im just sick of it!

Sounds like you need to run and run fast. I would not compromise my license by working in an atmosphere where you do not feel comfortable in doing your job, let alone you have not been properly trained to do things. This sounds like a concoction for failure.

Maybe you should first go to the DON or your supervisor to voice your concerns and ask for additional training/orientation. If she will not provide that, and you don't feel comfortable that you can perform the duties of your job by yourself safely. Then quit!

There loss, not yours. You will fine a job that is better suited for you. Good luck in whatever you decide.

Though 13 patients sounds like a dream to me, the organization or lack thereof sounds nightmarish and ridiculous.

Personally, I would not allow another nurse access to my cart especially where narcotics are concerned. Since you obviously have no predetermined shift breakdown/assignments, perhaps it would make sense to transfer the appropriate meds and MAR sheets to each nurses respective cart if for no other reason than to avoid gridlock.

As far as managing IV's without certification if mandated by your state of employment - I wouldn't do it - it's illegal.

New admits, falls, ER transfers and a myriad of other unanticipated events will allows throw a wrench into the works and the paperwork is endless- but that's life.

Your comfort level will improve in time and it may take a long time no matter how organized the facility. Don't be afraid to ask questions. Insist on help with procedures you're not familiar with.

Every facility has it's issues - however those you describe aren't ones I'd be willing to tackle be it 3, 13 or 30 patients.

even tho the meds may seem to be disorganized, the patient to nurse ratio sounds great. i used to have around 30 patients when i would float to ltc. you can always work around disorganization or better yet, bring it up to management so they can fix that. i would give the job a little more time and if you still feel the same about it in acouple of weeks or so, then just run. but remember, CYA- cover your assests!

My opinion may sound controversial at first, but here it is: I would stick with this job.

You are very fortunate to have only 13 patients in LTC subacute. Very recently, there was another new LPN who posted a thread stating that she worked the 3pm to 11pm shift, and was expected to care for 60 patients by herself. At her facility, 60 patients to 1 nurse was the norm, not the exception. The average subacute LPN must take care of 20 to 30 skilled patients.

In addition, I have found that these facilities tend to offer "more of the same" problems to a greater or lesser degree. Even the most wonderfully-operated facility will present problems, but to a lesser degree.

You only have 13 patients, so stick it out. You do not know how fortunate you are.

If I were able to press the 'thanks' button 100 times, or have a sign that had clapping, I would have done it gladly, TheCommuter. 13 patients for an LPN is usually a hospital assignment. Nursing, as a rule is usually unorganized, unfortunately. But, for some reason, your situation is not as bad as others; whether you believe it or not. With a bit of time management and experience (which you have to gain, anyway), you may be able to breeze through this in a few months. It is just that you are new and afraid; that is natural. But, you have to start somewhere.

Let me share a small story about disorganization. I became an LPN last year and am working in a hospital clinic. When I first transitioned from an aide to LPN, I had to do 6 weeks of med-surg before returning to my clinic. I had no regular perceptor and I kept screwing up the piggyback medications (not on the patients). I had plans to work per diem in med-surg to keep up the skills, but got scared after all of this disorganization, so, I went back to the clinic with no plans to go back for med-surg.

Now, Ambulatory Care is my home; I worked there as an aide, and will basically remain there as an LPN because I admit, I love having weekends and holidays off. But, I still wanted extra money, so, I was a vaccination and home care nurse. Now, I decided that I want to do med-surg per diem. I was scared, but, I called an LPN friend and she invited me up to her floor in med surg and worked with me to get the piggybacks together for hours. Then, I ran into an administrator who really likes me and she decided to hook me up with med-surg, so, she gave me the number of the agency to register for, and I will be doing two days of orientation at the end of September. She also told me that she will eventually arrange for me to work the ER.

I decided that while I do want to permanently work in the clinic, I do want to build my resume with other services, but want to do it at the pace that I want to. LPNs in my hospital primarily administer medications and treatments. We do no care plans and not many notes as the RNs do. Compared to long term care, this is the best situation for me. With all of the disorganization that exists there, I know that it can be worse. This way, I can concentrate on my skills (which is more important for me for patient safety) and not too much paperwork. I will have more control over how I obtain my experience, because I will be working when I want to work and building my resume. I am a bit scared, yes, but, if I continue to run from this, I will not have as many opportunities available to me as just a clinic nurse. Plus, I look forward to the challenge.

Your situation bad, yes, but it is alot easier than others. Just keep reading the posts for LTC and you will see what we are saying. Good luck...you can do it (I said alot, didn't I??)

That is the very reason why I refuse to work for LTC's. I know not all facilities are the same, but you never know until you actually start working there, unless you know a nurse that actually works there.

thats great for you!!!! congratuations! (pagandeva)maybe you're right ,,,my lack of experience and being a new graduate makes me afraid.....i guess i have to face it!!! welcome to the real world! but last night i feel like crying...my preceptor didnt come to work and so i was on my own,,they threw 2 admissions on me ,,,and i got so nervous but i ws trying to calm myself down! i was done with my med pass for the first time!and put my admission pt last,,and when i ask the other nurse to come help me,,,she gave me this attitude and she didnt help me,,no one else want to stay and help me out,,,but i managed,,i just dont know how,,,but thanks evryone for ur comments!!!!i know 13 pts is not a lot but working in a place who are totally disorganized is crazy and nerve wracking......i guess it takes time,,,,,

your getting the hang of it, just give it some time and eventually everything will fall into place. it will always be disorganized but you have to learn to be organized in a disorganized fashion. makes sense? cause it doesnt make sense to me lol... i actually cried while passing meds on my first day alone, which was actually my second day of work. but now i feel confortable like a tempur pedic matress, all it took was some time. good luck - jon

thats great for you!!!! congratuations! (pagandeva)maybe you're right ,,,my lack of experience and being a new graduate makes me afraid.....i guess i have to face it!!! welcome to the real world! but last night i feel like crying...my preceptor didnt come to work and so i was on my own,,they threw 2 admissions on me ,,,and i got so nervous but i ws trying to calm myself down! i was done with my med pass for the first time!and put my admission pt last,,and when i ask the other nurse to come help me,,,she gave me this attitude and she didnt help me,,no one else want to stay and help me out,,,but i managed,,i just dont know how,,,but thanks evryone for ur comments!!!!i know 13 pts is not a lot but working in a place who are totally disorganized is crazy and nerve wracking......i guess it takes time,,,,,

Thanks for the vote of confidence in my ramblings. I remember just a few months ago, I used to be terribly overwhelmed with teaching patients how to use their glucometers. We give them away for free to self-pay clients, and we have several brands. I used to choose the easiest ones because I didn't have the patience and would be flustered trying to explain it to the poor client. I stole one of each brand, took them home and reviewed them carefully. I found that outside of some minor details, most of them basically work the same. I had to take a deep breath, decide that I really wanted to learn things, and now, I try to be more patient with myself.

You did make it through that night with the admission and you will continue to improve. Sometimes, we have to admire the small things that we overcome. This is how we grow as nurses and in life.

now i'm the type of person who says stick in there it'll all work out but i'm telling you run get out of there, in this case the grass probably will be greener, much , much greener on the other side, please don't stay, how unorganized, i too had too leave a facility, my first job out of nrsg school!!!:angryfire for one they gave me the boot wrongfully but it was more of a blessing!! thankgod i got outta there!! good luck and go!!!

I have been in LTC/Rehab for 17 years now. Mostly it is a dead end job. Not to put any of you down. I am a nurse that thursts for learning. If you want excitement in your job go apply at a hospital. You will not find such disorgination and you will have few patients. You are a young nurse learn as much as you can. Remember you worked very hard for you license. You dont want to loose it over a facility or another nurse. Speak with your supervisor first about the issue. If you do not get the results you want then go to the DON. If you still do not feel comfortable give your notice and leave. Then in the mean while go apply at a hospital and see what they have to offer you.

Just remember a nurse is never with out a job we are always in demand. After you are a nurse for a year you can become a travel nurse and go where ever you want to. You choose how long and where you want to be. The money is much better.

Any way good luck to you. :monkeydance: