Lowest of the Low

Specialties Geriatric

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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.

dear colleage

sounds like too much too soon for anyone in the same position.

if they have said they wouldnt reccomend you well realy thats the end of the story. somtimes your face does not fit, thats life.

its hard not to take it personally, but try because thier are always alternatives

from the conditions you have described many nurses would have been overwhelmed to say the least. their is always agency work while you sort out what to do so dont despair.

as a new starter start small next time and try not to be pushed into higher duties untill you are ready.

take care of yourself first becaues if you dont you cant take care of anybody else

the ultimate truth is things always change

YOu need to quit that job. The future doesnt look very bright...as a matter of fact, it seems to appear very dangerous.

THen when you find a new job...please watch what you say. Dont gossip, limit your complaining (at best dont even complain), and make friends. If you dont build a healthy relationship with the ppl you work with, you wont survive. If the DON is telling to you that "she wouldnt recommend you for hire"...that bad...real bad. Youre a new grad, you can't start spitting out, in front of everyone, what wasnt done, what other's arn't doing, etc....be courteous, respectful, and be humble. If you went in with an EGO, you need to get rid of that pronto.

Specializes in rehab, antepartum, med-surg, cardiac.

KristiBRN,

RUN, don't walk, to another facility and apply for a job. :madface: You are risking your license by working in your current facility. They should never have put you in a charge nurse position since you are new to nursing.

There are too many other places that will give you an adequate orientation period, support, and will mentor you while you learn the ropes. Please don't even go back to that place. They have already told you what they intend to do. You don't owe them a thing.

And don't worry that they will somehow give you a bad reference. I wouldn't use them as a reference at all.

Good luck!!!

I'm sure you are feeling better by now. I have been a nurse for 10 years and my tip would be to start on night shift. I started as a charge nurse on night shift and then after a year moved to days. It is easier at night as there are less meds and treatments, the doctors are not making rounds and writing a bunch of orders, patients are sleeping, therapy team is gone, family members are not there making demands, etc. Just you and the aides and the patients, you have time for assessments and taking care of issues as they arise. I thought it was a great way to ease into nursing. I hope I'm not offending any night nurses, but in the experiences I've had, ICU/floor/nursing home, night shift is usually less stressful and busy. As a person who hates the feeling of missing something, missing following up on an issue, I choose to work were that is less likely for me. Also, consider a different type of nursing, like home health, where you can concentrate on one client at a time. Good luck!

Have you wondered why they sent you to be charge nurse? Maybe because they can't find anyone to cover that floor and needed to put a raw nurse there. Cripes, what a position to be in. On one hand, you can tell them what they want to hear so you can keep the job but drive yourself nuts second guessing yourself. You could ask for a different position. Whatever you decide to do, bide your time until a better job opens. Private Duty pays very well and you could go through an agency.

Specializes in Long term care, psychiatric.

I think it is fairly common in long term care to give a brand new nurse about 1 week or less orientation and then leave them in charge of up to 40 residents. It can take several months to feel completely comfortable with your new position. Until then ask your co workers for help and advice when you need it. such as how to prioritise The CNAs will try to test a new nurse, let them know what behavior you will not tolerate. I would look for another job. Maybe some of your former classmates can recomend a place that will offer you more support. Good luck and it does get better as you gain more experience. Sometimes it is a good idea when you are new to not air too much frustrations at work as it is difficult to know right away who to trust with yor opinions.

Specializes in pedi, disabilities, school, geri, home.

I am sorry to tell you this, but you need to hear it. If you have not already done so, quit this "job" which is not a career step for you. I will brielfly give you some reasons why I think this way. As an outsider looking in, & with 28 yrs experience, let me give you my take on this one.

First and foremost, RUN! RUN! RUN! from this supervisor, DON & this facility! Honey, do not question yourself. Do not begin to doubt your knowledge & the good nurse you know you are simply because a foolish, misguided, unprofessiional, supervisor & DON can't handle their positions. Leave this "job" immediately. Find another to start your "career."

That DON obviously does not know how to handle her position if she is hiring "green" nurses to do charge. It takes experienced seasoned nurses to do charge of a LTC floor. In no way is that a slight against a new grad. I was there too. But that is the reality of LTC.

If any DON, or supervisor does not want you after your probationary period is over becuase they do not believe in your professional skills, but they are willing to let you work out the entire probation period well, then, it is they who should be questioned. If they do not think you are not good enough for the residents after the probation is over, how can you possibly be good enough for the residents now? Why don't they just cut you loose now? I will tell you why. Because they can't. Because they are short staffed right? Don't let them play with you like that.

So, you see, the problem does not rest on your shoulders. It begins and ends with the superiors who hired you for the wrong position. They set you up to fail. They needed to fill a hole and they did with the first warm body.

According to your entry they gave you little to none oreintation, which should have been quite extensive considering the position you were taking over, and how green you are. So, don't go beating yourself up just yet. Leave some of your strength for those who deserve it. Don't allow any unprofessional supervisor or DON that you do not respect to feel you are not a good nurse. Shame on them not you!

I agree you should look for a new job, I have worked in LTC and it is getting worse not better, most places I see now, you have 40 patients and usually just two CNA's. I remember working one holiday in a LTC skilled unit, had 45 patients, lost alot of weight that day, from having my butt chewed off by all the unhappy family members. And I was only the agency nurse there for that day and had never been there before. Find another job you will not regret it and it might help you feel better about nursing in general. :nurse:

I agree you should look for a new job, I have worked in LTC and it is getting worse not better, most places I see now, you have 40 patients and usually just two CNA's. I remember working one holiday in a LTC skilled unit, had 45 patients, lost alot of weight that day, from having my butt chewed off by all the unhappy family members. And I was only the agency nurse there for that day and had never been there before. Find another job you will not regret it and it might help you feel better about nursing in general. :nurse:

Yes, I agree that things are getting worse. Just as the acuity in hospital patients is getting higher, so is it with some care centers.

Run away from this place. Give them the two-week notice and find another job! Life is too short to be stressed............there are better jobs out there.

It is not worth the stress and the agravation and worst of all your licence.

Wave them goodbye

I am so sorry that you had this experience. You have found out first hand how some facilities work. They put you in the situation because they need someone there and did not take care of you. I get very angry when this happens, but you will find it happens a lot. The problem is not with you, but with them. As nurses we used to have mentors who were assigned to new grad's that followed them even after orientation. They were avaliable to you to ask questions to and be avaliable for insights and feedback. I don't think this is a good situation for you and you may need to move on and find another job. During your interview you need to ask about your responsibilities and ask if you will have a shift supervisor avaliable to you if you have questions. You seem like a good nurse and just need some time to grow and learn. Don't let this first experience get you down.

Specializes in Med-Surg, LTC, Rehabiliation Nursing.

THANK YOU ALL SO MUCH FOR YOUR SUPPORT

Every single person who replied gave me something to think about, and most of all,the emotional support I needed.

UPDATE........After my written goals to succeed was given to the DON and my nurse manager, I was told they were very impressed. I have also made an effort to live by my words. I cannot learn it all in such a short time, but I can and will maintain my calm in the midst of chaos. :chair: I am also covering the weekend Baylor shift for 5 weeks, (the Baylor nurse is on military duty), and I cannot believe the difference on the weekend shift. First of all I have a wonderful experienced nurse, (she is Filipino, reminds me so much of my mother-in-law), friendly, and soooo calm and capable.) It is such a different atmosphere, it is like working in a completely different place. My last two weeks of probation period are up next week, if I am not hired full-time, well, SoBeIT. I know in my heart that I have given it my all. I have discussed this with my DON, and she has said to me that she is very impressed with my "change of attitude". I did let her know that MY attitude has not changed, she simply saw me on a very bad day, when Iwas overwhelmed and close to crying. In other words, the calm capable one is the real me, but jeez, we all have bad days, huh? I also let her know how shocked I was at her attitude that she was ready to give up on me without even getting to know the real me, and/or my accomplishments. She acknowledged that she had probably seen me at my worst, and basically stated that she has changed her position on keeping me. Despite the initial instinct to cut and run, I think I am going to continue with my position. The CNA's present a challenge that is going to probably be there in any facility I work with, correct? So it is up to me as the charge nurse to find my balance, and not let them knock me off my stride. It remains to be seen if my choice to stay is the right one. I do feel so much more confident, and i have three more weeks of working the weekend shift and learning from my co-worker. After that, if I must go back to the weekday chaos, (this is still up in the air, if the nurse with the baylor position is called to active duty, the baylor position is mine), but if I must go back to weekday chaos, then I will do so with more confidence in myself. It also helps that every day I am learning skills that will stay with me a lifetime.

Again, thanks so much for your support, emotionally I would have felt so alone without all your input. I have been actively recruiting friends of mine from nursing school to take advantage of this wonderful tool.

Thank you Thank You ALL!:thankya:

KristyBRN

Do they expect you to ignore every help? Even those who constantly cry wolf may at some time need real help. You cannot ignore that. A coworker once made the mistake of ignoring an elderly man who had a habit of yelling "help" and then one day he yelled "help" and she ignored him. Turns out he did need help as he had slipped out of his wheelchair and had broken a hip.

You are a new grad and they should be more considerate. Two weeks orientation does not sound like much. I'm an aide and I rec'd a month of orientation.

IMHO, you should quit. From your post, it sounds like it isn't going to get any better. Management sounds like it has an attitude problem. Is the turnover rate high? I would quit before I was accused of something I didn't commit. Good luck.

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