Hi, I am a new LPN (less than 2months) working in LTC ~ and hating every second of it
Every day I feel incompetent & frustrated. Unfortunately, I work in a facility where many nurses *do not* do the right thing (ie: pulling meds & getting them ready before a med pass, putting meds on residents bedside tables & walking out, starting med pass early ~ more than 1hr before scheduled time ~ in order to finish on time.)
My med pass is slow, d/t being new & following the rules. Other nurses tell me "cutting corners" is part of being a nurse in LTC & I just have to learn to make my own system. Ugh.
Last night a Res. didn't want to take all of her regularly scheduled meds at once. I said, "Ok, I'll bring the rest back later." Then she got upset & argued w/me saying that everyother nurse lets her keep her meds in her room & take at her convenience ~ she started yelling at me, calling me crazy & accusing me of trying to OD & kill her! This woman has some dementia, but not a lot. This scene went on for 20min. I finally let her keep the meds she was clutching in her hands but took the rest from the room & marked it as a Refuse. I know I should have tried again later, but she was sooo aggitated & she had the important pills (BP & psych) the ones she didn't take were vitamins & stool softener.
Unfortunately, many nurses *do* leave her meds in her room for her~ so she isn't totally unjustified in being upset w/me.
I have noticed that at my facility, nurses who do their job effeciently (even though they take illegal shortcuts) are thought of as good nurses. Nurses who go by the book or take their time are not respected by other nurses or aides. Experienced nurses tell me it is better to be slow & thorough ~ yet in the next breath they will complain about Nurse "X" who takes 3hrs to do a med pass. Honestly, is it like that everywhere?
Stuff like that is just one example of why I am already so stressed out. Does anyone have advice for the first year of LTC? How long did it take you to feel comfortable?
i would assume it's a bad thing to be OFF work, and find yourself unable to sleep because you aren't sure how your going to make it back into work on wednesday....
Im a new LVn as well. I graduated last year and working in a 167bed SNF here in Bay Area for over 8months now. My first 2months was a nightmare. But I get accustomed to almost every aspect on my 3rd month. I still do get cited from time to time but that is how it goes and everyday is a learning experience for me. I work in almost every station (we have 5) and have worked on all 3shifts during my first 3months. I was hired as a reliever so it was difficult at first, but now I know almost every resident's likes, dislikes and able to meet their needs. Just focus and take time to write down notes. Goodluck!
I've been working in a LTC facility for over 6 months now. I work days. I started in skilled nursing and it was absolute hell. Too many errors to be made. After 4 months I transferred to a different unit and now have 40 residents, mostly alzheimers and patients with dementia. All but about 2 or 3 are incontinent of b/b.
I do take some short-cuts but since I work the same unit 5 days a week I use my assessments on these patients I know as a guide. I have the vital signs cart with me and do vitals on probably 12 or more patients each med pass, more or less as needed. I haven't had a 10 minute break in the 6 months I've worked, but that is almost a choice. However, I stay completely busy and can't see how walking outside and standing around for 10 minutes would be any more relaxing then adding that time to my med pass and being able to talk to a resident or two, in a more calm and relaxed manner. Of course, I do not smoke.
I have two meals to assist with and I have to admit that I feel a little discouraged by the work I do in the dining room during meals. This, to me, isn't nursing. Still, I show up early and bust my hump every day, passing and setting up trays for about 30 residents who eat in my dining room, many of whom need fed.
My med pass takes a full 3 hours, for 40 patients. I find it incredible that I can do it in that amount of time, but I do. There is no other choice. Then I do CBG's and give B12 injections, chart prn's, whatever.
After my own lunch break, I work lunch with the residents, then back to my afternoon pass, when only takes about an hour. I usually have an hour or so left to do MDS charting on up to 10 residents.
I suppose my day goes fast but I am usually exhausted by the end of the day, leaving little energy for myself after work.
I plan on sticking this job out for a year, then quitting and finding something better before i lose my skills. We're saving every dime we can now.
WE are expecting survey any day now and we're on our toes, with tons of meetings of course. It's funny how yesterday, in a meeting, the infection control nurse said that documenting CNA's toileting patients q 2 hours is falsifying documents if it isn't being done. While that's true - do the math. 2 aids per 20 people on dayshift. Get them up, dress them, help with meals, showers, shave, toileting........it can't be done unless the aids are working non-stop and few work like that. (Can you blame them really? It's fairly thankless work).
Management is clueless, in my opinion. It's one thing to put on a careplan that a patient is getting or needs toileting q 2 hours, but then they understaff the facility, making it impossible to do with a full staff, and downright not happening with a call-in.
Specializes in Long-term Care; Geriatrics; Pediatrics.
I did LTC @ a few different facilities for a few months... It took a toll on me... I realized then that LTC was not for me. Thats why I started doing in home nursing...
When I was working in the facility (when I finally caught on) I started my med pass early and finished late... and each day I was there I had a ton of paperwork (because my halls had 5 hospice pts, 10 Blood sugars, 13 tube feeders, at least 1 admit, and 1 ER discharges per day). Even though I did transition to in home nursing, I had started to get the hang of LTC nursing. And yes... I did have 2 take shortcuts!!
My motto was... If u wouldn't do it 2 sum1 u love... Then don't do it 2 your pts.
I feel you, as a new LPN I just started my first nursing job at a LTC center, I feel like a failure for wanting to do the right thing and be the nurse that I know that i am, I don't feel comfortable taking the shortcuts, but with the load and timeframe what other options do I have
I worked as an LPN in mostly LTC for over 30 years. Was it stressful? You betcha! Did I love it? Yep! Newver a dull moment. Oh I had nights I was ready to walk out, but who hasn,t? I took a few shortcuts, but none that would ever harm the patient or any other resident. One thing to always remember. CYA!! Document! Document! Document!! Also, always have a small notebook on your med cart and write everything down you need to chart later. I would take small dressings, ung, etc on my cart to catch some tx. early before they went to sleep. You will be surprised how doing little things like that will help you. Just watch for when State is in and change your routine. Hard, I know. It gets easier. Most of it is planning ahead and never take a lull or extra time for granted. You never know when all hell will break loose.
Oh wow...if I didn't already work in LTC I'd be scared to death. lol It took me approx. 6 months to stop crying at work and to feel a little more confident in myself. The reality of the situation is that no matter how much schooling you have and no matter how much you think you know...you don' know enough until you experince it and you need to quit the moment you think you know it all. Hang in there. I truly cried every night at work for a long time and felt likeI was in way over my head and it passed. I always take my job seriously and do not take any "short-cuts" that would be harmful to the "R". Yes...I to have had to start my med pass before my window opened and have completed it after it closed but did the person who was only getting MOM get theirs last. You bet. I always try to think ahead, be very organized, and multitask. You will catch on. If you have the desire to be a LTC nurse it will be just as rewarding as any other nursing. I loved my job and only left the floor because of $ and I know that one day I will be a staff nurse again. Keep your faith and know that alot of people have been where you are and it all works out. Best of luck to you. Stay Strong.
I would like to ask you LTC nurses a question. I last worked in LTC about 12 years
ago.At that time we had a Charge nurse and a Medication nurse for a 50-60 bed unit.
The charge would do treatments ,assesments,orders,send pts out etc..The charge also acted as the house supevisor for the rest of the facility.I just wondered if things are still done that way.
New nurses are generally slow to start.As you get to know your residents and their meds
you pick up some speed.I would cut corners if there was no negative effect on the resident.
I NEVER left pills at a bedside. You have to protect your patients and your license.
The first year of nursing is hard....you are going to be filled with self doubt at times,
frustration,fear and a lot of other emotions.Just remember what you were taught in
school. It will get easier as time goes on.
As far as the backbiting....goes on everywhere....try to let it roll off your back.
Too bad the ones doing the backbiting have forgotten what it was like to be a new grad.
I would like to ask you LTC nurses a question. I last worked in LTC about 12 years
ago.At that time we had a Charge nurse and a Medication nurse for a 50-60 bed unit.
The charge would do treatments ,assesments,orders,send pts out etc..The charge also acted as the house supevisor for the rest of the facility.I just wondered if things are still done that way.
New nurses are generally slow to start.As you get to know your residents and their meds
you pick up some speed.I would cut corners if there was no negative effect on the resident.
I NEVER left pills at a bedside. You have to protect your patients and your license.
The first year of nursing is hard....you are going to be filled with self doubt at times,
frustration,fear and a lot of other emotions.Just remember what you were taught in
school. It will get easier as time goes on.
As far as the backbiting....goes on everywhere....try to let it roll off your back.
Too bad the ones doing the backbiting have forgotten what it was like to be a new grad.
It will get better!
The facility I work at has the same protocol for LTC; charge nurse for treatments, etc., and a medication nurse for meds.
I have 43 patients now, with a few empty beds. I pass meds on days. I start my med pass as close to 715 as I can; but I obviously have to have the night nurse with me on that as breakfast is going on.
I am supposed to be finished by 10. I am responsible for all vital signs and 80 percent of my patients are required to have them. Plus I have 2 peg tubes for meds, and tons of pills, inhalers, eye drops, liquids, and narcs to deal with.
Nobody takes less than 5 pills for the morning pass and I also give nutritional supplements.
I work nonstop without a break to try to finish by ten but it rarely happens. Patients are sometimes in PT, often in activity or being showered - there are usually a few that make me late.
But I don't sweat it.
I didn't create this monster, I just work for one.
Well as a new{yes really new}LPN I was out yesterday filling out applications at LTC's,I am really scared to work with the high number of clients in a short time with med pass,I just think this is awful and no wonder there are med errors,I want to work with Children but we only have 1 LTC that is for Children,{worked years with Disabled children}Today I am going to HH to see if they are willing to take some of that experience to give me a chance even though they want 1 year{not sure how to get that}but the stories of LTC is really scarring me:uhoh3:
alabastershadow
25 Posts
i would assume it's a bad thing to be OFF work, and find yourself unable to sleep because you aren't sure how your going to make it back into work on wednesday....
maybe i'm not cut out to be a nurse?