I'm a new hire & want to start making protocol changes

[A.dela]

So I am a new hire at a new job. They recently started going through a change in management and many of the nurses stayed with the company. Some have been there for 3+ years and love it there. Im enjoying my job and coworkers, however, I'm finding that because many of these nurses have been working there as their first and only nursing job, they don't have the experience to make 'good' nursing care into a 'well rounded and exceptional' nursing care provided. They're missing minor details that could turn into big LTC issues like contracture care schedules, turn schedules, oral care schedules, NO BM lists ....things I am used to receiving in report and rather I'm getting a only outline of what I should need to know before starting my shift.

So my question is: How can a new hire like me jump in, start taking charge, and start turning this place around? I don't want to seem like a know-it-all and deter EVERYONE from wanting to work with me, but I'm also very adamant about prevention and patient advocacy.

[A.dela]

Haha "salty". And yes I take pride in the care I provide. I love being a nurse. Like I stated earlier, all the mangement is new as well. And just as an update, it just so happened they decided to have an in service yesterday and accepted volunteers to take the time to start improving protocols (basically the way we chart them and communicate them). Me and a couple of other nurses decided to take on the challenges and focus on different things that needed updating. No one else volunteered so we did. I'm a new hire, not a new nurse so I wouldn't say I'm not qualified-there's a reason I was hired in the first place :) I'm sure I'll need help along the way, but I'm definitely taking this opportunity to make a change in these resident's lives :) that's what nursing is all about

---and if you absolutely must know why I took this job and not the others that were offered to me, it's because working at a top-notch facility is not the purpose of being a nurse. The purpose is to provide the best care possible because everybody deserves it, even in a lower end facility. The purpose is to make a difference in their lives, and it's my goal to provide my residents with the same quality care that they would recieve anywhere else

[Lunah, MSN, RN]

"Be the change that you wish to see in the world" — Mahatma Gandhi. ☺

[A.dela]

ABSOLUTELY!!! thank you for this!!!

[vampiregirl, BSN, RN]

Maybe a good starting place would be to see if there are any existing policies or protocols that aren't being implemented appropriately.

Also, things like skin care/ turning and positioning are often a shared responsibility between the nurses and CNA's in a LTC. Working with the CNAs caring for your residents to provide them education and defining your expectations for patient care. It also helps if you role model what you expect and build a rapport with the CNAs.

[DeeAngel]

Take lots of notes, but learn how to be a fully well rounded, experienced nurse before you go suggesting changes. Your very first project and priority must be making yourself into an excellent professional nurse who can lead by example. Once you achieve that you will find people will listen to you and not just dismiss you because you're a "new grad" and you can branch out into other projects.

[A.dela]

This is great advice! Yes I'm working on helping my CNA'S as much as possible, once I figure out their routine I will help out more :) thank you! This often gets overlooked and it's a great reminder to hear it from someone else

[ktwlpn, LPN]

**I would however like to jump into more for a management role eventually and be involved with protocol changes, I'm not even sure what this job would be called and it most likely doesn't exsist, but how would you bring that up? Again, not trying to be misunderstood and have the DON think I'm implying she sucks at her job or anything like that

Very few " management roles" exist for LPN's ( in my area) and even ADN's.You should peruse a BSN at minimum if that is your goal.

[A.dela]

Right. Thats the plan after my husband is finished with his doctorates. I know several LN's that are ADONs and that may be something I'd be interested in pursuing (given if the opportunity presents itself)