For all new LPNs

Valleyval621 · Sep 28, 2016

Thanks for your offer to provide advice! I just graduated in May and got my LPN license in July. Currently interviewing for my first nursing job and applied to Block 3 to start an RN program in January.

The interview I had yesterday was at an ALF and from all that I've read, I'm concerned about a lot of the issues nurse on this board have mentioned. But honestly, I haven't gone into a thread that wasn't terrifying in one way or another! It seems to be a sport around here :)

The second position I applied for was ped homecare - tons of negative info on here about that as well. Any thoughts on a good first job to gain skills experience and confidence without getting in over my head?

Thanks!

Jen4nursing · Oct 7, 2016

Hi Valleyval621,

First let me apologize for not getting right back to you. Life has been hectic.

In my first year of nursing I started as a vent and trach pediatric nurse because this gave me a specialty skill. It is in a home care setting but you only have one patient and as a new nurse I thought this would help me be more confident and not so nervous.

After getting 2 years experience in that setting I moved on to geriatrics. I worked in all units the sub acute, alzheimer/dementia, and 2 ltc units.

I felt more comfortable in home care pediatrics because it allowed me to not get in over my head until I gained more confidence.

Ltc is very busy for a new nurse and you will feel in over your head at first. The important thing is to find a mentor (a seasoned nurse). I was lucky to have one and boy did she help me a lot. My first week I had a code and she walked me through the whole process.

The med passes were crazy but once you get to know who takes what and who they are you definitley get faster at the med pass.

I feel you should get the clinical experience because you are going to get your RN and if you have a clinical background this will help you land a job.

Homecare pediatrics is great if you want a specialty skill but you would need clients on vents and trachs.

All in all it is up to you but nursing is not easy or everyone would be a nurse. You will hear horror stories and nursing homes are notorious for heavy patient loads. I worked with 25 patients a day and when I worked nights I had 50 patients. After 3 months of working there I gained confidence in my skills and I really enjoyed it. My issue was with management shoving more work down your throat daily because other nurses were slacking and our unit manager never helped on the floor. So I had to do med pass, wound tx, charting, had 2 incidents to report one day and had a discharge, transfer, and admission all back to back and my manager did nothing to help me instead she yelled at me that they need measurements right now. I was in the room with an admission. I told her I dont have time why cant she do it and I got wrote up.

So my story to you is nursing homes will give you the experience you need in a clinical setting but is also very stressful. If I was a new grad going into a nursing home I probably would have quit. However there are new grads that do great and there are nursing homes that are great to work for you just gotta find the right one.

I wish you the best on your journey and if you have any other questions please feel free to ask me. Congratulations on becoming a nurse it is very rewarding.

Valleyval621 · Oct 7, 2016

Jen4,

Thank you so much for your very thoughtful reply. I really appreciate it! There are no easy answers and I like what you said. Nursing is hard, otherwise every would do it. I'm not afraid of hard work I just don't want to make mistakes. But those are unavoidable as well. It's just a matter of doing everything in your power to keep them to a minimum and learn from them. I just need to make a decision, thank God that there are a plethora of choices and job offers for us right now and get to work!

Thanks again Jen and I'll keep you posted!

Jen4nursing · Oct 7, 2016

Your very welcome. Like I said if you go into LTC just remember it is going to take time to establish a routine. You will not be as fast as the other nurses and you shouldn't compare yourself to them either. Find a mentor if you can. Also please double check your medications before you give them. This is critical because I was doing a med pass on a new floor I didn't know the patients and there were no name bands so I asked the CNA if that was such and such and she said yes i put the pills in his mouth and looked at the.photo again and realized it wasnt him so i told him please spit those out. It could have been horrible. I confronted the CNA and she said she was busy and really wasnt paying attention. It could have been so bad. The guy also was almost like a twin to the other guy so it was subtle features that made me take a second look. Also never assume anything fact check it because as a new nurse this also got me in trouble.

I had a psych patient and when given report the nurse told me she gave that medication (psych med injection) the medication sounded the same as another one and I just assumed she was talking about the psych med. Come to find out she did not give the psych med and he went off throwing stuff and attacking staff they said it was because I failed to fact check and just assumed. So be careful. Check check and check and for the love of God document everything.

You will do great and please continue with your education it will open so many doors.

kbvn3210 · Oct 8, 2016

I'm a new nurses in an LTC and I'm thinking about quitting. I have been orientating for a month and just recently had to experience the full patient load. We have 30 patients days. I passed meds all day. My preceptor had to send a patient to the hospital while i finished my med pass. I wouldn't have finished I were on my own. I came home feeling extremely stressed and incapable. I don't know what to do at this point.

Jen4nursing · Oct 8, 2016

Hi kbvn3210,

I lnow it seems overwhelming at first but you will get the hang of it and a routine will develop. How long have you been working LTC?

I always started my vitals for BP meds right after report and those that had foleys or circaid dressings I would do then when 0800 came i would pop the meds for each patient in the dayroom having breakfast and used a zigzag pattern to get to the ones in the rooms.

Then I would chart what needed to be charted and then take a break. Unless some incident occurred lol.

Then I would do wound tx and then rounds.

Then the next med pass I would do all my diabetics before lunch and pass the 1300 and 1400 meds together.

Then I would chart, order meds, clarify or put in orders, finish wound tx.

Then 1700 med pass I would start with who was at my cart and in the dayroom for dinner and then zigzag through the rooms.

Then I would catch up on more charting such as UDAs and monthy summaries. I was busy from the time I got there until I left.

Give it time it takes time to get a routine that you are comfortable with and what works for you.

Hang in there it will work out.

NurseMari2018 · Jan 21, 2017

I am an LPN at a subacute/assisted living facility, in Chicago. I have been a nurse for almost a year now. The first day of being on my own I cried my butt off because I thought to myself how the hell did I graduate and get my license....I felt so stupid! But I had just graduated, gotten my license, and had been trained at this horrible facility for four days!!!! Then they just threw me out there on my own with 17 patients that i knew nothing about and had acute illnesses! It was a horrible experience, needless to say I quit after a month and started working at my current facility. Here they provided 3 weeks training, and I felt confident enough to be on my own. I take care of 15-17 subacute patients to 26 patients on the second floor to 40 long term patients. I can work any floor and can safely manage my day with my patients, no matter the number. Of course it was hard at first, takes all day to give meds to 40 people, but you learn to prioritize better, and just remember that things are bound to happens (falls, admission, skin tears, etc.) but take a deep breathe and remember we are here for a reason.....because we want to help people. No one said this career would be easy, but we do know how to manage our time better as we gain more experience.

smartassmommy · Dec 12, 2017

I'm getting ready to start my first nursing job. It's in a ltc facility. How can I make be the best possible orientee?