I just need to vent to people who understand

Specialties Geriatric

Published

hi everyone!

so i graduated with my rn in may, and began working at an ltc/sub acute rehab mid-jan. after four weeks of orientation, i had my first 3-11 on my own today, and was assigned to 35 patients. 8 of them with g-tubes, feedings, and g-tube dressing changes on my shift, 10 diabetics with fingersticks and insulins, and maybe 15 or 18 with meds that require bp checks at 5 or 9 pm.

the aids do not do finger sticks at this facility.

g-tube dressing changes are supposed to be done daily on 3-11 at this facility. i did all of mine, i don't know how, but i did, but i was taking off dressings dated 5 days ago, one even from last week.

i don't know how i got through today. i am so tired i could cry.

i feel like nothing got done on time. i feel like nothing will ever get done on time.

they told me that the maximum patient load is 25. i've been doing 25 patients for the last week and a half on my own, and felt very confident in myself. but tonight as soon as i got to work they told me it'd be 35, and from what the other nurses have said i should get used to it.

i feel like i'm not able to provide care.

i didn't go to nursing school to shove meds into people, but with 35 people there's not even time to say hello and ask how you're feeling today.

i couldn't even tell you if i made a mistake anywhere or not.

i just feel crushed.

is this normal? does this feeling go away?

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Oh my god, I feel like I'm reading a post I wrote when I first started LTC. Yes you WILL get faster! I've been a LTC for about a year now and I struggle at times. Best advise, just be consistent! It doesn't matter how slow you are, as long as you're doing your job right and providing the necessary care your patients deserve, that is all that matters! You will pick up the pace. You'll start to find what best works for you, what patients you should give medication to first, and how to managed your time wisely. LTC was the only job I was able to get right how of nursing school. I cried every day after work and sometimes at work! I finally found a place that I love and that's because of the people I work with! No one makes me feel like I'm stupid for not knowing how to do something. Everyone is so helpful. As long as you have a good support system at work, you'll do just fine. It's only temporary how you feel. Once you've been doing it for about 6 months or so it'll all become second nature. I learned something knew EVERY day and I learn from my mistakes too. Do NOT beat yourself up by a mistake you've made. EVERYONE has made a mistake. I about quit being a nurse forever because I accidentally gave someone somebody else's medications (thank god it was just mostly vitamins). Just admit to your mistakes and take ownership in it. Now a days organizations and hospitals are steering away from the "blame and shame" attitude to an educational learning tool of what you could of done differently to prevent this. I only mention this because making a mistake most likely will be in your future and I don't want you to react how I did. It could have changed my life entirely if I had decided to quit nursing. Now I'm in school again getting my bachelors. As this point, I don't care if I ever work in a hospital like I use to want to. I just want to be happy with what ever type of nursing I do. LTC is HARD, and when I ask many of my friends who work at hospitals if they would ever do LTC most say they wouldn't because it's too stressful. Imagine how much we have overcome and learned from taking on such a high patient load! We might be freakin ALL STARS in the acute care system if we get a job at a hospital. I'm looking forward to endless possibilities nursing has in store for me.

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Specializes in ICU,IV Team, Endoscopy, CM, LTC, Homecar.

I also worked in LTC, it can be soo overwhelming, but also rewarding. Just know you wil always work your *** off. Be careful in body mechanics. I love the elderly people and all

their wisdom,stories, they can be so mean, and yet so sweet. I think LTC gets a bad rap, we had residents with wonderful care from our aides, enter the hospital and return with horrible bed sores. So the old addige that don't get good care in LTC is wrong, it's like a family, esp if you can get together and get to know your aides, they can make all the difference in the world. I loved it even it was so hard. Don't be too hard on yourself, it is

hard work. Hang in there!!

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Specializes in LTC.

Nope, they get worse care in the hospital if you ask me.

No med tech??? You poor guy! It will get better tho...25-35 is normal and it does get better, tho passing your own pills is a pain..just you no other nurse? Ach. *hugs* It'll get better..it will.

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Thanks for the responses. I just don't know anyone else I graduated with experiencing situations like this.

At this facility, it's anywhere from 25-35 patients with one nurse (only one nurse--what's a med tech?), so I do all treatments, all fingersticks, all everything, it's crazy, and I feel like my head's going to explode.

Icing on the cake--our state inspection is going on now. I worked 3-11 last night and 7-3 today. Guess which nurse got followed during med pass?

Of course the one that got off orientation yesterday and slept for 3 hours. Thankfully I did well. The DON came up to me at the end of the day and said that the inspector who followed me (only two patients, but still...) said I did a great job, and complimented me for finding an error on the MAR.

Arrrrgh.

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Specializes in LTC.
Thanks for the responses. I just don't know anyone else I graduated with experiencing situations like this.

At this facility, it's anywhere from 25-35 patients with one nurse (only one nurse--what's a med tech?), so I do all treatments, all fingersticks, all everything, it's crazy, and I feel like my head's going to explode.

Icing on the cake--our state inspection is going on now. I worked 3-11 last night and 7-3 today. Guess which nurse got followed during med pass?

Of course the one that got off orientation yesterday and slept for 3 hours. Thankfully I did well. The DON came up to me at the end of the day and said that the inspector who followed me (only two patients, but still...) said I did a great job, and complimented me for finding an error on the MAR.

Arrrrgh.

Oh yes. Welcome to LTC. It is not an easy job. I've been doing it off and on for about 3 years. It will get better with time. Hang in there!

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Specializes in Pediatric Private Duty; Camp Nursing.

The first year of working as a nurse is your REAL education, and it's a baptism by fire. My first few months at an LTC, I kept my head above water, but barely. I made some small mistakes that freaked me out at the time, like one Joan got 0.5mg Ativan and another Joan got 1.0mg Ativan, and I got the two Joans mixed up. I thought I was going to be fired, but my ADON just laughed and said the other Joan could probably use the extra med. Then she worked me through the procedure for med errors, which was embarassing to have to call the MDs and the families, but it was a learning experience and I didn't get in any real trouble. I learned that getting all worked up about the small stuff is really detremental to my overall effort. Your med pass is going to be slow. And late. For some time. Just suck it up mentally and don't let it bother you. There's only so much you can physically do. It will come.

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Specializes in Hospice.

Been in LTC for nearly 7 years myself, and the most important thing I learned that made my life easier was this:

On any given day, 10% of your patients will take up 75% of your time. These are the patients with emergent situations, acute health issues, or are actively dying. It's OK to devote more time to these patients than the others. The majority of your patients will need nothing more than their meds and maybe a treatment. Do it, and move on. Don't feel guilty about not being able to spend "quality" time with each and every one of your 35 patients.

It does get better, you will develop a routine that works for you. Honestly, it was a good 6 months before I really truly felt like I had a handle on it. Hang in there!

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Specializes in Pediatric Private Duty; Camp Nursing.

I always saw each LTC shift like an episode of The Brady Bunch: every episode featured a different kid with a different problem.

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Specializes in LTC.

When I was that flustered new nurse finishing up her med-pass a half hour after her shift ended.. the off going nurse said to me as I was leaving and I probably looked like I was going to burst into tears.. "It gets better..."

It really does get better. You'll get quicker as you do the same med-pass. I don't want to use the phrase "cut corners" but you learn some tricks to help you save time.

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I feel the same way!!! I also graduated this pass may with a LVN degree and just got hired at an assisted living facility. I have 60 residents to care for. I've only received 2 days worth of orientation and 3 days worth of training with a nurse. So when I was on my own my med pass were late and it was very frustrating i wanted to cry sooo bad! Today will be my 6th official day on the floor. I haven't been on the floor working for 2 weeks now, because i'm only working part-time/on-call. I am terrified to go to work today and I just hate the feeling. I wonder if this is a sign that this field is no longer for me.

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Hang in there! I'll bet new grads in hospitals working on their own for the time feel the same way. Speed comes with time. Its not even about taking shortcuts, but becoming comfortable in your position and confident in your clinical skills. Don't put alot of faith into what the other nurses say, my nurses love to tell new people about how people get fired at the drop of a hat, etc. in our building. Then they don't understand when the newbies leave! Someday I'll convince some of them scaring people is not the way to retain staff!

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