I don't think I can handle this!

[eldragon]

WARNING: VENT VENT VENT!

I'm in the middle of my fifth week in a SNF, as a medication nurse. This is also my first LPN position.

I thought I was so fortunate to land the first job I applied for, and in fact, right there on the spot! However, this job is torture. Here's what my day was like today:

0645: Get to work 15 minutes early to find the six boxes I ordered to re-supply the med room, still not carried to the med room. Go inside the med room and see medicines for 3 new patients, all sitting on the counter, not put up. (We're talking dozens and dozens of cards here.)

0655: Count narcotics.

0700: Go to the dining room, where I am responsible for physically placing each tray in front of the 24 people in my dining room. I then pour coffee, etc., and pray for the pts to eat within 40 minutes, because I know what is waiting for me: the 0900 med pass from hell. Usually I end up taking a tray from one woman who suffers from dementia, and cannot understand why she can't sit there playing with her butter all day, while I watch. Everyday, she's mad at me for taking her tray.

0745: I push my cart out and probably have at least two people who are screaming for pain medicine - and I am required to give it within 15 minutes of their request.

0800: Start my morning med pass, doing all vital signs myself. Last week we had 18-20 patients, but now we have 26. This is a SNF, and orders change almost everyday. We got 7 new admits in the past two days, and everyone takes 12-30 meds at 9am - including multple inhalers, patches, PO, etc. Many pts have dysphagia. There are two peg tubes, and right now we have four known narcotic addicts, who each require pain medicine q 3 hours, sometimes up to 3 different meds staggered. Meanwhile, pts are in PT, the beauty shop, the shower....or outside smoking. I have to run them down individually.

10:30 - I'm supposed to be done with my 9 am med pass. Yeah right! That's about 5 minutes per person - and just gathering someone's drugs can take longer than that - much longer if the person is new and the meds aren't to be found in the cart. Then I have to find the patient, take vitals - and have them swallow the pills, which takes several :banghead:minutes if the pt can't swallow more than one pill at a time, and can't hold their own water.

10:30 CBGS on 10 patients. Of course, you realize I am way behind on my morning med pass, right? Nobody is getting their CBG at 10:30 right now.

11:00 my unpaid lunch break that is deducted from my check, whether I take it or not. Hello? I'm still passing the 9 am meds! Lunch for me isn't happening today!

11:30 - insulin for those that need it. But again, I'm way behind.

12:00 Trays are out, and everyone is waiting on me to get in the DR to pass them out. Too bad I haven't sat down, peed or even had a drink of water since 06:45 this a.m. I feel like crying by now I can't sit in the DR, either. It's standing room only for me.

12:45 Lunch is over? Back to work, hopefully I can get in 15 of minutes of charting and beg for the MAR back from the infection control nurse who is glaring at me for having it all morning. Now would be a good time to pee, even though I'm dehydrated from not drinking anything since 0600 this morning.

1300: Start passing 1300 meds, and most people get them. Also I have to fit in flu shots, pneumonia shots, B12 shots, etc. I have two more hours of my shift to get everything else done - calling the pharmacy, faxing new orders, all the charting I am responsible for, restocking the med cart, etc.

1500: Gosh, I seriously hope I'm finished with whatever I needed to do. I feel guilty because I had to race around like a chicken sans head all day. My back is killing me, so are my feet. The charge nurse is asking me this, asking me that. I guess my replacement is late.....keep on working.

1530: On a good day, I'm walking out. On a bad day, I'm calling my daughter at home and telling her I'll be late again. "What's for dinner, mom?" I have no idea. I'm too tired to go to the store. I can't take it.

That's been my day. No feeling of a job well done for this nurse. I can think of 10 things I wish I could have done better today. Will I get written up for not being able to find those 5 meds I couldn't give? Probably.

Oh, and today, the charge nurse asked me to get a demented deranged patient to take some medicine to "calm down," and I crouched down on the floor, and asked her kindly. She grabbed my hair - yes, most of it - and shook me like a ragdoll. "Leave me alone you ignorant *****!" I wanted to cry.

And this was my day. Did I mention I am earning $14 an hour?

What can I do? I just started, how can I quit? HOW?

HELP!

[eldragon]

I also want to add that since I took this job, five weeks ago, I've lost 15 pounds.

I'm driving my husband crazy from all the "work-talk," and I can't handle much around the house in the evenings either. I can't sleep most nights, cause I'm too stressed out.

[NickiLaughs, ADN, BSN, RN]

I used to work in a nursing home. One thing I learned is to put myself first. Because if the nurse isn't functioning well, she can't possibly take care of others.

It sounds like some things such as vital signs & food trays should be delegated. Do they not have any CNA's here? Another thing that helped me when I worked in a place like that, was having a sheet that had all the patients names & I created codes for special treatments. It seems like it would take a nurse team effort of ALL the nurses there to get organized. It would help everyone's sanity! This is your chance to be a patient advocate and call a meeting about getting organized as a group. Teams work much better than individuals. Especially in nursing homes. If all your efforts don't change anything, than I would pursue another job. That's what I ended up doing, unfortunately nobody where I worked was a team. Good luck!

[Dixielee, BSN, RN]

I feel horrible for you, but can't offer any help, only support. And administration (and others) wonder why we can't keep good nurses, hummmmm.

[catlynLPN]

Quit. Just quit. Isn't your sanity and health more important? How can you help anyone if you're in the looney bin or dead??

I thought I had it bad at my LTC. Mine is nothing compared to yours.

[nurseby07]

OH MY GOD>>YOU MUST QUIT NOW!!!!Not worth. I would pay someone $30 an hour to NOT HAVE TO GO IN. SORRY

ps My hub is an lpn, try the VA...He loves it and makes a lot...

[eldragon]

I used to work in a nursing home. One thing I learned is to put myself first. Because if the nurse isn't functioning well, she can't possibly take care of others.

It sounds like some things such as vital signs & food trays should be delegated. Do they not have any CNA's here? Another thing that helped me when I worked in a place like that, was having a sheet that had all the patients names & I created codes for special treatments. It seems like it would take a nurse team effort of ALL the nurses there to get organized. It would help everyone's sanity! This is your chance to be a patient advocate and call a meeting about getting organized as a group. Teams work much better than individuals. Especially in nursing homes. If all your efforts don't change anything, than I would pursue another job. That's what I ended up doing, unfortunately nobody where I worked was a team. Good luck!

We have 1 or 2 CNA's on our hall, and they are responsible for showering patients, helping them toilet, and making beds. They are quite busy also. At our facility, the nurse has to take vital signs. And in the dining rooms, a nurse has to physically place each tray in front of the patient, to "make sure the right patient gets the right tray." We also have to record intake for each patient, and cannot leave the DR for any reason as long as a patient is eating, or playing with food, as may well be the case. Oh, and I can't sit down at all. And I have to make new seating charts for the DR once a week, and give copies to the kitchen, the charge nurse...and two other places. Oh, and I am in charge of any menu requests.

[vernRN]

I would run from that position. The facility sounds like it needs additional staffing. I just left a job in a poorly run facility. There wasn't much team work, and little contact with the patients. The training was sporifice, and inconsistent. I dreaded going to work every day. I, too, felt extremely stressed out. After much thought, I decided to go back to my previous job, and have never felt more satisfaction and relief!

[JCLVN67]

Get Out of Dodge, you worked hard for your license, don't let this place jeopardize it! You are being taken advantage of by unscrupulous management and / or ownership. Try a state hospital or school. I"m an LVN at a state psychiatric hospital. I know mental health care is not for everyone, but I am frightened of nursing homes like the one you describe and one that I used to work at and quit after five months worth of grief similar to yours. It'll get better, there are a ton of other jobs out there for you.

[eldragon]

I feel bad for my patients.

By being dumped in a place like this, they are wronged several times, and losing people who care, like me, is just another bad thing that is happening to them.

The only way to stay in a job like this, is to routinely cut corners, and even lie about things you do/don't do.

Unless they come up with a way to add more hours in the day, my workload simply isn't reasonable.

The DON is off this week, probably lounging in Hawaii or someplace, paid for by the extremely wealthy man who owns the facility I work at, and others like it. She's basking in the sun, enjoying a huge bonus, I'd imagine, for running the place on the cheap.

Just last week she had a meeting during which she told us the owner was losing money, and how lucky we were to have so much staff, because the facility could certainly operate with less.

She also called us into the office another time, just to tell us that "we don't want to work at another facility, because working conditions are bad there." Never mind that they start new nurses five dollars more an hour, it's not someplace worth working.

HMM.

[ktwlpn, LPN]

What can I do? I just started, how can I quit? HOW?

HELP!

You are jeopardizing not only your license but patient safety every day.RESIGN ASAP...Write out a resignation and offer to give them 2 weeks notice.Lay it on nice and thick -stress things like patient safety and how you know that you cannot possibly safely deliver the care these people need in the time alotted .They may even let you go without requiring you to complete your 2 week s. If they do that make sure you get something in writing that states they waived the required 2 weeks notice and in the future they'll agree to give you a positive recommendation.Maybe write up a document to take in with your resignation-something simple that mentions your mutual agreement to tender your immediate resignation without penalty..blah blah blah....I've seen it happen-if you spin it right they'll be afraid you'll blow the whistle on THEM and practically hold the door open for you.You have to be very careful and not threaten in any way-you have to be very,very clear that YOU just can't cope in the situation.

Good Luck.I think you are talking about the joint I left about 6 years ago-I remember serving meds and breakfast to 22 dementia residents by myself while the "charge nurse" sat in the office and planned cookie exchange "tea parties" for the residents and their families...I HATED that job...

[Valerie Salva, BSN, RN]

I feel bad for my patients.

By being dumped in a place like this, they are wronged several times, and losing people who care, like me, is just another bad thing that is happening to them.

The only way to stay in a job like this, is to routinely cut corners, and even lie about things you do/don't do.

Unless they come up with a way to add more hours in the day, my workload simply isn't reasonable.

The DON is off this week, probably lounging in Hawaii or someplace, paid for by the extremely wealthy man who owns the facility I work at, and others like it. She's basking in the sun, enjoying a huge bonus, I'd imagine, for running the place on the cheap.

Just last week she had a meeting during which she told us the owner was losing money, and how lucky we were to have so much staff, because the facility could certainly operate with less.

She also called us into the office another time, just to tell us that "we don't want to work at another facility, because working conditions are bad there." Never mind that they start new nurses five dollars more an hour, it's not someplace worth working.

HMM.

With everythng you've said about this place- why are you there? I wouldn't be.

You can do better!