Hate My Job - LTC

HyzenthlayLPN · Sep 7, 2017

LTC can be hard: lots of residents, not enough time. How long have you been there? What are some of the things you have been asked to improve upon? How many residents are you caring for? Are you doing all the meds, treatments and documentation for them?

MJ48 · Sep 7, 2017

I have been there for approximately 5 months. The things she is asking me to improve are the risk management documentation and how I handle myself in emergency situations. More specifically regarding the documentation, that I am not documenting that I do certain things but I know that I do. The orientation that I received was only six shifts I believe. I did ask for more but only got a few extra orientation shifts. Plus we did not go/over what I should do in emergency situations. We had a false code red and I did not know really what to do. The RN from another floor came and helped me. As the RN on the first floor I'm suppose to run it. As an RN at this facility I'm in charge of an entire floor but I do have 2 RPNs that do the med pass thankfully and help with treatments. I think there are about 40-60 residents per floor or more not exactly sure. It just feels like I'm being picked on. Also another thing that I found out after the meeting my union rep knew about the meeting about a week or two before. Where as me I only found out the day before and I had to come on my day which made me think that I was going to be fired or something worse. Ever since the meeting I have had like this cloud of stress and anxiety. I haven't really been eating or sleeping well. I dont know how the other RNs stick it out for as long as they do. I'm trying to find another job but its hard when potential employers want prior experience.

debiklages, MSN, RN · Sep 14, 2017

I was in a similar position as I had my probationary period extended on an adult medical unit. I actually knew that I was a lot slower than other nurses. I stuck it out for a year, found another job and quit. In the meantime another new nurse started and there was someone new for the NUM to focus on.

Keep your chin up , nursing is a hard job and nursing school doesn't really prepare you for the complexity of the workplace, time management and inter professional relationships.

Orca, ADN, ASN, RN · Sep 20, 2017

LTC facilities in particular are notorious for underpaying, understaffing and undertraining. When something goes wrong, they want to nail the nursing staff (especially RNs), even though the facility may have failed to adequately prepare the staff for certain situations. The answer I always got is "It's in the policy manual." I was supposed to read and memorize the policy manual (which was huge and poorly written), and that was supposed to be my guide. Heaven forbid that anyone actually instruct me on anything.

CapeCodMermaid, RN · Sep 20, 2017

Maybe you really DO need to improve your documentation. You know the saying: If you didn't document it, you didn't do it. It doesn't matter how much you might have done if it's not in the clinical record. Y'all need to know to cover all the bases to keep yourself safe in the event of a law suit and these days people will sue for anything.

JBMmom, MSN, NP · Sep 21, 2017

You may have trouble finding a new position with your limited experience, I hope that you can find a way through to get more experience and build your skill set. Documentation is a key skill that you're going to need in any environment and many nurses struggle with it, ask for help from a nurse you work with if you can. There are many valuable skills to be gained in a long-term care facility. After caring for 20-40 patients in a shift, moving into acute care with 6-8 patients doesn't seem as daunting. Yes, the acuity is higher, but you've learned time management and that transfers anywhere. Focused assessments are key in long-term care, not everyone is having their vital signs recorded every shift, not everyone can communicate effectively, nurses have to learn to rely on their aides and also take action based on their observations if patients have a change in conditions. It's quite possible that your management is picking on you, or that you need to improve, or a little of both. Try to relax, everyone was new at some point, and there are lots of nurses out there that have been around a while, so it can be done. But if you're so anxious that you make it worse you're dooming yourself to failure. Before your shift, take a deep breath, put a smile on your face, tell yourself it's going to be a good shift, and you'll find that more and more often it will be. Good luck.

caffeinatednurse, BSN, RN · Oct 3, 2017

Find someone in your workplace that seems to be excelling at their job, and do two things: 1. Ask them for feedback, but be prepared for brute honesty. 2. Mimic their work ethic and habits. I got lucky and landed a great preceptor who told me to always CYA with my documentation. I didn't understand the true importance of doing so until I started training newer nurses who would leave out things that they may not have viewed as important, but actually were. When I could give them a reason to do so, they usually did fine. Like hey, I know it seems stupid to write down if so-and-so came in w/dentures or hearing aids, but if they really don't and they claim to have "lost" them after they're admitted, we have to pay for those. Or better yet: if you forget to document something, the DON is definitely going to be calling you on your day off.

Use your extended probation time to your benefit. Find your weaknesses and work on them. The rest will come. LTC is a hard place to start out, but after you've been there for a year, you can pretty much work anywhere.

MJ48 · Nov 21, 2017

Just wanted to post an update. Since my last post there has been some changes some for the better (in my opinion) and some not so much. I will start off with the positive. Since the my last post. The DOC has been fired and a new one has been hired. This new one was the ADOC. To me she is more approachable than the last one. Her attitude and personality great. Definitely more supportive. The new ADOC as well. She was RN who orientated my on a couple of shifts. So she know what it is like working as a nurse there. I believe my documentation has improved, haven't heard any complaints about that.

Now for the not so positive. There has been so many changes in staff people being fired an hired. Makes me worried that I might get fired or something. I have made a error in transcribing/processing two orders. Luckily it was caught before pharmacy sent us the medication. I incorrectly input the schedule and the ADOC brought it my attention. She did so in a polite, thoughtful manner. Unlucky the previous DOC, she would have probably schedule a meeting and probably have my union rep there. Even though I hate that I made the mistake and having someone else catch it and bringing it to the attention to the ADOC, I'm glad no one was hurt. Learning moment for me. Although in my defense I did ask another nurse how to process them and she said to process it the way it was written. I suppose I could have been more clearer. Last week we had an RN meeting. We were told that head office is wanting to make some staffing changes. They are wanting are planning getting rid of 2 full time day RN positions and moving one to evenings and one to nights. Leaving only 1 RN in the entire building during days. To me this doesn't make sense. So the RPNs in turn will have to take on a lot more, which is totally unfair. Since the heaviest shift is days with all the stuff you have to do. They didnt say how it is going to affect the part-timers like me. Im expecting a layoff notice soon. These changes will come in Feb 2018 right around the same time my extended probation will end. Likely I found another part-time job but still it means I might have to find another part/full-time job.

At the moment I feel great this job is not bad than at other times I'm like I hate this soul crushing/sucking place. Does anyone else feel like that?

MJ48 · Nov 21, 2017

Part two of my rant. Today, Nov 20. I was stressed out. There was so much to deal with. A resident had passed away during the night. The paper work was done and everything all that needed to be done was the on call doc had to come and pronounce which he did. But when it came to filling out the death certificate it was a bit a struggle but we managed. Secondly, the funeral home couldn't pick him up until 9 AM so he was there for a bit. Then dealing with resident's family members, orders & the other usual stuff. What stressed me out and sort of ticked me off. Was at the end of my shift. I had a resident who returned to the home from hospital. The on coming RN stated that I was suppose to do the head to toe assessment, readmission note, and confirm all orders and medications. In my head Im screaming are you kidding me? Instead of causing a scene I did everything expect confirm order/medications. When I went to start the orders/medication she stated that I was doing them wrong and that she previously told me when I did one before. First off I asked the DOC how to do it and she gave guided me. I even told the on coming RN this. Secondly this is my second readmission (with no prior training) and the last time I didnt have to do the orders/medication part. The only other time I had to confirm orders/medications was an admission (which I did not have any training). Had the medication orders been faxed before my shift ended I would have gladly done them. Apparently the ambulance/patient transfer was sitting in the parking for a bit, according to the RN, and didnt bring the resident in right away. I feel like this nurse (and one other one) hates me. Am I in the wrong to feel pissed off or was she right or is it 50/50?

Crystal-Wings, LVN · Jan 16, 2018

It sounds like it's time to start looking for another job. That environment sounds toxic to work in!

Sunshine.nurse · Jan 19, 2018

Lack of the correct details can make any nurse manager's head spin... lol Use to drive me absolutely crazy chasing down details of an risk management event. However, the devil is in the details.