How long did it take you to feel comfortable in LTC?

MrsMissyLPN · Nov 19, 2008

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:

Hey don't be scared mume2mykidz. With any job you will always have the negative but there is always the positives. It is very rewarding in many ways and there are good days that go along with the bad ones. Its more good than bad.

Best of luck to you. It's all good. :)

alabastershadow · Nov 19, 2008

Its starting to get easier. Med pass takes me more like 2 and a half hours without short cuts.. and under 2 with. I dont do things half assed, but I will pop joe smith's meds out with John tuckers when they are in the same room and give the first to the first and the second to the second. saves steps. yes I realize this is cardinal sin #1. but as long as state isnt in the building... I dont see the harm. I know what person gets what.

And charting is getting easier too. If nothing happens you chart (working nights) vitals, what they are doing.. (resting in bed with eyes closed)...then if something IS wrong you put that here. (Combative with staff during pericare.) it's all simple in the charting business really.

What causes the most issues now:

distractions. distractions. distractions.

Always remember (and this is to me as much as anyone else):

You have a 2 hour window that does not include, transferring, emergencies, and the like. If state can't see that transferring two residents in the span of a med pass causes you to seep into three hours... well who cares. Your facility gets a red flag.

I've learned a lot since starting LTC. Some of it good, some of it bad.

But it's never dull, as I feared it would be during school. I have every hope of going back to school in the spring semester, finishing up the few basics i have for RN school, and then proceeding on as soon as possible.

Not because i'm not happy with what I am, but because I aspire for more. I want to work with children, I want to do Emergency care. And who knows after I continue on, I may find myself back in Geri Care. And that would be cool too.

sistasoul · Nov 27, 2008

This is my fourth week out of orientation at a LTC facility. I find it impossible to get the med pass done in 2 hrs. I run all night long, never take a break and have taken an actual lunch once since I have been on my own. I have overtime every night. It is crazy. I do not understand how the other nurses have time for breaks and chit chat and are out the door at the expected time. It seems like I have barely enough time to get the medication down the residents mouth and then I have to leave. I did not become a nurse to be a glorified pill pusher. How can I get to know my residents when I barely have time to give them their meds? I have a G-Tube that is often so clogged that I need to spend 30-45 minutes unclogging it and one woman has treatments that take me at least 20 minutes to do on a good day.

I feel like these people are not being treated the right way. As a nurse I don't have time to do the smallest thing for my residents and the LNA's are so busy that the residents have to wait a good while just to go to the bathroom. I feel horrible when a 90 year old lady tells me she needs the bedpan and because I don't have enough time to do my med pass and treatments I have to tell her to put her light on and someone will be along to help her. To me this is not how a nurse should behave but the LTc system leaves little choice in the matter.

eldragon · Nov 27, 2008

I wish I could offer you encouraging words but I am finishing up my 9th month in a LTC facility and it seems like it's getting harder as opposed to easier!

We have a new director who clearly doesn't know what she's doing and the facility is going through tons of changes, none of which seem to benefit the patient or the nursing staff. I have 44 patients now on dayshift and am expected to get all vital signs and pass meds to all the patents in 2.5 hours eac morning. It's impossible.

And everyday the orders on some patients are changing, creating havoc. Every single day I want to quit.

I am just sticking it out to one year - then I'm out of there!

Rexie68 · Nov 27, 2008

i have a g-tube that is often so clogged that i need to spend 30-45 minutes unclogging it and one woman has treatments that take me at least 20 minutes to do on a good day.

one small thing that might help with the gtube....we have plastic gtube uncloggers....they look kind of like a knitting needed but are specifically made for gtube...and they work wonders. good luck!

wejuststandhere · Dec 4, 2008

Wow, as a new lvn grad, this thread's been very enlightening to me. I'd like to thank the OP for this. That's a lot of scary stuff about LTCs alright. Funny, though, that I don't feel scared at all despite of these stories. It's really concerning to me but it doesn't feel like I'll need to back out of this one. I dunno why... maybe because of the idea that being a new lvn grad an all, I'll be forced to deal with LTCs since I have higher chance with them like it or not ...orr maybe I'll love the challenge... or maybe it just reminds me of my ol' job. But whatever...wish me luck on them, and hope that I get to find a job soon.

softstorms · Dec 31, 2008

As nurses, the one thing we do is to make sure our pts. are taken care of. Like our children, we often take care of them in a way that is best for us and them. Like the old Fable....."in a perfect world"......we could pass all 9am meds at 9 am. But to see 24 pts. get 9 am meds at 9 am? In long term care, after getting to know all the pts? Maybe!!! In acute care (as most long term care facilities go by now) not possible. I have done State Survey many times, and each year it is easier and easier. They only want to know that we know what we are doing and never do harm.

JoAnnS · Jan 1, 2009

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?

OMG me too> I am a new LPN too and all the stuff you are saying is the same darn thing I hear... Its all a bunch of bull! There aren't enough hours in your shift to do it by the book. NO WAY!!!! Impossible and I will be on my own on Monday. I'm scared to death!!! But I will do my very best. I am not sure about cutting all the corners, but some corners need to be cut in order to get to all the residents. This whole thing just freaks me out and I am the most honest person around. So this job is hard to follow.

GOOD LUCK TO YOU. Never give up, just go to a Doctor's office or something else like that

makes needs known · Jan 5, 2009

I work 3-11pm and there's the 4p med pass and the 5p meds and 5H bs's and the 6p meds and the hs meds and the 8p meds and the 9p meds and the 10 p meds and some people what their pain pill an 9p and their sleeping pill at 915p, and so on and so on. Some nights it just one long med pass and you get them when you get them.

rnlately · Jan 5, 2009

I work 3-11pm and there's the 4p med pass and the 5p meds and 5H bs's and the 6p meds and the hs meds and the 8p meds and the 9p meds and the 10 p meds and some people what their pain pill an 9p and their sleeping pill at 915p, and so on and so on. Some nights it just one long med pass and you get them when you get them.

Yeah tell me about those OTBS. I work per diem as a floater meaning I have no set floor. Last night was my first night on a different hall in over a year. I promise you that out of approx. 25 res. every other one was a 9pm BS and everyone of them also got a dose of Lantus. Not to mention having to familiarize myself with which resident wants their crushed meds in applesauce vs. pudding, the nebs tx, gravity g-tube feedings, wound care, shower assessments, in addition to the po med pass. Sometimes it seems like the work will never get done so the best thing to do is not agonize about how much you have to do but just work on doing what needs to be done. After all, the show must go on.

makes needs known · Jan 7, 2009

I know I do many things that in school, we were told, not to do. The only way to get it all done is to cut where you can.