I got a job as a graduate nurse/RN at a nursing home recently here in California. I've been training in a very fast-paced busy hectic environment. I'm not learning a whole lot (atleast not enough to be completely on my own) because of the environment. My nurse (LVN training me) has been very patient and as helpful as she can be while still taking care of 17+ patients at a time. She said she wishes she can go more in depth with all the paperwork and things like that if she had the time. I asked to be moved to a slower unit of the nursing home. But I was told that there is only 1 nurse per unit of the nursing home for every shift (~20 patients per nurse). And if I were to move to another unit, I'd be completely alone and I'd have to be READY to be on my own.
This place is SEVERELY understaffed. There is no unit secretary to call doctors, fax papers, deal with jammed copiers, etc. No wound care nurse. Not enough nurses. You have so much to do. Nurses stay atleast an hour past their shift just to catch up on what they need to do. The nurses are constantly overwhelmed. One says that she thinks about quitting every other day. There's a nurse who doesn't even document correctly. She documents about a right arm PICC line when the patient actually has a left hand peripheral line... That is how crazy it is. And people get written up a lot... I wonder why. Maybe because they're overwhelmed and can't possibly do everything. And we only get 30 minutes lunch. The nurse training me doesn't even have time to eat... I don't have time to actually sit down with my patients and have a nice conversation with them. It's just like, "Hi. Here's your meds. Gotta go now bye."
I've only been given 5 days of orientation. How is anybody supposed to learn how to do their job in 5 days? Apparently they'd give me more time to orientate if I need it. But I need like 6 months (like new grads at hospitals get). I'm supposed to have a sit-down discussion with the DON and whoever else on Monday. I don't even know if I should show up. They won't even give me 1 week off to study for my NCLEX. They'll just give me 2 days off before my test to study. I need to pass it the first time to start my BSN program. They said the job is more important than the NCLEX...
This is my first job. So I don't have anything to compare it to. But I know this isn't how it's supposed to be. New grads should be trained well to do their job in a reasonable amount of time... especially when human lives are involved. I don't want to screw something up and lose my license before I even get to RECEIVE my license.
I want to just quit and concentrate on the little time I have to study for my NCLEX and then focus on getting my BSN. Apparently some hospitals won't even accept nursing home experience anyways. And I don't NEED a job right now. I don't have kids to support or an apartment to pay rent.
As many have said, your situation is not uncommon for LTC facilities. I've been working in a LTC facility for almost two years. Right out of school, it was the only job I could find. I received about 5 days orientation to the NOC shift, and I have 34 residents at NOC with 2 CNAs, and up to 54 residents if the Alzheimer's unit nurse is sick or out. That unit is a locked unit and although they have 2 CNAs on that unit, it's impossible to constantly monitor the other unit which is blocked by locked doors. Many times I have to depend on the CNAs to monitor the residents and just notify me if something happens. It's completely UNSAFE for the residents to have only 1 nurse covering both units, but for the new Executive Director (not a nurse) Her only concern is the bottom line. If there are some empty beds on my regular unit, they use the excuse of "low census" to say they cannot staff the Alzheimer's unit if the nurse is out -- even though the 34 residents I have are a mix of Medicare SNF residents, and LTC residents. Each night I have to chart on 20-30 residents, pass all their meds and PRNS, and do treatments. It's difficult when you "need" the job to survive, but the job's killing you. Several of the NOC nurses had to go on medical leave because the pressure can be horrendous when 2 residents are going downhill fast and you also have 2 falls.
So.... if you're just starting out and your GUT is telling you that this is not the job for you, listen to your GUT.
Listen to us, and your gut We know from whence we speak. Don't quit nursing over a bad LTC job. LTC will only get worst. Go get two years of MED/ Surg. and then find a place when you can be happy. Wishing you the best.
Well, I am glad you decided to leave if you didn't need the job anyway, but your employer gave you a job in a tough economy and you return that by leaving with no notice? Sorry but that is very disrespectful to any employer, you should have at least given a two week notice if you were't happy. From the way you described it that facility doesn't sound too bad, there are much higher patient to staff ratios in most nursing homes than the 17:1 that you described. And to all the responding posts that seem to think once you pass that NCLEX you can get a job anywhere, read all the threads that are saying otherwise. It seems like jobs are hard to find right now, even for experienced nurses and for new grads it is almost impossible to find work in some markets. Last but not least...PLEASE stop with the Long Term Care bashing people! Not all SNF are terrible places to work!
Im really sorry that the healthcare system is soooo corupt , I have been a LPN for 2 yrs and going through the same stuff, at my first job orientated for 3 days at a LTC facility and worried that I didn't know enough to go out on my own, when i told this to another nurse she said that " These are old people don't worry about it they are going to die anyway." Sometimes I wonder is that what management think. At least at your facility nurses can stay an hour over,we have to clock out at 3:15 no matter what! I always clock out and then finish my work before I leave because I need my job and don't want to loose my license.
Sorry your situation is so lousy! Boy, what a crappy place to work. Why would any nurse continue caring for people that she doesn't care about? Where I work they might not like paying out overtime [no facility does], but coming back to finish work off the clock is grounds for immediate dismissal
Kudos to HawaiiGuy! Man you're so right! We've the same problem here @ an LTCAH here in San Diego. Currently we've 36 pts. with 2 more on the way. The acuity level of the majority of these pts. is high considering most of them are on vents, have trachs, or dialysis. Today for example they sent one CNA home out of 4 @ 11 this morning because of "low census". Low census my ***! The rest of the CNA had to take on 3 more additional pts in addition to the 9 pts. they already have. Now mind you they have to turn/position these pts q 2 hours, change/clean those who don't have foley or are able to get up and use the bathroom. They call themselves saving money, but all it doing is causing turmoil and safety issues. So like every one is telling you listen to thst inner voice/follow your gut and do yourself a favor and leave (after giving them your 2 weeks notice) so you don't mess up your career/loose your license. From what you're saying I doubt they would stand behind you should something happen on your watch.
So sorry for this experience. I train in new grads at least once every 6 months, and I do give them a very good orientation, but our unit is fast paced with 20 residents, loads of meds, faxes, call outs and of course the occ fall. I am an LPN day shift charge. The new nurses, LPN/RN have no idea what goes on in SNF/LTC.
I have seen some very good Nurses crumble under the pressure. My first order of business in orientation is that BREAKS ARE ESSENTIAL to your life and the wellbeing of your residents. I teach them how to prioritize, pace themselves, delegate to ULP's and understand that not always will those meds get out on time, be patient you won't learn it all at once and most importantly smile and enjoy experience after all you only live once.:heartbeat
Two weeks notice? I didn't get a two weeks notice about how understaffed their company is and how overworked this job was going to be and how inefficient the training was going to be.
And you know what... that's how they'd get me. Work an extra 2 weeks, end up accidentally killing someone and/or losing my license within that time period, end up firing me, and have a black mark on me forever. I decided to quit now while I'm... ahead.
This is not a LTC facility, it's a business. In Business nothing is personal. Two weeks gives the LTC time to find a replacement and in return the facility can't put down that you quit without notice. Life is not fair, Nursing is not fair. You will just shoot yourself in the foot if you just up and leave. You will just have to grin and bear it, that is until you are out then you can trash them all you want. I know your pain. One job that I had was a LTC, the only nurse for 120 patients and I was and am an LPN. The RN was on call ten miles away. Calm down and think of your future. Someday that job will just be a line or two on your resume.
HawaiiGuy
4 Posts
As many have said, your situation is not uncommon for LTC facilities. I've been working in a LTC facility for almost two years. Right out of school, it was the only job I could find. I received about 5 days orientation to the NOC shift, and I have 34 residents at NOC with 2 CNAs, and up to 54 residents if the Alzheimer's unit nurse is sick or out. That unit is a locked unit and although they have 2 CNAs on that unit, it's impossible to constantly monitor the other unit which is blocked by locked doors. Many times I have to depend on the CNAs to monitor the residents and just notify me if something happens. It's completely UNSAFE for the residents to have only 1 nurse covering both units, but for the new Executive Director (not a nurse) Her only concern is the bottom line. If there are some empty beds on my regular unit, they use the excuse of "low census" to say they cannot staff the Alzheimer's unit if the nurse is out -- even though the 34 residents I have are a mix of Medicare SNF residents, and LTC residents. Each night I have to chart on 20-30 residents, pass all their meds and PRNS, and do treatments. It's difficult when you "need" the job to survive, but the job's killing you. Several of the NOC nurses had to go on medical leave because the pressure can be horrendous when 2 residents are going downhill fast and you also have 2 falls.
So.... if you're just starting out and your GUT is telling you that this is not the job for you, listen to your GUT.