Just started my first nursing job in LTC and it is killing me!!!

[namazonian]

Hi all,

I just started a job in LTC in NJ and am still an orientee (4 weeks left) and I already hate it. At this point I'm not sure if the hospital setting would be much better because I realize that it is nearly as stressful. I'm kind of upset that I spent so much getting my BSN through an accelerated program (had another degree) so I don't want it to go to waste but now I feel like the only thing keeping me is the fact that besides feeding myself and paying bills, I have to pay back all these loans. I would like to say first that I did not get into this for the money as this was a career change I made because I didn't want to pursue my masters to become a PT. I felt that in my prior experiences in working as a unit clerk, PT assistant, and home companion while I was completing my previous degree in Exercise Science and Sports Studies that I would enjoy nursing so I decided to go for it within 6 months after I graduated with my first Bacherlors.

I am being oriented by people whom I believe to be very knowledgeable and kind but I am being taught "short cuts" because the work load is just too much. I've been told that "there is the facilitiies' way, then there is the real way." At first I thought that this was not that true, but how wrong I have been because I've seen nurses on my floor and others so overwhelmed that they've fudged numbers on vitals and even scheduled meds together just to save time. I feel like a drug bartender, maid, and a slave all at the same time on a daily basis pushing a cart up and down the hall during med pass in which we "are not to be interrupted" but is a fallacy. One couple threatens to "have us fired" if we don't hurry up with her vicodin while I have to keep an eye on a confused woman who recently fell and keeps continuing to walk around without her walker and can't seem to sit for 1.5 mins without getting up and wandering and asking me where her teeth and glasses are even though I reassure her that they are on her face and in her mouth. They tell me that this is a "no lift facility" even though I already had to lift a patient into bed because there was no one to help and there was only one hoya lift on the floor that was in use already. This same patient I had to help into bed already had family that came in that threatened to sue because he had fallen once and they accused us of not being vigilant enough.

It scares me and annoys me constantly that we can and will be written up for staying late too much because of not being able to get everything done on time. I'm still learning and even up until now with the 36 patient per nurse load, although I only have 18 for now, its still too much to get done in the 8 hours. I've not been oriented on my shift because "there were no eligible nurses to orient me" so I may be left alone after the next two weeks on my assigned shift of 3-11 and all this while I've been oriented on days.

Already I've witnessed things that made me question how corporations can continue to squeeze the life out of the bottom line just to make money. I attended an "inservice" which entailed us being talked at rather than being spoken to, about how we need to be more cautious of how we prevent infection control even though only 12 of the 24 rooms on the floor had hand soap and some of the hand sanitizer dispensers were nearly empty. We were then told that at "XYZ facility, the patients are allowed to do whatever they want and we just have to let them."

I and the CNAs who happen to be of color, were called N's to our faces and told we were !@#$ers because a patient lost a football jersey that his dad got him for Christmas and he thought that we stole it. All the while of him spewing explitives and racial slurs for 5 mins straight an ADON was present and didn't even budge until he started to throw things and that's when she finally intervened.

I got sick last week and have been trying to work through it and between what I'm dealing with, not getting to take breaks, and just feeling generally overwhelmed and drained, I feel horrible.

This is week 3 of orientation for me and 2.5 weeks on the unit and already I am thinking of looking for something else that will hopefully encompass my nursing and previous degree while keeping this job on the side after 6 months. I've started job searching again and feel so sad that its come down to this once more. I'm not sure what else to do and if it will be better. I will not quit and know that I "have to find my niche" but med surg sounds like more pain if anything or just as bad. If anyone has been in this position and knows what else to do please let me know because I refuse to be unhappy after working so hard to get to this point and I can't leave my job because I need the money.

[taalyn_1, CNA]

LTC isnt for everyone. Hospitals and LTC facilities are all short staffed, administrators are all worried more about saving money for their bonuses than hiring appropriate staff, and families always think their mom or dad are the only residents that need to be taken care of... NOW. :nuke:

BUT, LTC can be very rewarding. I know I am only an aide, and dont have the added stress that Nurses have (yet), but its very great when one of these little people tell you thanks for finding their hearing aid, or for getting them polygrip for their dentures which no one else had done for them all day, etc. Its the little things that mean so much, and regardless of the crap staff goes through, the residents need us there, because if the family could (or wanted to) take of them better, the residents wouldnt be at the facility. I am sorry you have had such a rough go so early on at this place, but maybe if you can focus on giving the residents the best care you can, maybe you will see a small reward in the faces, smiles or even a small Thank you that might make it all worth it?? Good luck and I hope it gets better 4 you.

[Ms.RN]

Hi

Ive worked at LTC for couple of years and 36 patients seems to be too much for one nurse. I think the average ratio is like 25 to 30. I want to ask you this: Do you have enough staff? Are managers supportive of nurses and listens to you guys? For me some nursing homes are better than others. Better patient raitos, managers acutally helping nurses, managers actually listens to what nurses have to say about patient care.

I recently quit my nursing home job that sounds exactly like your facilily. We cant send patient out to the hospital, they send CNA home so we are always working short, managers talk to us like we are some kids, and lot of blaming games. I've learned that the best way to work in LTC is acutally not to listen to the managers but to advocate for the patients and the staff, like if my DON says I cant send patient to the hospital, I'll tell her to talk to a doctor first becuase I know patient really needs acute care. Have you looked into subacute care facility? Nurses usually have aout 20 patients and they are similar to med/surg units in the hospital. Once I worked in ventilator unit and I enjoyed it.

[Up2nogood RN, RN]

It is never okay to be spoken to in a derogatory, prejudicial manner with racial slurs. That your ADON stood by and did nothing shows what a poor facility this is. I wouldn't even finish orientation here. I would find something else like yesterday, I know there has to be better LTC's than this. I hope you can find someplace that treats you with respect but please don't stay in that craphole.

[elprup, BSN, RN]

namazonian - I hear you and feel exactly the way you do. That is exactly why I didn't last more than several weeks at the place I was at. I am now in a different area of nursing, that I actually really like, and my coworkers are great, but the pay is sooo low and I am being soo overworked that my health is starting to deteriorate again. I called in sick today and basically may not have a job anymore. I am too wondering if I will ever find the right place for me, and one that will actually train me rather then my always winging it because they are short and cannot afford it. Nursing is so dysfunctional it's scary.

Document what happened now and keep documenting any other derogatory racial slurs that happen and who was there/what was/wasn't done if you stay on any longer. That is not ok anywhere. The job market sucks out there, but until we start standing up for ourselves in these types of jobs, these types of jobs will keep working us to death.

[MntnGirl]

I have never worked in a LTC facility, I started as a new grad RN on a Med/Surg floor about 1 year ago and yes, there is stress and it can be hectic, but my experience is not one bit relatable to the one you've had. I work graveyard shifts (LOVE this shift) and I find that I can get everything done and have ample time to take breaks and such. Typical patient load is 6-7 patients and we have aides which helps out a lot. Honestly, I have no desire to work in a LTC facility. What I like about working in the hospital is the turnover of patients, when I have a bad day or 2 I tell myself that when I come back next week we'll have new patients. I guess in a LTC that is not the case, these places are the end of the line (in most cases) for the patients (until they end up back in the hospital). The place you work for does not sound safe or supportive - lifting a pt by yourself is very dangerous for yourself and the pt, being verbally abused should not be acceptable, and the lack of basic necessities such as hand soap, are all reasons why you should look into starting your nursing career in a different environment. Not all LTC are like this, you just happened to end up at a bad one.

[namazonian]

Hi Ms. RN,

I have thought of subacute care because during the interview, I was lead to believe that our facility has sub acute care characteristics (we have a floor that is acute care) and that I would be exposed to acute cases but for the most part I think I will be relegated to the more long term care floors unless I get floated elsewhere which will not be anytime soon I'm guessing. Now that you have mentioned it, I think I will start looking into subacute facilities in nj/ny.

[namazonian]

Hi Mntn girl,

I would have liked to work in hospital but it has taken me soo long just to find work and with loans, bills, and more hardships I took on this job in LTC. I'm hoping that as I'm looking again now that I will find something as it is quite difficult, especially if you don't know anyone. I will still keep positive and continue however.

[Altra, BSN, RN]

I and the CNAs who happen to be of color, were called N's to our faces and told we were !@#$ers because a patient lost a football jersey that his dad got him for Christmas and he thought that we stole it. All the while of him spewing explitives and racial slurs for 5 mins straight an ADON was present and didn't even budge until he started to throw things and that's when she finally intervened.

I'm sorry this has happened to you. This is not acceptable, ever. A call to the EEOC might be in order.

Hoping that you find another job very soon. This one will not improve.

Good luck to you.

[Caffeine_IV]

I hope you have been filling out other applications. That is an unhealthy environment.

[RN1263]

I and the CNAs who happen to be of color, were called N's to our faces and told we were !@#$ers because a patient lost a football jersey that his dad got him for Christmas and he thought that we stole it. All the while of him spewing explitives and racial slurs for 5 mins straight

I would have turned on my heels, walked away and let him eat my dust!.... What a creep!

I hated med/surg, only did it for three mo., then went into home health. I've been there for three years, it's the best kept secret in nursing!

You don't have much experience, so if you can hang in there for awhile you'll have a better chance of finding a job elsewhere.

Good Luck

[namazonian]

Hi RN1236,

I pray every day that I can continue on. I just feel so sad, stupid, and lied to that nursing wouldn't be like this but I feel that it just is. I am so much in debt but I just want to be happy. I love caring for people but I feel like I'm a doormat with excess responsibility.