I'm new will this get better?

pagandeva2000, LPN · Jun 17, 2007

I just started as a new nurse in ltc and will have 2 wks orientation and then orientation on the shift I will be working 2x. I'm starting off slow in my med pass and there is so much more to learn. The girl I'm orientating with can pass meds without even looking at the MAR. I can't do that because I'm afraid I'll make a med error. We haven't even touched the paper work yet. There are also a lot of things being done I don't agree with but I know these nurses are overworked and there doesn't seem to be enough time in one day to do everything. Will this get any better? I am being told that technically we do this, but in reality we do it another way that I'm afraid these habits can cause me to lose the license I have worked hard for. I really like the place so far but this has just been the first week. Does anybody have any advice or suggestions? It will be much appreciated.

It sort of gets better in weird ways, I hate to say. I had a horrible orientation as well, and what I did was watch what other nurses did and decided to myself what I would and would not do. I work in a clinic, so, it is different to me, but I also found that even in that sort of setting, I had to take short cuts. What it did teach me to do is to sharpen my observation skills to see which patient really needs my attention, and the ones that can get by. I did find myself speeding up as time went on, though. I also continue to do a great deal of reading so that I can better address things the next time they show up. I work at an agency to do home care on Saturdays, and this is where I am gaining by bedside skills. I don't have the same stress and I deal with just one patient and can sort of take my time.

It may be that this particular place may have an unsafe nurse to patient ratio. If it does, you may consider going on nights, where it is slower, or gain what bit of experience you can and move on to a more suitable place to work. Easier said than done, I assure you, but, remember to be patient with yourself. It DOES take TIME, TIME, TIME. I would rather not do something I am not sure about than to act and jeopardize someone's safety and my license. If this place is not patient with you, then, consider moving on.

pinkidust · Jun 17, 2007

Thanks for the advice! I do like the facility so far, so I think I am going to have to a better observer and then get my own schedule down pat.

**Elektra6, ASN, BSN, RN** · Jun 18, 2007

Yes, I started in LTC and it does get better! If you work the same cart/same residents you will know which ones to do first and can prioritize your time better. For example: It might make sense to give some residents their meds first or some residents will tell you they want their sleeping pill at 9 or 10 etc. I worked a mixed unit so I tried to catch the confused residents when they were in a good mood or during an activity rather than waking them up in bed. As long as you are within the correct time frame you don't have to worry. Two bad ideas I've seen nurses do: 1. Go by the MAR in order. This will slow you down. It's better to get the 5 confused people in the dayroom at 7:30p than wake some up at 9:00p, although both are within the correct time frame for 8 pm meds. 2. Give all meds at one time. I have seen this happen more times than I can count. It's just wrong.

Another tip for 3-11 shift is I would bring any creams/lotions on my cart and apply them before bed at the same time as giving PM meds. I only used the separate cart for wound care. That saved me from waking residents up to apply a cream & I could spend more time with them rather than running in and out.

It was really hard but it got easier. Hang in there!!!!

fultzymom · Jun 18, 2007

Many people think that working LTC is a piece of cake. It is hard. It will get better as you settle in, get into a routine, et get to know the patients et their individual likes et preferences. Hang in there!! I remember the days of thinking the med pass will never end. And I took an office job last year et have to fill in on the floor at times et I am right back there like a newby, taking forever to pass meds!! Good luck! Keep your head up!