Is it me or just the nursing home I'm working in

josinda421 · Feb 24, 2011

I hate to say it but....Welcome to the world of LTC nursing. been there done that.

Really, if that's the case, you really should ask them for more training. And don't let them put you with just anyone, but someone who's been working for a long time. They pretty much know the in's and out's and got it packed down.

soon2begrad2010 · Feb 24, 2011

kinda thought that ,thanks

mazy · Feb 24, 2011

Not you, it's typical for LTC. A lot of that paperwork stuff gets so ingrained in people over time that they forget what it's like coming in from the ouside and not knowing how to do it. Also, no one has time to be helpful, or want to be helpful, and some people who seem to be on top of everything often are completely clueless themselves, they just don't want to admit it. So they won't be very helpful at all and might actually lead you into a mistake.

Best to step back and take a look around and see if there is anyone who looks like they might be someone you can trust to get some advice.

One thing that helped when I was starting out is if on some rare occasion I got a few minutes free I'd pick up a patient chart and read it and as Igot more acclimated to the job, I would see where things needed to go and how they needed to happen.

Best of luck, hang in there, it'll get easier.

noctanol · Feb 25, 2011

Its you, its definately you

SpEdtacular, MSN, RN, EMT-P · Feb 25, 2011

LTC is really tough. I work at a place per diem and I just hope and pray nothing out of the ordinary happens. You barely have time to do your usual paperwork G-d forbid you get an admission or have an emergency. They use pictures in the chart instead of name bands so I constantly have to ask the other staff is this so and so (because I don't see them very often) and even then I'm still afraid maybe it's the wrong person. During the day the residents move around to different areas so I asked how do you know where to find them "You just know" was the answer I got. Super stressful. I always look for the policy and procedure manuals because sometimes that's the best and only place to get straight answers.

rainbowsandsunshine · Feb 25, 2011

I started as a new grad in LTC and I had a 1mo orientation. IMHO, if you are in training, you should have your trainer right by your side or easily accessible for your orientation. Even if you are completing the work, they should be right there watching, making sure you are doing it correctly.... not on the other side of the building!!

As I learned, the 2 hardest parts were learning your residents (names, medical conditions, whereabouts) and the paperwork. Working a cart and reading a MAR is not that difficult (just really busy!!)... but doing the paperwork can be extremely nerve racking when you arent sure what to write and worried you are missing important stuff.

Be vocal about your concerns to management. If they are not receptive and want you to work independently without the proper training, you should probably look for a different facility.

Also, if you cant find a resident, ask a CNA... they will be able to point out who is who, or tell you where that person is. All of my residents are predictable once you know their patterns. I can usually find anybody within 5 minutes unless they have been taken over to therapy. Once you know them better, you will be able to predict their actions, and catch them in their room for care before they cruise off to the dining room (1.5hr before mealtimes, LOL). Even our dementia patients who wander seem to follow the same pathways each time.

soon2begrad2010 · Feb 26, 2011

Thanks rainbowsandsunshine,you hit the nail on the head,I attempted to talk to the DON,but she had already left,my problem is the medpass and reading the MAR is no problem,I've also gotten to know the residents pretty good also.But oh my the paperwork is no JOKE! and I have been left hangin a by myself some and I know charting and doing paperwork is very important and I'm not taking that lightly,I have no intentions on losing my license because of LTC , I was told a month orientation,but I haven't gotten oriented on any paperwork but the bare minimum and then I ask for help and everyone is tied up in their own duties or they stress to me it's end of shift and they leavin quick cause they got stuff to do after work.

GapRN · Feb 26, 2011

I am in a similar situation - just finished week 2 of orientation in LTC. first job. I am VERY thankful that they are training me as much as they are after reading horror stories on this site about new grads being tossed onto the floor with a cart and told to pass meds. But I feel like the training time is being poorly allocated. We spend a lot of time talking about basic nursing I learned in school, but no time on the specifics of accomplishing that task (They say I should get apical pulse for digoxin, but don't show me where to click on the computer to record the HR)

I am having what I think are cultural/language issues with the Filipinos that are training me. i.e. they seem to have difficulty with pronouns (he/she) so i get confused about which patient they are talking about, they have trouble w/ past/present/future tense so I'm not sure if I should do a procedure or expect it to be done already. They rarely understand what I mean when I ask a question (usually I want to know about documentation and they usually address why a nurse would assess/intervene instead). Culturally, they start talking before other people stop; they don't understand what subject I am talking about but start talking about what they think I'm talking about. Is this a grammar issue? should I start with a verb and then noun?

Finally, the nurse educator (who hired me because they were between DONs at the time) has spent 16 hours chatting with me and not really telling me anything. She is super nice and she gave me a job after 1.5 years of unemployment, but she has been useless in orienting me and never lets me talk! she just keeps rambling, and forgets what she taught me, and what she taught the other new grad. I'm kind of worried that she is going senile, she get confused/forgetful frequently (in one conversation she said she knew I was a BSN, and later said "well, you're just a 2 year RN so you didn't get as much leadership education."). But she is so nice and has been the only one to give me a chance in 2 years of job hunting that I don't want to say anything about her. She is also the worst at understanding my questions. [i deleted a rant here] I'm not even sure who I would talk to. The DON is new, and i think the Director of the CCRC would understand my issues better as he is American and has observed my communication problem. I know I shouldn't go to the director first but I suspect he is the best person .

sorry, I didn't mean to go on like this, I guess I needed to vent. Anyway, any advice about interacting with Filipino culture or steering my orientation so that I learn what I need to time manage would be helpful!

TheCommuter, BSN, RN · Feb 26, 2011

when I was hired I was told a month of training

A month of training for a new nurse in LTC is totally nonexistent in the area where I live. Over here, the norm is three days of training before new orientees are cut loose. You might receive a full week if you demand it, but management will be laughing in your face if you ask for any time beyond a week.

I was promised three days of orientation when I was a brand new nurse back in 2006. I ended up receiving only one 8-hour shift of orientation before being cut loose to work on my own because the nursing home didn't have the staff to train me. In this case, 'baptism by fire' is the manner in which you'll learn the paperwork, routine, and other aspects of your job. You've gotta jump in and do it while learning along the way.

tiroka03, LPN · Feb 27, 2011

I understand how hard it is. I don't have a good answer. If you can get with one of the nurses off shift and just go over things, it might help. Try to write down all the areas you need help, and bring them here to this site. I am sure people will help you with each area. If you bring this home, like homework, you will find the answers you need.

Forever Sunshine, ASN, RN · Feb 27, 2011

The paperwork in LTC is ridiculous!. You chart 15 different things in 4 different places and theres flow sheets and accountability records for every little beep, breath and step.

I've been at my job for a year now. I'm STILL learning all the paperwork involved. There are some things I do now that I didnt even know I had to do when I first started.