LTC is making me hate nursing!!!

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I'm a new grad charge nurse in a LTC facility. I've been there for almost 2 months and I'm at the point where I'm literally scared to go to work. At first I floated, and that was ok, but I just became a regular on a dementia/psych floor. The paperwork and charting is sooo heavy, and I'm the only nurse on a 40-bed unit. I know I have to "manage my time" more effectively, but there's not enough time in one 8 hr shift to do everything that is required of me.. and i don't take lunch.

I have to pass meds (and the time schedules of the meds are so crazy), start tube feedings, supervise CNAs, chart, pick up orders, check orders, treatments, and various other paper work that come in books.. and the worst of all is getting an admission.. i always fear that i'll get an admission :confused:.. and on top of all that, i JUST learned that i'm required to re-do the whole treatment book for the new month.. and my god, the daily interruptions i get.. supervisors coming every 5 mins to check the medex while i'm giving meds, CNAs calling me for this and that, residents not wanting to take their meds (i have to spend so much time just to encourage them to do so).

I don't want to quit because I want to be able to handle everything, and I've floated to every floor to know that other floors are easier to handle; still hard, but a little easier. I just don't believe one nurse can do it all safely.

Specializes in Hospice / Psych / RNAC.

Call your state nursing board and ask where/how you can file a complaint. The patients are at risk when there is under staffing. You want to protect your license and if you continue working in such a compromising situation something will happen.

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Specializes in Telemetry, Case Management.

I am afraid every LTC I ever worked at was that way. Even if it wasn't when I started and a couple weren't, eventually the company gets sold, or an administrator quits or moves on, and the new management wants to shine. So they cut staff, cut supplies or buy cut rate ones, staff and patients truly are the ones to suffer, but the management gets good numbers, gets kudos from their boss along with a bonus, and things that got worse, remain bad.

Sorry to be a killjoy, but that's been my experience. And its always a really good day when state comes in because every single staff member is bribed,coerced or just plain ordered to come in to work and make it all look good.

The last LTC I worked at, the treatment nurse was little friends with the DON. Until state came in and saw that her "skin tears" on the patients were actually Stage II and III bed sores. Oops!!! And amazingly, she didn't get fired, just "demoted" to a regular floor nurse, and all the floor nurses got to to all those treatments as well as all the other stuff they didn't have time to do before!!!

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"Now as far as the ones that say it'll get better once you get a routine, no it won't" as Erie stated, and it is sooo True!!, It won't get much better. It won't as long as LTC nurses don't do something about it, I am not sure what, but something needs to be done. On this forum there are hundreds of threads just like this one. I think it has to change in the laws, national ,.. state? Many have said approach the DON, administration ect.. but it never changes!! It must go beyond that, Union yes!! but real laws againt this ratio of residents/nurses must change! does anyone have any more ideas? Some good nurses are leaving LTC, and the ones that stay spend most of their careers learnig how to cut corners,... I mean, how else do you do that much work?? It is NOT humanly possible!

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I feel that every time I read these ltc posts, it is me! It has to be the same in every ltc all over the country. The longer I work in ltc, the more I am starting to hate it and wonder why I decided to go into nursing. I do love the patients but it's everything else that bothers me. Management loves to give out warnings for stupid reasons, they expect you to do everything, and never say ank you for the hard work. The med pass has gotten easier but there's so much paper work and responsibility when in charge of 40 patients. Forget about admissions, a fall, or incident report. I'm a new grad and only been in ltc for 3 months and trying to make it to the 6 month mark. it's not getting better, its getting worse! My manager reprimands us all of the time and talks to us like we a children. I hate it! It's sad because these patients deserve good caring nurses

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Specializes in LTC, Level 1 trauma, Cardiac.

I'm a new grad and just started working at LTC in November. I've applied to numerous hospitals and was not able to land a job. I have my BSN and I was wrong to think that would help me land a hospital job. I'm miserable. I hate going into work. They hire all the new employees on call/per diem. I get floated to different floors all the time. I don't benefits, I work holidays with no time and half. I have 41 patients and I have to administer medication within a 2 hour time frame and if I don't I get written up. None of the patients are ever in their rooms so I have to go looking for them. I can't seem to get the hang of it. I hate my job. I had orientation for 2 days. I was told I can only receive 2 days of orientation because they were short staffed and needed me to get on board. I want to quit so badly but I have student loans and bills to pay. I just needed to vent...don't get me wrong I am truly grateful for a job in this horrible economy.

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Specializes in Gerontology, Med surg, Home Health.
That sounds tough...the reason I don't do LTC. I know that someone has to do it but it's not going to be me. Give me my 2 in the unit or 6 on the regular floor and call it a day. I imagine that everything will get easier with time, but I just can't imagine how one nurse can safely take care of so many residents. That why when we admit SNF patients we find all those bedsores, etc...the nurses just don't have time to turn 40 patients every 2 hrs..it's impossible. I really can't give you advice for the LTC b/c I've never worked it...only heard horror stories. I suggest you hold onto your job while you look for something else...at the end of the day, it's your license...and this experience is still work experience. If you don't stay for at least 6 months...don't even bother putting it on your resume...that is if you want to leave...but not all of nursing is like that...although almost all of nursing will frustrate you.

I know this is an older post but....MY residents do not usually get pressure ulcers (Yes, that's the term these days not bedsores) UNTIL I have to send them to the hospital. Then a man with cdiff whose skin has been kept immaculately clean and intact in MY facility goes to the hospital and comes back with 4 stage 3's because you people don't turn them at all.

My saying this is just as ridiculous (although not really) as what you said.

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Specializes in LTC.
I know this is an older post but....MY residents do not usually get pressure ulcers (Yes, that's the term these days not bedsores) UNTIL I have to send them to the hospital. Then a man with cdiff whose skin has been kept immaculately clean and intact in MY facility goes to the hospital and comes back with 4 stage 3's because you people don't turn them at all.

My saying this is just as ridiculous (although not really) as what you said.

We recently had a resident go to the hospital for a CVA and she went with an intact bottom and she came back with a stage 3. She looks terrible now. She has a pale look and barely recognizes us.

LTC isn't what people think it is. I tell people I work in a nursing home and they think all I do is change diapers.

Its very very stressful to be given about 16 hours of work and squish it all in 8 hours. Nobody understands the amount of work we have hanging over our heads when we walk in the door unless they've walked in our shoes.

The paperwork is RETARDED. I spend more time doing paperwork then I do talking to the residents. (I love when they come behind the nurses station and talk with us, that makes my night so much better.) Everytime someone makes a mistake.. or misses something .. we have inservices, another form to fill out, videos to watch, new flow sheet, new page to sign every shift etc. Its annoying and a waste of time.

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Deja Vu...The OP's post matches one I made last week about not having enough time to do all I have to do in an 8hr shift. I can't say things have gotten better..in fact due to them cutting back on aides it has gotten worse as i find myself doing my work and covering patient needs that my two regular aides can't get too becuase they are busy with one or two other patients. I look after 54 patients divided among 3 halls on the 11p-7a shift. As for me answering call lights I have heard it sets a bad precedence...but a call light chime to me has a pavlovian effect (I was an aide for several years before I became an RN)...I can only listen (ignore) that sound for so long until I just rush up to the residents room to answer the call.

The ONLY good thing I see from starting in LTC is "if" I ever switch jobs to a mid acuity floor with less then 20 patients I am gonna feel like I have died and went to heaven...cuz right now I sure do know what Hell can feel like...its an understaffed shift that has additional call offs, an admit, one or two discharges to the hospital, and the "fall" you can count on happening during your longest med pass.

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Specializes in LTC.
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The ONLY good thing I see from starting in LTC is "if" I ever switch jobs to a mid acuity floor with less then 20 patients I am gonna feel like I have died and went to heaven...cuz right now I sure do know what Hell can feel like...its an understaffed shift that has additional call offs, an admit, one or two discharges to the hospital, and the "fall" you can count on happening during your longest med pass.

I totally know what you mean. I feel I can handle care for 7-8 med surg patients with no problem at all after all the crap I've had to deal with in LTC. Falls, admissions, sending residents to the hospital, etc. Don't get me wrong.. I'll be working all shift. But it won't be like the "pulling my hair out and crying in the oxygen closet" shift.

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Totally agree with RealityCheck1. Why do we put up with it?????? Think about it. If every single nurse out there refused to do it, then what? "They" would wake up and smell the coffee and change things.

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I totally know what you mean. I feel I can handle care for 7-8 med surg patients with no problem at all after all the crap I've had to deal with in LTC. Falls, admissions, sending residents to the hospital, etc. Don't get me wrong.. I'll be working all shift. But it won't be like the "pulling my hair out and crying in the oxygen closet" shift.

Having recently done both LTC and worked in a hospital setting (mixed unit with average 4-5 patient load) I can tell you that having fewer patients with higher acuity is not magically easier. Just different! Yes there were a few days here and there that I had a light load and little to do. That would be about the only difference in workload, IMO. The other days I was running, running, running. The higher acuity, the more stuff you have to do. (IV pumps, complicated med administration, wound care, ostomy, trach, wound vac, contact isolation with gowns/gloves/etc, acute changes in pt condition, charting and more charting, etc.)

What I REALLY miss about working in the hospital is the electronic medical record. We could chart everything with the click of a button and the med administration was electronic too. Beautiful! If only LTC had the budget for that kind of thing. :rolleyes:

Anyway, I am currently working as a supervisor at a LTC...as a new grad. I had to cover for a nurse that quit last weekend and was totally overwhelmed. Ended up staying 2 hours past my shift on both days, and still barely got everything done- and did not get it done well! I feel underqualified for this job. On the other hand, if I can stick it out hopefully it will be great experience. I am lucky in that most of the time as a supervisor I am not working a cart at all, just doing management stuff and many times don't have anything to do! Crazy. I'd almost rather be working as a floor nurse so I could be learning and working on my time management, etc. (I think I'm insane for saying this after the experience last weekend working the floor)

Hang in there, hopefully it gets better. If not, try to get at least 6 months in so you can use this time on your resume. Less than 6 months would not be worth mentioning and would look bad, IMO.

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In some ways I think it might be harder to be a supervisor and occasionally have to take the cart because you never get a chance to get a routine, plus you are responsible for everything everyone does or doesn't do. I was a supervisor in a 200 bed facility and if I hadn't had the great staff I had, it could have been a terrible job. Good luck.

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