" but surely somewhere out there is a facility where smiles arent forced due to fear of losing your job, and the residents get the care they deserve. Hang in there, your residents are the most important thing - paperwork should go to office nurses that dont do hands on work any more.