I was let go !

[gt4everpn]

i'm a new grad, started 1 wk orientation at ltc last week. this is how it went and why i was asked to consider somewhere else:

1. the 1st preceptor i had came down on me alittle hard when i was giving out meds for the 1st time. she also got annoyed with me asking questions.

2. changed preceptors and asked for more time.

3 got more time and my 2nd preceptor wondered why i asked for more orientation time because i was giving out meds so well

4. had to do a med pass today, where someone other than the preceptor watches u give out meds - failed it, here's why:

-i put my meds on a tray and set it down on a chair next to the resident, to give it- according to the person giving the med pass this is not allowed

- she says i didnt wash my hands long enough- even though i was counting as i washed my hands, and 1 or 2 little not drastic mistakes were made- i was nervous, she said these were the problems not giving out meds themselves.

this is annoying and discouraging seeing that it took me 5 mo to find this job, cause here in nyc everyone wants pn with experience. what do you guys think, and what should i do!:trout:

i posted earlier on how i was ''let go'' on my new job. anyway, do you all think 1 week of orientation is enough for a new grad (pn) working in a nrsg home with 40 residents.

[Sunflowerinsc, ADN, RN]

If the peg tube is not in the right place, wouldn't you get water in the lungs and cause a serious problem? Sounds dangerous to me. I was always taught to use air.

PEG tube, percutaneous endosicopic gastrostomy tube means the feeding tube was inserted by a small incision to your abdomen and tube is placed in your stomach. The feeding goes directly through gastointestinal tract. Aspiration of gastic contents can happen ,of course, but is generally due to pt. positioning. To check for placement you would aspirate green or yellow stomach contents or if a conti feeding ,the feeding.

[Dolce, RN]

I'm so sorry to hear about your experience. What a nightmarish orientation! Sounds like the one I got when I did LTC as a brand-spanking-new grad. I think I got one week and it was implied to me that I should be grateful for that "extensive" training. Don't get discouraged. As hard as it is to believe when you are looking for work as a new grad, there is a nursing shortage. I would suggest placing your resume on Monster.com, absolutelyhealthcare.com or careerbuilder.com. There are LOTS of jobs out there but you may need to relocate (not sure if that is an option for you or not). Keep your chin up. You wouldn't have been happy at that place anyway.

[Ms Kylee]

God, that place sounds like the PT place that decided that a transcriptionist didn't need any orientation. They just plunked me down in front of the dictaphone and said "type". I took the job as a second job, and hated it so bad I left after the third day. This place is notorious for not being able to keep any staff except for the therapists. They would stay, no matter how awful that place is for the $60 an hour they were paid. I missed the money that the job paid, but it was worth not working not to have to put up with the petty BS and totally ridiculous demands of the owner. It will get better. I promise.

[kellyskitties]

Come to Missouri - we'll hire you!!!

She was upset over handwashing! Was she also a nursing instructor? How long does she wash her hands? I don't see many nurses in reality take that long to wash their hands unless they just did something gross. We use the alcohol handwash, when it's dry - you're done.

Sounds like a not too friendly environment. No jobs for new nurses? Plenty here in Missouri.

[pagandeva2000, LPN]

I am sorry to hear this...I remember reading your posts recently about finding this job. I specifically paid attention to your posts because I also live in New York. Try applying at Health and Hospital Corporation, such as Elmhurst Hospital, Kings County, Jacobi, or Bellevue. I do admit, their nursing is not worth squat, but, usually, they do hold on to you until you are ready to go. Best wishes.

[pagandeva2000, LPN]

I'm sorry to hear this...have you tried applying to any one the NYC hospitals?

http://www.nyc.gov/html/hhc/html/careers/employment.shtml

Funny that you mentioned this, and I didn't see your post before I already answered. I work in a city hospital and we take anyone. Pay sucks, but you can get some experience.

[P_RN, ADN, RN]

PEG tubes are placed through a hole in the abdomen directly into the stomach cavity. You need to keep the head of the bed up to let gravity help the contents from refluxing up the esophagus.

My way and what I believe to be a standard is to aspirate the tube to see if you get stomach contents. My remembrance is 25-50 cc and you hold.

[YooperNurse]

If the peg tube is not in the right place, wouldn't you get water in the lungs and cause a serious problem? Sounds dangerous to me. I was always taught to use air.

I think you are confusing an NG (Naso-gastric) with a PEG tube or a J-Tube (jujenostomy tube). There is no way to check placement on a peg or J, it is a tube that is inserted and sewn in, so you don't need to worry about placement, and if the stitches ever come apart the tube pops out, I've had it happen!! The only thing you need to check with these is by doing an aspiration every 4 hours or so (this is usually ordered per MD, but some places may have a protocol) to see if the patient is tolerating the rate of constant feeding that is being delivered.

An NG is the tube that goes into the nose, this is the one that you check with air because yes, they can come out or move around and possible end up in a lung if not advanced properly.

[gt4everpn, BSN, RN]

You were told to check a PEG placement with water? That is called a flush before you give a med, which is usual procedure. You check an NG placement with air, but not a PEG or a J-Tube. I would do some serious talking with the DON at this place, sounds like your preceptors need a bit of orientating here.

That's exactly how my 1st preceptor was showing me, with water to check placement. The 2nd preceptor had an attitude when I came for the 1st day. She pulled me aside and said that she already oriented someone and now she had to do me and that she was angry at the DON, but she said it was nothing against me. I still felt like an outsider, as if I had to beg for someone to orient me properly as a new grad. Kinda felt it was my fault!

[gt4everpn, BSN, RN]

You would have to be some kind of masochist to want to continue to work at a place like that.

Count your blessings. They were looking for a reason to push you out, but don't take it personally, these places can be very clique-ish.

Well, I am only 18, my H.S had a nrsg program. When I walked into the LTC, you could see the looks on the staff's faces as if they were thinking, ''doesn't this girl belong in school''. A couple even asked my age, which I was hesitant to give. Some of the CNA's, particularly one either didn't respond to me when I said good morning or gave me a not so friendly look. My 1st preceptor was kinda impatient with me so I guess her and the CNA's had some conversations about me. I went to the DON about switching perceptors and she did. So I guess after switching preceptors and not passing the med pass, the DON was tired of helping me out and let me go.

[gt4everpn, BSN, RN]

thanks everyone for the support and the links for hhc, i will try them. i still feel alittle guilty about what happened, it seems as though some nurses don't remember when they were new. i was so surprised when the don let me go, i was doing so well all along and she herself said that i gave out meds fine, but i guess she couldn't get over the handwashing, etc.. mistakes.

[P_RN, ADN, RN]

Hey you are going to do well. You will find the perfect place. We were all 18 once. Heck I'm like 3 1/2 x 18 now!!