Advice for a brand new LPN at a LTC facility

  1. So I am a new LPN that just got hired at a LTC facility while still in school for my RN degree. I have never worked as a CNA before so this already puts me at a disadvantage. I want to offer the best care in a timely manner and not make serious mistakes while still learning. Any advice from taking doctors orders, to advice on med pass, neuro checks after a pt fall, charting, and forming a good relationship with the CNA's. ANY advice is extremely appreciated!!!
    Last edit by Scrublife16 on Dec 3, '16
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    About Scrublife16

    Joined: Dec '16; Posts: 3; Likes: 1

    7 Comments

  3. by   Livelife100
    I am a LPN from March 2016....i have left 2 union jobs already ,reason is I hate the staff atitude,they speak to me with disrespect, treat me like a child . They expect me to function like an experience nurse ,with speed and all knowledge like some who have been there for years, my last job they put me in the worst situation and expected perfection and then treat me like crapp after, I love helping others but nursing field is not what I expect it to be it is all about speed and not Care. I am going to try Homecare . Don't even want to do my RN I am already disgusted by these nurses who act like b.....
    I wish i did PT or something else, nurses I have meet are mean for no reason,I guess I am to soft for this career , to survive out there maybe I have to be mean also.. I am so discourage and disappointed.
  4. by   NurseNick4994
    To form a good bond with your CNA's, make it known that you aren't afraid to get in, get your hands dirty, and help them. They will greatly appreciate that. I also found my CNA's work better with me when I keep them in the loop about their resident's condition. At the beginning of my shift I meet with my CNAs and quickly give them report on the residents, what we need to look out for, etc.

    For the med pass (no matter what shift) you will need excellent time management skills. When you have 20+ residents to pass meds to, do treatments for, deal with falls and other things that come up, there is little to no room to waste any time. Make sure your med cart is stocked before you start. Over a period of time you will learn all of your resident's quirks, how they like to take their meds, when they want them, etc. Also, don't worry about speed when passing meds, that will come with time and experience. For now, focus on accuracy because nothing will put you behind more than making a med error and having to do all the paperwork that comes with that.

    I always chart from 1800-1900 (I work swing shift and this is usually when I have down time). Never do your charting at the very end of the shift because you will forget important things to chart due to the fact that you will be rushing. At my facility we have to chart on new admits, resident's that have fallen (for 3 days), resident's that are on antibiotics, resident's that need skilled nursing care, and anything else that pops up on our alert charting list.

    Assessing your residents is another issue. You will need to get really good at doing a very quick focused assessment because, as we are all aware, you will never finish if you do a full head-to-toe on everyone like how they teach in school. Try to focus your assessment on whatever the resident's main problems are. If they have COPD you will want to assess their lungs, get a pulse ox, ask about shortness of breath, assess their color, etc. If they have a g-tube you will always assess the bowel sounds, patency, etc. Over a period of time you will get really good at doing focused assessments based on what your resident's needs are.

    When calling the doctor make sure you have all the information ready for any questions the doctor may have. Always have a new set of vitals if there is any change in condition, make sure you know the allergies, etc, etc. Nothing will make the doctor angrier than when you call them but you don't have all the information you need.

    I'm a fairly new nurse as well, so I don't exactly have a lot of advice to give, but I certainly hope this helps.
  5. by   quiltynurse56
    NurseNick said everything I was thinking.
  6. by   BSNbeDONE
    Quote from Livelife100
    I am a LPN from March 2016....i have left 2 union jobs already ,reason is I hate the staff atitude,they speak to me with disrespect, treat me like a child . They expect me to function like an experience nurse ,with speed and all knowledge like some who have been there for years, my last job they put me in the worst situation and expected perfection and then treat me like crapp after, I love helping others but nursing field is not what I expect it to be it is all about speed and not Care. I am going to try Homecare . Don't even want to do my RN I am already disgusted by these nurses who act like b.....
    I wish i did PT or something else, nurses I have meet are mean for no reason,I guess I am to soft for this career , to survive out there maybe I have to be mean also.. I am so discourage and disappointed.
    A lot of nurses that you encounter in LTC facilities are "mean" because that facility is more likely the end of the road for them. (This is not to say that all LTC facilities will be like this). They realize that they don't have what it takes (motivation) or the desire to move up or move on. So, they settle in, become complacent, and territorial. This place becomes their sense of 'power', a chance for them to throw their weight around with newcomers because newbies are easily intimidated. Attitudes like these should be motivation for you to pursue your education and make things better for you by moving on with your career, not an experience that discourages you from progressing past the entry-level point of nursing.

    If you allow a couple of nurses at two facilities to run you out of a career as broad as nursing, then you've not really learned or heard about the vast amount of opportunities available in this field. Right now, you are just entering the field at the very bottom of the nursing barrel. If it was your choice to become a nurse, you'd be doing yourself an injustice by formulating such an opinion as the one you currently have, and walking away with only two positions and 9 months in. You've not even stuck around in one position long enough to learn the ropes that gives one confidence.

    Your LPN license is the gateway to making your career into what you want it to be for you. You should not let a few barking dogs send you running with your tail tucked. My advice to you is whatever job #3 may be, hold on to it for the next year or so because if you don't, you're on the verge of committing professional suicide.
  7. by   Livelife100
    Thank you for responding, I did felt like I choose the wrong career and I am the only one experiencing this nightmare but I look at the situation and decided to go up the ladder because I feel LPNs are not respect especially is you are new. Next job I will start fighting back ,I had enough of the bullying any advise how to deal with mean nurses.Thanks for the advice I will go after my RN my option as you say will be greater. Thank u
  8. by   BSNbeDONE
    Quote from Livelife100
    Thank you for responding, I did felt like I choose the wrong career and I am the only one experiencing this nightmare but I look at the situation and decided to go up the ladder because I feel LPNs are not respect especially is you are new. Next job I will start fighting back ,I had enough of the bullying any advise how to deal with mean nurses.Thanks for the advice I will go after my RN my option as you say will be greater. Thank u
    You have to analyze each situation and pick your battles carefully. Your best weapon is the facility's policies and procedures against workplace harassment, discrimination, and violence. Follow the chain of command. Be respectful even when you're being disrespected. You'll see that that will get you farther in the career than those who are being mean. They know this. Misery loves company. They sense your potential and that is why they behave as they do in an attempt to throw you off course...anything to block your progression in this career.
  9. by   Livelife100
    Thank you , I always try to keep quite about those things because I felt a new employee Voice will not be heard and if I complain everyone will look at me as the trouble maker , then it open up a whole can of contentment with the other workers so I always stay quiet and take the bullying and when I am all stress out ,I just leave without reporting anything. I sign up for college to do my RN ,I will use those experience to push me forward but next time if it happens which I hope it wouldn't I will document and report it .....

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