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Specializes in Med-Surg, LTC, Rehabiliation Nursing.

Hi all,

Hoping for some insight, support, advice. I have now been working LTC for 9 weeks. I am a new grad, had two weeks of training, and been on the floor on my own since then, hired as a charge nurse. The job has been challenging, to say the least. I have 24 residents I am responsible for, plus the challenge of Cna's who have been there for 15 to 20 years, and seem to have something against me from the start. NOT all of them, just a few. I was pulled into the DON's office today and told that as of today, she would not reccomend me for hiring at the end of my probation period. The DON is new, started 3 weeks ago. I was told that my proffesionalism was not good, (I was giving report and did not know that DHS was there, and my supervisor told me afterwards that it was not okay to complain in front of them, I was giving the usual report, what was and mostly what wasnt done, ect., ect., my fault, but I did not know she was there!) I also missed dressing changes on one patient, the last time her dressing for her peritonial cath was changed was on 10/01, she is gone for dialysis on Tues and thurs from 6 to 1, my shift ends at 3, the docs come in at 1 to give orders, anyway, bad excuses, I did mess up, but I work only 4 days a week, what about the other 3 days? When I told my supervisor I was feeling overwhelmed, Which I was, they never let me do anything, then they throw it at me and say, "Why dont you know how to do this by now?" Anyway,those are really no excuses for my mistakes, but to call my professionalism to task when I am still learning? And to be written up? I have been crying all day. I called in sick yesterday, I had vomiting and diarrhea in the morning, called in at 5am, my scheduling director called me at 8am to ask if I could cover Thursday, my husband answered the phone and relayed the message as I was vomiting at the time. I dragged by butt to work today, despite a fever, chills and sweats, sore throat and a headache that made me want to vomit more. I really should not have been in there, I wore a face mask so as not to kill a resident with this bug. I had confided in my supervisor about my personal problems, she acts like a friend, only to have this thrown in my face during my meeting with her and the DON. I feel so betrayed, so very stupid.

WHY? What are the expectations of a new grad? I have had one med error, it was a transcription error on my part, I have done my best to maintain my professionalism during harrowing times, (residents sister sobbing heartbrokenly beside me, dementia patient hitting me cause I had 'her' shirt on, constant yelling, sundowning which I only get the very first part of, I know, ) God I feel like such a dummy. If you cant tell, I am feeling so stupid, probably because I really thought I was doing a good job. Maybe not a great fantastic job, but a competent, safe one, as I learned how to become a really great nurse, you know? I feel like a failure.

I was written up for concerns about my professional demeanor, my inability to focus, and time management issues. I do understand the focusing issue, she told me I let to many things 'distract me', like residents screaming out "HELP, HELP". It has taken me some time to know which ones are really needing help, but while I am learning, and I dont know the residents that well, how am I supposed to know which "HELP" is real or not? The time management issue is because of the dressing change I missed.

The Cna's dont report to me, and last week I heard them commenting on a resident who was playing 'possum', and I dont know why, but I thought to myself, "Jeez, he always yells at them when they are mad", and I went to check on him, long story short, his blood sugar was 56, he was going into a diabetic coma, and they would have left him in bed. I ended up doing IM glucagon, his physician came in, I assisted him in doing IM dextrose, and he came out of it. The doctor told me he would have died. I feel like I have good instincts, if I am just given the chance. Now I am evaluating every thing I do and say, I am afraid to talk to anyone, and I am so discouraged I feel like I made the biggest mistake of my life. I am so sorry to ramble on to everyone, I am just so hurt and discouraged, insulted and I feel so stuck. Sure, move on and find another job, and be a job hopper. To top it all off, my husband just lost his job.

Sorry everyone. Thanks for letting me vent. Friday I have to meet with the DON and my supervisor and give them my list of 'goals to hellp me succed in my job'. Half of me wants to walk out and say the heck with you. I have put my all into this, I am not half-***** with anything I do, and your expectations are ridiculous. The other half is to proud to let anything or anybody say I cannot do this job. In the meantime, I still have to pay the bills. and they wonder why there is a nursing shortage.

sorry about the typos.

Thanks for being here.

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I graduated only a year and a half ago as a new LPN. I remember how I felt when I first started out, too. It can be very overwhelming!! Hang in there--it does get better!

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I am sorry to hear about your situation.... I know I have been off the floor for many years, but where was your proper orientation? And how can a new grad be in a Charge position?:o

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Specializes in Med-Surg, LTC, Rehabiliation Nursing.

I guess that is my question, are they just expecting to much from me, and was I stupid to think that I could do it? My 'orientation' was my two week training period. Which when I mentioned that today to my supervisor, she said, "yes, but you have been on the floor for what, 9 weeks now?"

Is it me, or am I out of my league?

I am sorry to hear about your situation.... I know I have been off the floor for many years, but where was your proper orientation? And how can a new grad be in a Charge position?:o
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Specializes in Day Surgery/Infusion/ED.

I think you've bitten off more than you can chew. As a new grad, you're really just not ready to be in a charge position. This is the time for you to solidify your skills and build on the knowledge you got from your nursing program. Just because you have the license doesn't mean you're ready for the responsibility of being in a leadership position.

My suggestion would be for you to find a job in a hospital and get some basics down. If LTC is your calling, believe me, it will always be there. Don't put yourself in a position where your license could be compromised.

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Specializes in Med/Surg, ER and ICU!!!.

\ And how can a new grad be in a Charge position?:o

I started out as a Charge nurse. It is not all that uncommon in the area that I am in.

OP, wow, take a deep breath. Everything will be ok. How much longer do you have? If the DON has already said she does not plan to keep you, there really is not much else you can do. I would immediately be looking for work elsewhere. And I would just explain that were you are now is not a good fit for you. Be careful not to bash anyone, it can be easy to do, but you want to be professional. Also, if you are not going to stay there, and you can not find work elsewhere, look into unemplyment.

Now, for everything else, take care of yourself. Do not feel like you have to kill yourself for these people. They have already said they do not plan on having you stay:angryfire , so if you are still sick, stay out. It was good of you to wear a mask, and that used some great nursing to think of that , but still, you need to take care of you.

Ask the MD that you assisted if he knows any job openings, and if you can use him as a reference. It sounds like you at least have him on your side.

I mean for all this to sound supportive, and hope it does. If you need anything, then come back so we can support you. Good luck!

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Here's my $0.02 on this issue: QUIT as soon as possible!

If my nurse manager told me she would not recommend me for hire after my probationary period was up, I would see absolutely no point in returning to a place that does not respect me in return. Your skills would be appreciated at another facility. I wouldn't even bother returning to this place ever again.

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Specializes in LTC,Hospice/palliative care,acute care.
I guess that is my question, are they just expecting to much from me, and was I stupid to think that I could do it? My 'orientation' was my two week training period. Which when I mentioned that today to my supervisor, she said, "yes, but you have been on the floor for what, 9 weeks now?"

Is it me, or am I out of my league?

It sounds to me like they have just thrown you to the wolves.Either they are willing to work WITH you and help you mature as a nurse or they are going to victimize you.You are actually getting sick over it-is it worth it?At our LTC we have never thrown a new grad or even a new employee right into day shift charge nurse.What are they thinking? The issue with the aides is enough of a challenge (they always give the newbie a rough go-search out the other threads here on that topic) but throw in the charge nurse gig and you have a recipe disaster.Is there another unit you could move to-a larger unit with a team of nurses? We have units ranging from 44 to 22 beds-and none of the nurses that have come on board in the past year or so are in any way ready to charge any unit.(no offense-you sound like you have something on the ball-some of the nurses I am working with are downright scary) A unit that size can get pretty hairy for one nurse.I get through those days by hitting the ground running in the am .I do dressing changes aearly in the shift and date and initial them.You learn exactly where you can cut corners and that is not a good place to do it.I try to get through the med pass as quickly and efficiently as possible-if you get bogged down and then have an emergency you are screwed.Our docs all have a schedule for their rounds -that helps alot.They never just pop in. Even though I have been doing this for more yrs then I care to admit I still make myself a check list every a.m. and review it through the day.That's the only way I can be sure to get everything accomplished.Maybe that means I have trouble focusing in and staying on track but it works for me...Also-don't put work ahead of your health.I have learned that they will suck the life right out of you if you let them and in the end it won't matter-if you are sinking they won't even through you a life jacket..I have seen many a co-worker learn that sad truth...No job is worth your health and sanity.I think you can find a better situation elsewhere.Have your meeting this week-take along a list of your concerns.You need support first in dealing with the cna's.They can NOT jeapordize the residents just to haze you and they are working against you instead of with you.I really think that this is the root of the problem If they were seeing to the needs of their residents you would be better able to carry out you duties.Let them tell an inspector that a resident yelling "help,help" is faking-big trouble,baby.They have to learn RIGHT NOW that there behavior is unacceptable-they must report any changes to you immediatly.If the DON does not back you there then I would say the best thing is to give notice.good luck
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Specializes in Cardiac/Tele/Step-down.

Don't let it get you down. I'm sorry this is happening to you. If you were one of my close friends and were telling the exact same thing this if what I would tell ya. "only my 0.2 cents"

OMG! Are you serious?

Quit! I work at the hospital and orientation was 12 weeks!

We just hired a new charge nurse and she orient for 2 weeks but my gawd she was been a nurse for 2yrs some where else. Try the ER or med-surg. No way I would be a charge nurse straight out of school, even if it has been 9 weeks! Who cares! You can't learn everything over night or 9 weeks! My gawd you would assume someone who had been @ the LTC for 15 yrs would be able to tell if someone's BS bottomed out. Heck you with only 9weeks plus school knew that! How you s'pose to know what to do or say infront of DHS if they hadn't told you.(Why should there be a problem with what you say anyways? Unless they are already on their bad side at DHS) Sounds like they got bigger problems. You can't do everything! RUN I tell you RUN! You have to have a good team to make things work. Sounds to me they might be a little grumpy that you are so new and a charge nurse.

ok that's all

:monkeydance:

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Specializes in Med/Surg, Ortho.

I agree, go find another job. Who in their right mind would suggest that a new grad/employee of 9 weeks come up with "goals" to help them succeed on their own. Isnt that their job as your peer/supervisors to HELP you come up with attainable goals to help you succeed?

My guess is they have a "friend" waiting in the wings to fill your position when your 90 days are up and they dont hire you permanently. Dont let them waste your time. Offer 2 weeks, go find another job and i dont know that i would bother fulfilling the 2 weeks if i did find another job. Let them swing like they have you.

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Specializes in nursing home care.

Hi friend,

I totally undertsand where you are coming from. In the UK very few graduate nurses choose to work in LTC - I am the only one I know of who did as I have a passion for LTC. The sad fact here in the UK is that many homes run with one nurse on duty, I got three days induction in my current job and I have nursed for 4 years - I felt overwhelmed and had 3 really crap days afterwards. The long and short of it is that there are better facilities out there. Previous to this post my first job after graduating was in a crap home that did not care about residents, I was put on with an italian nurse who made repeated drug errors and did not speak english very well - I quit after 4 weeks! Then I found StF a haven, I was given one week induction to the 20 bed unit and there was always a nurse on duty in the upstairs unit for support. The carers you encounter will come in three varieties 1 - the been there, seen it all, know it all variety 2 - the inexperienced but willing to learn variety and 3 - the do gooder who feels the need to report every breath of a resident! Carers can be bossy especially if you are younger than them (I think this is an authority issue) but stand your ground. I feel it is good to explain your actions to them, it helps them understand and learn from you. Get a new job and hang in there, you will learn, LTC is great to work in and you will work on your instincts more than any other sector. Good luck!;)

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Ahhhhhh.......New DON, DHS on the premises, new charge nurses (and new grads at that)......

In LTC this all screams: PROBLEM FACILITY!!!!!!!!!!

Run...Run very, very fast. With all due respect to some of the other posters the situation will NOT get better for you, at least not at that facility.

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