I am a new grad who finally got this terrific opportunity at a Long Term Facility. Working with the elderly has always been my dream, ever since my granny died in one where they took such good care of her. I was given a lot of responsibility right off the bat and I feel so overwhelmed.
First: I have to pass meds four times a day and I just get so confused, I am sure I make mistakes. So far, no one has been hurt I don't believe anyway. I am just being honest here though I know I am going out on a line to tell this.
Second: I had two patients die at almost the same time three days ago. They were DNR of course, but the documentation shows that I hadn't checked on them in several hours. When the doctor came to pronounce them he said that both of them had the beginning of rigor mortis. That just can't be true. I told my aid to take vitals just a couple of hours before. I think that I am in trouble over this one.
Third, I don't know what to do about all the inappropriate comments made by the clients at this place. I know that some of them are senile and all, but it is more than that. I get my butt slapped, my breasts pinched, and called a whore almost everyday by older men who otherwise seem alert and oriented.
I have always wanted to work at a nursing home, but I keep hearing snide remarks by other nurses about it being the bottom of the barrel for nurses. They call it a pre-mortuary. They call it a death waiting room. I am not sure how much more I can take of this. Is it really true that REAL nurses don't work in LTC facilities? I hear it so much I am beginning to believe it myself.
I need some company in my misery. Anyone got anything positive to say? Words of encouragement?
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
have you worked in ltc? i have been working in ltc for almost 3 years now and yes some of the things the op mentioned happened to me. still do actually except for the bathing part. i simply do not have time for that with 25 patients and the cnas do those. please remember the op is a new rn in ltc. to have 20+ patients right after school is tough!!
and yes a lot of people think ltc nursing is not real nursing experience. some hospitals in my area don't even look at you if you only have ltc nursing. it is absurd but what can you do.
after 32 years i have worked in many places and i have seen good facillities and bad facilities. one on my favourite places was an ltac. i never saw a more decated staff who care more about their patients than any other nurses i have seen. when i got out of nursing school new nurses, after orientation, were placed on nights. the nurses with senority were on the other shifts and no we couldn't request what we worked we were told what we would work. it was me and lpn (who taught me more than i can ever repay) and an aide for 35 patients inan acute care facility on 11-7.
if the op is really a new grad they need to be a little more concerned with making me errors than " i don't think i've hurt anybody" "i am sure i make mistakes" is not acceptable and " at least i don't think i've hurt anyone" is ludacris. if she is a new grad then she need to be a little more serious and concerned and not so lassefair. to say you think you are in trouble over a patient's death because you hadn't seen them in a couple of hours or so just doesn't strike me a new grad freaked out about what's going on. if the old men are "alert" and pinching someone's breasts then they need to be told to keep their hands to themselves or their family will be notified as well as the md. remind them they can be charged with assault whether or not they are "old". and then to say that ltc is the bottom of the barrel for nurses a "pre-mortuary" and that they are begining to believe it themselves? is very provacative statement from a new grad.
hospitals aren't looking at many nurses these days young, old, experienced, or not. i'm all for playing devils advocate for the arguements sake........but to say you don't think you've hurt anyone????? really? it isn't what the op said but the delivery of the message that makes it seem insincere and looking to cause trouble.......if not then my bad:o.....find another position before something happends and you lose your license because it seems the other nurses don't care and can't or won't help a new nurse in need. but......
Thanks to those of you who gave non"snide." comments to my question. Just because I am a new grad does not mean that I am stupid. I have worked with the elderly all of my adult life. In school I was led to believe that I would have the right to practice safely and free from assault. I am not safe where I work. My license is not safe and my own physical self is not safe.
As for bathing my own patients. Are you kidding me? We are chronically understaffed with CNAs. If I don't bath them on some days, then they aren't getting a bath that day. Talk about naive. Do you mean that you always have someone else to perform this basic nursing function for you? Because if so, I want to work where you do.
I thought I would get more support here, and other than a couple of people who did give me words of encouragement, all I have heard it something about trolling for an argument. I don't get it. That was my first post and I feel like I got raked over the coals for being inexperienced and honest. Do you all treat everyone this way?
I am a new grad who finally got this terrific opportunity at a Long Term Facility. Working with the elderly has always been my dream, ever since my granny died in one where they took such good care of her. I was given a lot of responsibility right off the bat and I feel so overwhelmed.
First: I have to pass meds four times a day and I just get so confused, I am sure I make mistakes. So far, no one has been hurt I don't believe anyway. I am just being honest here though I know I am going out on a line to tell this.
Second: I had two patients die at almost the same time three days ago. They were DNR of course, but the documentation shows that I hadn't checked on them in several hours. When the doctor came to pronounce them he said that both of them had the beginning of rigor mortis. That just can't be true. I told my aid to take vitals just a couple of hours before. I think that I am in trouble over this one.
Third, I don't know what to do about all the inappropriate comments made by the clients at this place. I know that some of them are senile and all, but it is more than that. I get my butt slapped, my breasts pinched, and called a whore almost everyday by older men who otherwise seem alert and oriented.
I have always wanted to work at a nursing home, but I keep hearing snide remarks by other nurses about it being the bottom of the barrel for nurses. They call it a pre-mortuary. They call it a death waiting room. I am not sure how much more I can take of this. Is it really true that REAL nurses don't work in LTC facilities? I hear it so much I am beginning to believe it myself.
I need some company in my misery. Anyone got anything positive to say? Words of encouragement?
First of all congratulations on becoming a nurse. I have worked in LTC for 16 years and while I haven't loved every shift I have worked, looking back I can say I love what I do. I was totally against working in a nursing home when I graduated from school, unfortunately at that time, hospitals were not hiring and I needed a job. So, I took a midnight position at a local nursing home and prepared myself to hate it.
I didn't hate it at all and have had so much fun and so many positive experiences working in LTC. For every one difficult resident I have 2 residents that feel like they have become my grandparents. I don't think that it should be considered "the bottom of the barrel for nurses" but I also know alot of nurses feel that way. I have also worked with many nurses who decided to leave the hosp and come to LTC because they wanted an "easy" job and within months went running back to the hospital. I think it just depends on where you find your niche. Some people are cut out for LTC and some are not. I for one would probably run from the ICU if someone tried to make me work there LOL.
Good luck and give it a chance. You may find you like LTC or you may find something else you like better. One of the good things of our profession is the many different choices it gives us :)
Thanks to those of you who gave non"snide." comments to my question. Just because I am a new grad does not mean that I am stupid. I have worked with the elderly all of my adult life. In school I was led to believe that I would have the right to practice safely and free from assault. I am not safe where I work. My license is not safe and my own physical self is not safe.
As for bathing my own patients. Are you kidding me? We are chronically understaffed with CNAs. If I don't bath them on some days, then they aren't getting a bath that day. Talk about naive. Do you mean that you always have someone else to perform this basic nursing function for you? Because if so, I want to work where you do.
I thought I would get more support here, and other than a couple of people who did give me words of encouragement, all I have heard it something about trolling for an argument. I don't get it. That was my first post and I feel like I got raked over the coals for being inexperienced and honest. Do you all treat everyone this way?
I have 30 residents on my hall and if an aide calls off my hall is left with one aide. she manages to get all of her baths done. I will help her with toileting, changing incontinent residents and answering call lights, but there is no way I have time to do complete bed baths. Maybe if you weren't doing baths you could get your meds passed. Have you tried combining some passes? say you have 12p meds and 2p meds you could give them at 1p.
If you worked with elderly all your life then you know that some tend to be inappropriate. tell them firmly that it won't be tolerated. make sure to document the behavior and notify social services. if it continues, social services should take care of it.
Nurses in LTC are very special. we take care of a wide range of illnesses, you will gain a lot of knowledge working in LTC. Some of the residents are there waiting to die. Our job is to give them the best quality of life the can have in the meantime.
If the person in question was in the death process he should have been checked on every hour and his condition documented. If he was not, then your aide should have been checking on him every two hours. If he was in distress the aide should have notified you.
as for getting raked over the coals for your post. You do give the impression of being a little aggressive, or defensive or something.
LTC is tough....why 4 med passes..are you working 12 hr shifts. Normally they are 9-1-5-9 or 8-12-4-8pm with an odd ball or two times. Ask the DON about the times. Med passes take for evah and a day. As far as the errors or risk of, try not to let things interupt you durring your pass.
I only have 22-26 residents, so even tho I'm not touching my residents I'm walking by them and assessing them visually. People die in LTC...don't get worked up about this..it is a fact.
As far as the resident comments....do not tollerate it from the alert and O x3 residents. Dementia..okay, but no go with the ones that know what they are doing/ saying. Leave the room, tell them it is unacceptable. *look thru this forum for tons of advice on this one*
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thanks to those of you who gave non"snide." comments to my question. Just because I am a new grad does not mean that I am stupid. I have worked with the elderly all of my adult life. In school I was led to believe that I would have the right to practice safely and free from assault. I am not safe where I work. My license is not safe and my own physical self is not safe.
As for bathing my own patients. Are you kidding me? We are chronically understaffed with CNAs. If I don't bath them on some days, then they aren't getting a bath that day. Talk about naive. Do you mean that you always have someone else to perform this basic nursing function for you? Because if so, I want to work where you do.
I thought I would get more support here, and other than a couple of people who did give me words of encouragement, all I have heard it something about trolling for an argument. I don't get it. That was my first post and I feel like I got raked over the coals for being inexperienced and honest. Do you all treat everyone this way?
No 0ne called you stupid. Frankly I hate the word. It's the delivery or what you said and key "trigger" words that fired off the debate. For a new grad you sound a little burned. This enviroment is obviously toxic...find another job. In better facility you won't be so overwhelmed ALL of the time. If you don't feel safe...get out and get malpractice insurance......good luck.
When it comes to sexual assault or sexual harassment then you need to follow your companies policy and make a report up to and including a police report. Just cause male is a res. in a LTC facility does not give him the right to sexually assault/harass you. There are various stages of death that an MD can use to determine a persons approx. time of death. The rule of thumb is a person needs to be checked on at least every 2 hours by a licensed nurse an unlicensed nurse or CNA can not substitute for that requirement. The field of nursing that one chooses to pursue is a very individualized thing. Not the type of thing someone can decide or not decide for you. From what you say you might want to think about if LTC is really for you and if not then to look into an area that is.
thanks to those of you who gave non"snide." comments to my question. just because i am a new grad does not mean that i am stupid. i have worked with the elderly all of my adult life. in school i was led to believe that i would have the right to practice safely and free from assault. i am not safe where i work. my license is not safe and my own physical self is not safe.
as for bathing my own patients. are you kidding me? we are chronically understaffed with cnas. if i don't bath them on some days, then they aren't getting a bath that day. talk about naive. do you mean that you always have someone else to perform this basic nursing function for you? because if so, i want to work where you do.
i thought i would get more support here, and other than a couple of people who did give me words of encouragement, all i have heard it something about trolling for an argument. i don't get it. that was my first post and i feel like i got raked over the coals for being inexperienced and honest. do you all treat everyone this way?
you are not answering any of our questions to give you a better advice. i know you said you work ltc but what kind? what shift? how many patients? why are you doing shower? is that the norm? do other nurses do those too? i am not above giving a patient shower but i simply do not have the time and cnas are responsible for those. i help as much as i can but i need to do my job first before i can help anybody.
do you have a unit manager/supervisor? how long was your orientation? did hr or whoever in charge give you your job descriptions when you started? why 4 med passes?
you are getting support here and good advice. don't expect people here on allnurses to sugar coat everything. you need to develop a thick skin in order to survive in ltc.
you are not answering any of our questions to give you a better advice. i know you said you work ltc but what kind? what shift? how many patients? why are you doing shower? is that the norm? do other nurses do those too? i am not above giving a patient shower but i simply do not have the time and cnas are responsible for those. i help as much as i can but i need to do my job first before i can help anybody.
do you have a unit manager/supervisor? how long was your orientation? did hr or whoever in charge give you your job descriptions when you started? why 4 med passes?
you are getting support here and good advice. don't expect people here on allnurses to sugar coat everything. you need to develop a thick skin in order to survive in ltc.
i work in an ltc that is 120 beds and takes mostly patients that have been rejected by other facilities, due to behavioral or insurance issues. like i said in my last post, we are chronically short on cnas and i don't believe that any patient's hygiene should suffer because of short staffing. my orientation was supposed to be 6 weeks, but my preceptor quit after two weeks and that was the end of my orientation. when i say 4 med passes i am sort of throwing in the q6 prns into the mix. this is an inner city ltc. it's not where most people would want to work. i said at the beginning that it was a great opportunity...but to be truthful, i have been trying for months to get a job and this was the only place that was hiring. and now you can see why. there is constant threat that we are going to get shut down and the only reason i think we are still open is that there is simply no place else for these poor souls to go!
and as for your last comment, i don't expect people on allnurses to sugarcoat anything. however, neither to do i expect nurses to be eating their young on this of all forums.
Esme12, ASN, BSN, RN
20,908 Posts
after 32 years i have worked in many places and i have seen good facillities and bad facilities. one on my favourite places was an ltac. i never saw a more decated staff who care more about their patients than any other nurses i have seen. when i got out of nursing school new nurses, after orientation, were placed on nights. the nurses with senority were on the other shifts and no we couldn't request what we worked we were told what we would work. it was me and lpn (who taught me more than i can ever repay) and an aide for 35 patients inan acute care facility on 11-7.
if the op is really a new grad they need to be a little more concerned with making me errors than " i don't think i've hurt anybody" "i am sure i make mistakes" is not acceptable and " at least i don't think i've hurt anyone" is ludacris. if she is a new grad then she need to be a little more serious and concerned and not so lassefair. to say you think you are in trouble over a patient's death because you hadn't seen them in a couple of hours or so just doesn't strike me a new grad freaked out about what's going on. if the old men are "alert" and pinching someone's breasts then they need to be told to keep their hands to themselves or their family will be notified as well as the md. remind them they can be charged with assault whether or not they are "old". and then to say that ltc is the bottom of the barrel for nurses a "pre-mortuary" and that they are begining to believe it themselves? is very provacative statement from a new grad.
hospitals aren't looking at many nurses these days young, old, experienced, or not. i'm all for playing devils advocate for the arguements sake........but to say you don't think you've hurt anyone????? really? it isn't what the op said but the delivery of the message that makes it seem insincere and looking to cause trouble.......if not then my bad:o.....find another position before something happends and you lose your license because it seems the other nurses don't care and can't or won't help a new nurse in need. but......
misery does love company........