Lowest of the Low

Specialties Geriatric

Published

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.

Specializes in Telemetry, post partum, critical care.

wow - let me just share a few of my choice memories from 1985 when i started as an rn. first of all i got a new grad program at a very large hospital chain. it was a thorough orientation and i was put on day shift on a very busy med/surg unit. oh wait - that's not the beginning.

during nursing school i worked as a nurse aide at a medium sized community hospital. after being there about three months the night sup called me into her office. she took out this writing tablet - a huge legal size and showed me about two to three pages of staff complaints against me. bear in mind that i was a cna - a new one at that. as i was a nursing student this was totally devastating to me. i don't remember what the complaints were specifically - just that i almost started crying when i saw it. i mean, the shock of being there so long knowing that someone was keeping a list of my mistakes and not sharing them was a little hard to take! i came to find out that this would repeat itself throughout my career span. ineffective and lazy management bow to certain staff to protect their own butts and it is very common. i'm not talking about exposure to one hospital either. a very effective way for managers to protect their position is to hire a "pit bull" charge nurse and let her go to work on the staff. anyway, the supervisor did not seem to care or show any emotion regarding my plight. coldly she said "i'm going to extend your probation". she was going to fire me for these "infractions" - and without any counseling or warning whatsoever! it was clear that she was such a miserable and hateful person that she enjoyed what she was doing too. fast forward to my graduation from school and applying to that same hospital as a new grad. the director of nursing sat in her office waiting for me, drumming her fingers on the desk and glaring at me for being 15 minutes late. i said i misunderstood the time of our appointment and apologized. she pulled out my file - and the list of infractions saying to me in a very cold voice "i thought you said there were no problems with your performance". i didn't get that job. on to being a new grad. i was responsible for entering orders because we had no secretary on the day shift. i missed entering a b-12 level because on this particular patient there were about 50 orders. the nursing manager called me in to her office and gave me a formal counselling. i was crying because i was so frustrated, upset, and overwhelmed. she looked at me and said "i don't know if you're worth it" - meaning that she didn't want to deal with me at all. i am not looking for pity here. i am telling it as it is and it's not a pretty picture. i'm sorry you are gong through that. it sounds like hell and maybe you will need to last one year before you can get out of there. try to avoid taking it personally. fly "under the radar" and avoid conflict with anyone. that's my recommendation. it may sound cowardly. however, the new manager is new (three weeks as you said). she is playing politics to solidify her position and does not care about you. your only hope (if you don't care about being fired) is to write this up and take it to the director of nursing. even if you leave you will have planted a seed as to this manager's character. in nursing it all depends on whether you can get the job done. right now the nurse aides have more longevity and political clout than you. this will change in time. you have my sympathy! :nurse:

Specializes in Telemetry, post partum, critical care.

also i agree with those telling you to consider leaving. especially when you are a new grad it might take you a few tries to find a supportive environment. you don't want a situation to occur that will invalidate your license. you are the most important thing here - not that nursing manager or the facility. you have to take care of yourself first and it sounds as if you are alone in a war zone!

Specializes in Med-Surg, LTC, Rehabiliation Nursing.

THANK YOU all for the support. I sat down and wrote a list of my 'goals for success', and gave it to the DON and my nurse manager. They stated that they were very impressed. We will see. I have two more weeks to make my decision. I really do like my job, (much to my suprise, I did NOT think LTC was in my future), and at this point, I hate to give up, having truly put my all into this. So I guess I will see at the end of my probationary period. Will keep you posted, again, thanks for the support!

KristyBRN

THANK YOU all for the support. I sat down and wrote a list of my 'goals for success', and gave it to the DON and my nurse manager. They stated that they were very impressed. We will see. I have two more weeks to make my decision. I really do like my job, (much to my suprise, I did NOT think LTC was in my future), and at this point, I hate to give up, having truly put my all into this. So I guess I will see at the end of my probationary period. Will keep you posted, again, thanks for the support!

KristyBRN

Kristy - hope it works for you!! :) If not, you'll know you gave it your best shot. Good luck!:flowersfo

I agree with The Commuter. I would not even bother to return and just look for a new position elsewhere that is going to give you proper training and the respect that you deserve. It's sounds as if their are unorganized!!

I cover 43 residents in LTC--it is insanity!! That being said...in my opinion, a new grad should NEVER be hired as a charge nurse. If you feel like you're not ready, maybe you're not...not your fault. You just need a few notches on your belt before you are in charge! Best of luck, how awful to be so upset and sick. You should be enjoying your new job.

Get out now! Go get a job in a hospital where you'll hopefully get a better orientation, and have some support.

I started out in LTC, went through their CNA class, then went to school and got my LPN, then RN. It was great there as a CNA, but as a nurse, I was in fear every day for my license. They had me spread so thin and in charge of too much. And when I expressed my concerns to the DON about being the only RN in the building after 5 pm, and therefore house supervisor by default, I was told not to worry about it, "You have good experienced LPNs here, so you really aren't house supervisor." But if DHS had walked in, they would have come immediately to me. I tell you this because your story sounds a lot like mine, and I was a new grad and questioning my career choice.

I didn't truly enjoy my career until I went somewhere that supported me!

[Hi There

I am an RN in Australia (i'm in my 2nd year out) and we do have similar problems with new grads being placed into senior positions (charge nurse) in aged care facilities. I remeber how overwhelmed I felt when I started as a new grad in the hospital. My mother in law has just left an aged care facility after working in that industry for around 20 years. I seriously had not seen a week go by where she was not complaining about the workload, and she is experienced. I managed to talk her into applying to a hospital and her life has changed. She is soooo much happier and her workload has about halved. My advice to you is to apply for a grad program (if u have them over there) and work within your scope of practice as a new grad. Let everyone around you know your new, and if anyone gives you a hard time stand up for yourself. As alot of others on here have suggested, leave now before they let you go, otherwise your confidence as a nurse will drop and they simply are not a caring helpful bunch of people. Good luck, I hope it all settles down for you, hang in there it is overwhelming, just always remember to only take on those tasks/jobs where you are working within your scope of practice.

Tracy

A new grad in a position of such authority/responsibility is probably the mistake. Yes...we want to be in great positions with good pay, benefits and the feeling of responsibility because we have just spent so much time being a student....but...know your limitations. Distraction of any type, personal, professional has been known to interfere with your ability to concentrate. Maybe it is time to step back and rethink where you want to be. Being a new grad is overwhelming in and of itself, never mind supervising people that have been there since the beginning. Sometimes, it's ok to say I can't do this, where else may I be of benefit to this organization? Propose staying in a different position and show them your talents and you may be able to flourish from there! If you go to them with your thoughts of being overwhelmed, they may be able to offer you some help with time-management, etc.

Specializes in Community Health, Med-Surg, Home Health.
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

That was what I was thinking...it would take at least a year of so to be acclimated to the environment to take charge of a whole unit.

My question would be what happened to the last charge nurse? I think the DON and the sup are dysfunctional and they've chose you to be the whipping boy for their enjoyment.

Do you even have to give 2 weeks notice? If not, I wouldn't.

Good luck!

Specializes in ICU, HOME HEALTH, NURSING EDUC, CASE MGT.

Hi KristyBRN,

What a sad situation! Seems like your LTC wanted the warm body, but did not take the time to properly train you. Nobody is born a nurse! For a new grad. to receive only 2 weeks of orientation tells me what they are all about. Why did'nt they team you up with a seasoned nurse/mentor/preceptor??? And, I totally agree...why did'nt you get fair warning that DHS was present?

We are all human! We make mistakes and hopefully we grow and learn from them. Unfortunately, this appears to be another opportunity for nurses in which they eat their own, management does not care, or some other senseless reason. The picture is clear...you were not trained properly,

there is no support, and your work environment is toxic.

The decision is entirely yours to remain, "suck it up, and see where it goes. Or, start looking for another job immediately. If this situation is making you a nervous wreck and your health is being affected, is it really worth it? There are other jobs out there. And, since this is your first...I personally would not bother with putting this LTC on my resume.

No job is perfect. But, I agree that wherever you go it is important that an individual is afforded the opportunity to grow professionally, given the tools to get to the level where they need to be, and provide a positive environment, in which it encourages you to become the nurse that you want to be. Let's also mention about having a supportive management. Best wishes in whatever choice you make. Life is short! Enjoy the journey that you are taking. Keep in touch with us, and let us know how things turned out. Remember...we are always here for you!!!!!

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