Is this the norm everywhere? Should I turn & run the other way?

[LPNKY2012]

I'm a new grad, new LPN, new orientee to my first job in a LTC facility. Friday was my 3rd day on the floor, & my first time on the med cart. I am a bit frightened by what I saw & what I ended up having to do under pressure. Maybe I'm just a rookie, naive to the reality of what goes on in this type of facility & what you have to do to operate from day-to-day. Please tell me...

Is it the norm to have patients run out of meds & to have to borrow/steal from another patient's meds?

Is it the norm for a facility to run out of testing/treatment supplies & not be able to do proper treatments & tests on dozens of patients for the entire day?

Is it normal for nurses to sign off on whole med passes & treatments & not actually do any of them?

Is it common for nurses to skip vitals on multiple patients & then just "come up with something" to put in the chart?

Is it common to meet what seems like an excellent nurse only to have to do a double-take when they sneak a pill out of the patient's cup of meds on the way down the hall & pop it into their mouth - slide of hand?

Is it common to have a policy of "Here's what you're supposed to do, but in reality here's what we do to get by. I'm not telling you to do this, I know you're going to do it because you gotta do what you gotta do...but if you get busted it's your butt on the line."

To be honest, I like the facility I've been hired at. I like the people. I wanted to work there. But, after the last few times out on the floor I feel like I'm putting my license on the line. I'm hoping with all my heart that this is not the reality that's out there & you guys tell me to turn tail & run like the wind. I have a part-time temporary seasonal job lined up to start next month, but I don't want to burn bridges - I had connections to help me get this job.

Any advice for a newbie? Thanks!

[BrandonLPN, LPN]

Fair enough, EVERY is a strong word, and there's always exceptions.

Still, I'm incredulous that any LTC facility never (resisted urge to capitalize, lol) borrows meds. Some may be efficient enough that it very rarely happens. But at some point there's a resident who runs out of a pill that can't wait and the only option is to borrow. The only way I could see getting around this is if you have a 24/7 in house pharmacy, then maybe you could never borrow. (I know hospitals never have to borrow for that reason)

[DSkelton711]

There is some stuff on your list that is quite common and is considered "ya gotta do what you gotta do" such as having to borrow meds or dressings, etc. Some things you should never do and are considered dangerous. This is not exclusive to LTCs. You know what is right so it is up to you to decide what you can or cannot accept. However, I would be afraid of being just as guilty by not saying anything. Good Luck to you.

[Wild Irish LPN, LPN]

I'm not questioning whether or not this is "appropriate," & yes, I absolutely know better. What I was questioning, in my lack of experience is whether or not this kind of stuff is the reality of the workplace in LTC. Thus far, my only experience has been in the lab & in a choice few clinical settings, & therefore I really am ignorant as to what the real work environment is like. My gut told me that this could not be the reality everywhere - & that is why I wanted input from real nurses who are out there working in real LTC facilities, to tell me whether or not this is the norm - meaning this is what I will find wherever I go in LTC, or if this is just an exceptionally poor facility. I appreciate everyone's input & advice. I did resign from my job, as my gut told me that my license was in jeopardy - I haven't been able to get malpractice insurance yet, so it was definitely a bad idea to stay. You live, you learn. I definitely have learned my lesson - as much as I love geriatric patients, I cannot work in a facility that is so poorly run, ethically, morally, & legally.

Sorry if I sounded like I was coming down on you....I am certain you are a great nurse....I am a recent graduate too and I was just coming from the stand point that we both just killed ourselves to get that license....I think it is awesome that you love your geriatrics too, the world needs great nurses like you....Maybe I am just trying to look out for ya :-).....Find a place where the standards are as high as yours, and Good Luck!....

[WildOne]

I'm a new grad, new LPN, new orientee to my first job in a LTC facility. Friday was my 3rd day on the floor, & my first time on the med cart. I am a bit frightened by what I saw & what I ended up having to do under pressure. Maybe I'm just a rookie, naive to the reality of what goes on in this type of facility & what you have to do to operate from day-to-day. Please tell me...

Is it the norm to have patients run out of meds & to have to borrow/steal from another patient's meds?

Is it the norm for a facility to run out of testing/treatment supplies & not be able to do proper treatments & tests on dozens of patients for the entire day?

Is it normal for nurses to sign off on whole med passes & treatments & not actually do any of them?

Is it common for nurses to skip vitals on multiple patients & then just "come up with something" to put in the chart?

Is it common to meet what seems like an excellent nurse only to have to do a double-take when they sneak a pill out of the patient's cup of meds on the way down the hall & pop it into their mouth - slide of hand?

Is it common to have a policy of "Here's what you're supposed to do, but in reality here's what we do to get by. I'm not telling you to do this, I know you're going to do it because you gotta do what you gotta do...but if you get busted it's your butt on the line."

To be honest, I like the facility I've been hired at. I like the people. I wanted to work there. But, after the last few times out on the floor I feel like I'm putting my license on the line. I'm hoping with all my heart that this is not the reality that's out there & you guys tell me to turn tail & run like the wind. I have a part-time temporary seasonal job lined up to start next month, but I don't want to burn bridges - I had connections to help me get this job.

Any advice for a newbie? Thanks!

The borrowing from other patients meds is normal but definitely not the watching your preceptor steal abd swallow someone else's pills!!! That needs to be reported

[Jawsona]

Noooo this is not the norm. These are things that need to be reported and stopped. Do not get into these horrible habits or you will end up harming a patient or yourself. Don't be one of those nurses we see on the news or hear about in school that made a huge mistake. Make an annonymous call, if you are not comfortable calling someone within the company call/email JCAHO http://www.jointcommission.org/ on the middle right hand side you can report an organization. You should be following standard work and taking care of your patients the way you would want to see your family treated. I doubt any of those nurses would want a nurse skipping out on their mothers vitals and stealing her pills. Stick to your gut, I'm glad you recognized these bad habits. Good Luck

[Jawsona]

I work at a hospital and that is NOT allowed, everything is tracked and audited. If there is no med we wait til there is one, which usually is not that long