My first day...

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Specializes in ED, Rehab, LTC.

I have had a difficult experience recently. I've started my first nursing job, (LPN) recently and have only been there a couple of weeks. My first day I was assigned to 25 patient's which I know isn't that much to some of you but keep reading. First I had my 25, an unbelievable medpass, several diabetics, peg tubes, treatments, One patient screaming at the top of her lungs all day, another that stood by my side and asked me the same three questions about 80% of the day, The aids are great but they can't do vitals or fingersticks and there was only one!!! How much can two people do? I felt okay at first despite all this because there was an experienced nurse close by. Well she had to leave early and said someone was coming from another floor shortly to take her patients. She showed up about three hours later. There is no secretary or unit clerk. The phone rings constantly with no one but the nurses to answer it. I know your thinking "welcome to nursing!" But OH MY GOD!!!!!!!!!!! I wanted to run away and hide. I had to call the doctor for all these issues that couln't have just happened before the stupid newbie came on the floor (me). Not to mention all the other paperwork and orders and this and that involved. Anyway the point of this is that I made a med. error on my first day. It wasn't life threatening but I feel awful. HOW PATHETIC. So what happens now? Is my license at risk??? I understand that when I took the cart I was responsible for these patients and I did it with the understanding that I only had 25, not 50, I did not have keys to the other cart, but anytime there was a problem and I was the only one there, they came to me and several of them were persistant and insisted on getting what they requested. I know I need to be accountable for my actions, but I do not feel that I would have made such an error if I wasn't so horribly overwhelmed. Seriously the nurses take the fall for these kind of mistakes with this kind of staffing??? I have to leave this place, this probably is not that unusual, and Im sure it happens all the time. I'm miserable already, I thought it was just nursing school. I am so discouraged. I hate that I chose this career now.

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Specializes in critical care transport.

that's crazy.

You need a better orientation, and I feel, more staff (duh).

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I really feel for you. I am a new graduate in New Zealand and have never had more than 5 patients at a time. I don't know how you managed to last the entire day. I would have quit there and then I think. Also we have a period working as a supernumary nurse about 3 weeks on first placement then 2 weeks on the 2nd placement. This is vital for a safe orientation.

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Thats crazy!! I'm a new grad myself and I'm about to start working. Its scary to hear they assigned you 25 pts, but whats the limit on how many pts they can give you?

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That's disgraceful. Even someone experienced would have trouble with that load.

Can you find another job? New grad to new grad, you're riding for a fall.

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Specializes in ED, Rehab, LTC.

I had about a week orientation, the nurses didn't explain much of anything. They were to busy or whatever. I just followed them around and took some patients to help lighten thier load, I guess thats considered an orientation. Whatever... I'm so upset. I thought about leaving, but then there would have been less nurses there for all those poor patients. I'm going to have to find another job because I can't stay there or I'm afraid I won't be a nurse for long. I really only took the job because there wasn't anything else. Well I was worned.

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Specializes in Maternity.

don't be discourged did u do an oncident report on the med error ? i feel for u though i'm about to graduate in july and i'm afraid to eork in LTC. don't they hire LPN in hospitals?

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Specializes in Geriatric/LTC, Rehab, Home Hhealth.
That's disgraceful. Even someone experienced would have trouble with that load.

Can you find another job? New grad to new grad, you're riding for a fall.

I agree! On my first nursing job, I was hired as a "helping hand" until I passed boards then I was supposed to orient for 2 weeks with the charge nurse before taking over her 1st shift position (22 residents). The day after I passed boards the DON quit suddenly and unexpectedly - the guy that took his place told my preceptor that I had two days to train and if I couldn't take it I should be "cut loose"...I turned in my resignation that day and have never regretted it. I ended up finding a facility that really cared about proper training and orientation. I stayed with them for years. I think you know the right thing to do. Best of luck and congrats on finishing school/passing boards!

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Specializes in Rehab.
I had about a week orientation, the nurses didn't explain much of anything. They were to busy or whatever. I just followed them around and took some patients to help lighten thier load, I guess thats considered an orientation. Whatever... I'm so upset. I thought about leaving, but then there would have been less nurses there for all those poor patients. I'm going to have to find another job because I can't stay there or I'm afraid I won't be a nurse for long. I really only took the job because there wasn't anything else. Well I was worned.

Here's a truth that unfortunately you will need to learn. I just learned it for heaven's sake.

You need to work someplace that is working for you. I got hired at what seemed like a great job. I quickly learned that the pts were NOT taken care of the way they should have been. I wanted to stay and try to fix things. But darling, this is the truth. It doesn't work if you are the only person trying to do the fixing. You can't do it alone. It's better to get in your car at the end of the day, pray that God protects the patients, and go find someplace where you are part of a real team.

Blessings,

Crystal

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Specializes in Gerontology, Med surg, Home Health.

Unfortunately, 25 patients for one nurse is the norm these days in LTC.

I've worked in many different places and that is how it's done.

My first job back in nursing after being out for 10 years raising my kids was on a subacute floor. I had 30 patients...IV's, Gtubes,TPN...central lines, trachs...I almost bolted after the first 10 minutes. But, you develop a system slowly and you will be able to do it.

Some day the powers that be (medicare) will learn that good care cannot be given when one nurse has 25-30 patients on a day shift. (I worked at one place where the night nurse had 60 !!).

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Unfortunately, 25 patients for one nurse is the norm these days in LTC.

Yeah, but left alone on her FIRST DAY with 50? No other nurse? And ONE aide?

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I agree with the poster who said you can develop a system after awhile. But I do also agree that the current ratios are rediculous and unsafe. I currently have 28 patients on my hall with all of the previous mentioned conditions. I graduated last September and have only been liscenced since October. I oriented for 3 days. I worked nights for the first 3 months but have now taken a 7-3 shift. I decision that I regret deeply. Our unit has 56 residents and at nights there is only one nurse. Every morning we are "challenged" with lack of CNA's. For example we should have at least five for the basic minimum care for the residents and this morning none showed up. They usually start trickling in around 900 am. Of course administration is doing nothing about this. I often go home with so much guilt because it is impossible to throughly care for that many residents. Honestly some issues just get pushed to the side and hopefully I can get to them the next day. I don't care what people say these patients are supposed to be more stable, but in my opinion they are just as sick sometimes as patients in acute settings. It doesn't help that you don't have the supplies needed to care for these poor people. When the families get in my face screaming, I usually can't say anything in response because their complaints are valid. I just pray and take each day at a time until I have more experience under my belt.

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