need some advice, is it me?

Nurses LPN/LVN

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Brand new nurse, 1st job at an ltc/rehab. 1st 3 days I was put on my own, in crazy land, my 1st med pass takes 4 hours, with 2 bouts of tears, guessing at things I should have had help with, (that didn't happen) getting yelled at, no time to potty much less eat, 2nd med pass was in tears, I never got to the treatments much less any charting, and walked out that shift feeling like a total loser, with others snickering over my shoulder. Is this normal? My week as it went on just got worse, with people telling me it should only take 90 minutes to complete my 1st pass, while I was floated to a new unit I knew nothing about, and that day (my 5th) did not get any easier, or faster. When I did watch other nurses do theirs, I saw many shortcuts being used that I dare not do much less speak aloud, for fear of killing someone. I sit here in tears, feeling worthless, wondering if there is something wrong with me, I cannot simply quit, I support my entire family, and finding jobs with no experience has proven to be very difficult. Please, I need to hear the truth, is it me? Thanks in advance.

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Specializes in Trauma Surgical ICU.

You are brand new and received very little orientation, NO.. it is not you. I have no advice to give because I have never worked LTC but what you wrote is pretty common. I hope others chime in and give you some tips or more support for what you are going through.

I can tell you the first year of nursing was horrible for myself and many others. It takes time to build all the tools, tricks and skills to be a good nurse..Hugs

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I started my nursing career as an LVN in LTC. My first medication pass as a new nurse took nearly four hours to administer to 30 residents.

It's not you. . .LTC is challenging because you've got so many tasks to complete in a limited time frame. However, your med pass time will speed up as you become confident and assertive.

Yes, I said assertive. No offense, but your coworkers will pounce on you like wolves eating the prey if they see any signs of weakness such as crying and cowering. You must walk in there, act confident, fake it until you make it, and never allow anyone to walk over you.

As far as shortcuts are concerned, you are not going to complete medication pass in LTC in a timely manner without them. I used safe shortcuts to get through my day. There's a real world of nursing and a textbook world of nursing, and you will be left behind with the dust in LTC if you attempt to practice by the textbook IMHO. There's just too many residents and too many things to do.

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No it's not you. I felt the same way when I got my first LPN job. It was awful, had two days of orientation, showed up for the third day and found myself on the floor with those who said they would be around nowhere to be found. I bit the bullet so to speak and did my job to the best of my ability. Meds got passed and treatments done sure I may have been slow, but it was all done safely and accurately. Over time it got better with the med pass. I created a "brain" sheet for the residents I care for which helps A LOT!! After three weeks and my confidence building as a "new" nurse I convinced myself to find a different place of employment. This particular facility didn't fit the values I had within myself and found myself becoming upset. I left that job was unemployed for 5 months.I have since found a job that I absolutely love. There are days where I find myself running behind...who doesn't? However, I have confidence, my employer has confidence and most importantly the residents and their families have confidence they are getting good care. Hang in there, things will get better.

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Thanks. I've spent the day going over and over in my head what it is specifically that is bothering me, and what it is that is keeping me slow. I've come up with a myriad of legit things that slow me way down during my pass that I cannot control, such as missing meds that have not been re-ordered, and are not on hand. Not knowing who is who because no one wears id bands, and residents frequently bed hop or wander. Taking time to chase someone to help and actually getting them to help or at least admit they know what to do can take up to 45 minutes. Seeing as I don't know the residents, I tend to stay with them while they take the meds to make sure they are ok with swallowing, many times they talk or want to know each and every med, or family wants to dictate what meds they get or they threaten calling state because they're loved ones meds are 10 minutes late. I have not gotten through 1 patient without being interrupted at least twice with petty things that cause me to have to log out of the computer, lock the cart and go take care of it, and logging back in takes a minimum of 5 minutes each time. When I speak of short cuts, I mean others giving both med passes in one so that they're actually only doing 1 pass. What happens when these patients get double doses of bp meds? That in itself scares me to death, I couldn't morally do it. When I ask for help because 1 pass takes 4 hours, others are eating and sitting, telling me that it's my choice to take this long and it looks like I'll be doing a double just to finish what should be done in 1 shift. I was literally taking a 3 minute potty break midst tears when another pounded on the door yelling that I did not have time to pee because i was behind, (while they and 3 others were eating take out and laughing about it). I'm putting other apps in, but much of what I'm seeing is either 1 year experience or 50 miles from my home. A big part of me keeps saying to dig in, suck it up and it will get easier (although I don't know how when I have been on 4 different halls in 5 days), yet another part tells me I'm just not cut out to be a nurse in a rehab/ltc combo. I would give anything to stay on the ltc side, but that won't happen I was told, and it seems that the trend here is all ltc's are doubling up as rehabs as well, so I'm doubtful that it would differ from one place to another in that aspect. Your responses are helping me to see it's not me, I'm just hoping that I can keep that in mind when I head back into Mordor (my nickname for work) for my next round of nervous breakdown. (by the way, I am nor have been a negative person, and even seeing what I have written here has just blown me away because I typically try to find the good in any situation, but I have failed to find it yet in this job.) I apologize for all the negativity, but I need to get it out, it's eating me up inside.

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Specializes in 4.

That is absolutely wrong for others to pound on a bathroom door, when you are using it. It sounds to me like the place isn't a safe environment. Keep looking elsewhere applying & watch the meds that you are giving!!!! What happens if you double up on a bp med? A severely low bp is what can happen & a possible incident. I'm sorry that you are going thru this. I would've said in time you will get better as we all do but this place sounds like a horrible place to work yet live.

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Specializes in 4.

I had to go back & read again....you legally can not give a medication that is intended & directed to give at 2 different times, cause of time constraint you give once a day. That's changing Dr's orders & sets you up for a huge lawsuit let alone you can hurt somebody. Go with your heart & do what's right.

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Specializes in Clinical Documentation Specialist, LTC.

As others have said, it is not you. You are a brand new nurse and I say shame on the others for laughing at you. Seasoned nurses would do well to remember what it was like when they were first getting started. It burns my butt knowing what you went through.

I will share something with you that happened to me just two days ago. I have been a LPN for almost 18 years. I have worked in LTC the majority of those years with most of that time being spent as a MDS Nurse. Four months ago I started a job as Head Nurse in an Alzheimer's Assisted Living home where the most us nurses have to do is pass meds. to 36 residents and a handful of fingerticks. We have no peg tubes, no treatments, no colostomies and only one person on O2.

So anyway, all nurses who work for the company take turn taking call three or four times a year and this past weekend was my turn. I was assured there was plenty of nurses to cover LTC and Assisted Living so it was unlikely I would be called in. Guess what? A nurse on day shift in the LTC home who NEVER calls in, called in and I had to cover it.

Keep in mind it had been more than a year since I had worked a med. cart and I had not been oriented to work the LTC side. It took me more than three hours to pass morning meds., then there were a boat load of meds. due at 12pm and 2pm, plus wound care that needed to be done before end of shift. The meds. are all kept in different places, the liquids and powders are nearly impossible to find if you have no clue, eye drops like I've never seen, Miralax, colace, crushed meds., supplements, hearing aides, etc... I did not sit down and did not get any breaks for the eight hours I was there. And in all that chaos? I ended up having to change a foley catheter because it was leaking. Didn't find that out towards the end of the shift.

I clocked in at 7:45am and left at 3:45pm. I barely squeezed in those treatments and did quick documentation on the acute residents.

You will get better. I promise! It takes time and patience, plus you will get your own system down. When you are the one teaching a brand new nurse, remember your experience as a newbie. *HUGS* and good luck to you.

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Never worked in LTC but will be starting soon. I am praying that everything works OK. However this is not my first job, on my last job it was my first nursing job too and I was in the same situation as you. I had lots of issues with co-nurses not being able to understand me being a new nurse. Very similar to you and some other horrible experiences.

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