Ltc

[witter11]

Well I started LTC and my goodness it is a bit overwhelming. I work nights. They told me 2 weeks orientation,well the 4th night they through me out to the wolves. It took me FOREVER to do my med pass and as far as charting I watched another nurse so I needed help when I was in my own. OMG I get a bit of an attitude for needing help!! I mean give me a break. Im the type that needs to do something a few times then I should be ok. Later in the day the don questions why a resident got her meds late. Another stops me and tells me in the treatment book I marked my initials on the wrong date of course its 330 in the am so I marked that day. No big deal Ill correct it. Their expectations are high Im brand new nurse in LTC never worked as an aid so it will take me a little time to adjust. Its like im expected to have good time management have all my responsibilities done and done correctly right off the bat. 4 nights and I already see why there is a turn over and questioning if this is for me. Sorry to go on rambling im just aggravated. So how long was your first med pass??? does it get better? :uhoh21:

[mcg1929]

dont you worry,,you're not alone,,,i myself had a hard time when i first started a month ago,,,i worked in a subacute rehab place and had 20 pts,,it took me the whole night to do my med pass too! and these nurses that supposed to shadow with me were out of nowhere! my orientation was terrible because the nurse tht suppose to teach me just got off from orientation too! i just dont get it....everytime i ask a question they keep passing it to one another,,because most of the nurses were new too,,,then my other job keeps switchin me from one place to another....i guess it takes time to manage your time and knowing the residents....you'll do fine! cheer up!

[dcrrlb8185]

Unfortunate to say, but I see it all the time. You should talk to managment about more training. It is your license after all, and your lively hood. You have a right to protect it. They will be upset but too bad.

[TheCommuter, BSN, RN]

I work on a subacute/rehab unit at a large nursing home/SNF, and my workplace only gives nurses a 3-day orientation before they are cut loose to work on their own. Not surprisingly, the employee turnover rate is rather atrocious at the facility where I work.

My very first med pass was to 30 patients, and took about 3.5 hours. Now, it takes about 1.5 to 2 hours for me to get the same med pass completed. Therefore, it does get progressively better.

Some time management tips may help you, so here they are! Here is how I organize for the day. I work 16 hour shifts, from 6am to 10pm. Typically, I have about 15 patients to care for. At the beginning of the shift, I'll go through the MARs and TARs with a fine tooth comb and, as I go, I will jot down the things that must be done in my notebook. My notebook is how I organize the rest of the day, and I usually won't forget to do anything. Here is how Sunday's notebook page looked (names have been changed due to HIPAA):

9-23-2007

DIABETICS, FINGERSTICKS: Agnes (BID), Agatha (AC & HS), Bill (AC & HS), Wendy (AC & HS), Rex (BID), Jack (BID), Esther (AC & HS), Margie (0600, 1200, 1800, 2400)

NEBULIZERS: Margie, Esther, Bill, Jack, Jane

WOUND TREATMENTS: Jane, Bill, John, Jack, Lillian, Rose, Lucille

IV THERAPY: Wendy (Vancomycin), Laura (Flagyl), Rex (ProcAlamine)

COUMADINS: Agnes, Agatha, John, Lucille

INJECTIONS: Agnes (lovenox), Jane (arixtra), Rex (heparin), Bill (70/30 insulin), Esther (lantus), Mary (vitamin B12 shot)

ANTIBIOTICS: Wendy (wound), Laura (C-diff), Rex (pneumonia), Agatha (MRSA)

1200, 1300, 1400 meds: Margie, June, Rose, John, Jane, Jack

1600, 1700, 1800 meds: Rose, John, Rex, Lucille, Lillian, Laura

REMINDERS: assessments due on Agatha, Jill, and Louise; restock the cart; fill all holes in the MAR; follow up on Jane's recent fall, fax all labs to Dr. Smith before I leave, order a CBC on Rex...