Need Advice

AndSleeep! · Jun 23, 2005

Hi everyone. I am a new nurse with just 3 months of experience. I started at the LTC facility that I was employed as a CNA. Anyhow I feel so frustrated and disappointed with nursing. I work a LTC unit of 39 patients by myself. I tell myself It will get better, but it dosn't. The CNA's try to boss me around and management loves them. I have one aide who I think is dangerous. I suspect her of being on drugs...I have seen drug addicts in my time...she was high on coke. Anyhow this place refuses to perform mandatory drug testing. This CNA is their lead CNA and for some unknown reason the DON loves her. If is say something I know they will not do anything about it. THey look the other way in most situations at this facility. I am so overwhelmed trying to take care of 39 pts. along with med pass that is soooo tough. I feel like I am dying. My question is this: Is nursing suppose to be like this? Does it feel like a battle ?
I love my residents but dislike management and a few staffers who are unsafe. I am concerned for my license. I am a LPN but have no support from the RN who works 2nd shift. I am going through mood swings with this job and feel so depressed. Any suggestions? Thanks in advance......
LTC nurse who's going crazy:crying2:

Time to throw in the towel and get a new job. There are so many different jobs out there that you can be happy with. 39 residents is ALOT! I would not like my job ethier. I would rather be a bum.

Antikigirl, ASN, RN · Jun 23, 2005

You are obviously very dissatisfied with this position, and I do think they are spreading you more than thin! I would seek out newer employement and be VERY good about picking the new one!

When I interviewed at new places, I asked to shadow a nurse there for a few hours (the shift I planned on doing) so I could get a picture of what really goes on. I also really looked deep into what they expected of me. Usually I found small things snuck into my job description I was unaware of, and had to really weigh the pro's and con's. So really be careful in picking new jobs, and really see if the 'ratio' they quote is the real deal!!!!

Good luck, that doesn't sound appropriate for a newer nurse!

Blackcat99 · Jun 23, 2005

Hi fuzzball. I have been an LPN for over 30 years. I have worked many LTC's in my lifetime. It's not worth it. I would always get depressed and totally frustrated every time. LTC is one disaster after another period. Oh I hear people say that there are "good LTC's" but I never found one. I got tired of always feeling angry, overwhelmed, totally frustrated and depressed. I refuse to work in LTC anymore period. I would much rather scrub toilets for a living than work LTC. LTC's are a no-win situation period. Run for your life before you become severely depressed. Good luck :)

Sue7573 · Jun 23, 2005

I don't know if I am niave (sp) or just actually have a positive out look on the LTC environment. Of course I have never worked as a nurse anywhere. (starting ADN in Aug) but I have been an aide for over 16 years 8 of those years in the LTC I am currently employed. Fuzzball you sound just like a friend of mine. She just graduated in april or may and she works the midnight shift with 40 + residents alone. She is frustrated and is looking in the help wanted section all the time. I talked to her the other night about her confidence. I am not saying fuzzball that you lack confidence I am saying that my friend that is frustrated does. Ok here is an example of her lack of confidence. I reported to her that Mr. Jones foot was red and could feel fever in it. It started about mid calf and went down to his toes. Immediatly she wanted to call a nurse off of another floor. I asked her why. My friend said because I am green, I don't know for sure what I am looking at or for. I said but you don't need what's her name to look at his foot. I told her that we would go down there and look at it, at least then she would have something to tell whats her name. As it turned out when we went back to look at his foot it was no longer red and resident said he had just been sitting up on the edge of the bed before I saw his foot the first time. I felt awkward talking to the nurse about it, mainly because I have the same concerns as her, and the pep talk is as much for me as for her. but I told her that she has had as much education as any other nurse on the floor (midnights no RN) and that she could do the small stuff without calling another nurse. I don't know about her but if I can do the small stuff over and over again with out help my confidence would be built enough to handle the big stuff.. ANd I am in no way saying that I think I could or would handle the BIG stuff without help. But that I could handle more variety of things without haveing to call someone to help. I don't know does any one understand what I am saying. Now as I speak I don't know that I will be working at this LTC when I graduate. I admire my friend for working at this LTC after she had been a CNA in same facility. But I also think that she can do it and I think she will be one of the best nurses there when her confidence builds.

As for your problem with the lead CNA. If administration wont do anything about it. Go over thier head. I don't know how your facility works but at ours we have our own administration, but then we have the company that owns us. When I have a problem in the past and our immediate administration does not satisfy me with my problem I go to the owners. I have done it more than once and will do it again if I have to. If your administration is the top of the ladder for you call state. or the omsbudsman. or any one that will listen. What about the board. I know that one of our board members that has a family member in our facility said before that we can go to them with problems. Another board member found out that a CNA worked the midnight shift by herself with 64 residents one time and told the CNA if that ever happened again she was to call him no matter what time it was. There are things that can be done. It is hard. I went thru pure Heck and back the times I had to go over administration's head. But it was worth it in the long run and I love my facility.

Sue

medsurgnurse, RN · Jun 23, 2005

Start looking for a new job NOW. I've been there. It doesn't matter how well you do your job, if management loves this lead CNA they will always believe her over you. save your sanity, save your license and get out now.

Hairstylingnurse · Jun 25, 2005

I don't know if I am niave (sp) or just actually have a positive out look on the LTC environment. Of course I have never worked as a nurse anywhere. (starting ADN in Aug) but I have been an aide for over 16 years 8 of those years in the LTC I am currently employed. Fuzzball you sound just like a friend of mine. She just graduated in april or may and she works the midnight shift with 40 + residents alone. She is frustrated and is looking in the help wanted section all the time. I talked to her the other night about her confidence. I am not saying fuzzball that you lack confidence I am saying that my friend that is frustrated does. Ok here is an example of her lack of confidence. I reported to her that Mr. Jones foot was red and could feel fever in it. It started about mid calf and went down to his toes. Immediatly she wanted to call a nurse off of another floor. I asked her why. My friend said because I am green, I don't know for sure what I am looking at or for. I said but you don't need what's her name to look at his foot. I told her that we would go down there and look at it, at least then she would have something to tell whats her name. As it turned out when we went back to look at his foot it was no longer red and resident said he had just been sitting up on the edge of the bed before I saw his foot the first time. I felt awkward talking to the nurse about it, mainly because I have the same concerns as her, and the pep talk is as much for me as for her. but I told her that she has had as much education as any other nurse on the floor (midnights no RN) and that she could do the small stuff without calling another nurse. I don't know about her but if I can do the small stuff over and over again with out help my confidence would be built enough to handle the big stuff.. ANd I am in no way saying that I think I could or would handle the BIG stuff without help. But that I could handle more variety of things without haveing to call someone to help. I don't know does any one understand what I am saying. Now as I speak I don't know that I will be working at this LTC when I graduate. I admire my friend for working at this LTC after she had been a CNA in same facility. But I also think that she can do it and I think she will be one of the best nurses there when her confidence builds.
As for your problem with the lead CNA. If administration wont do anything about it. Go over thier head. I don't know how your facility works but at ours we have our own administration, but then we have the company that owns us. When I have a problem in the past and our immediate administration does not satisfy me with my problem I go to the owners. I have done it more than once and will do it again if I have to. If your administration is the top of the ladder for you call state. or the omsbudsman. or any one that will listen. What about the board. I know that one of our board members that has a family member in our facility said before that we can go to them with problems. Another board member found out that a CNA worked the midnight shift by herself with 64 residents one time and told the CNA if that ever happened again she was to call him no matter what time it was. There are things that can be done. It is hard. I went thru pure Heck and back the times I had to go over administration's head. But it was worth it in the long run and I love my facility.
Sue

Hi Sue, I'm glad to hear you have confidence in your nurse freind and that you are there to help her (we should all be so lucky:) )But I really hate to hear you discourage her from asking her other nursemates questions. I have learned soooo much from more seasoned nurses. That is not to say she should be totally dependent on the other nurses (I always look up procedures or meds I'm not familiar with in my own little library)but I have learned soooo much by watching and talking with my nursemates. Building her confidence will defiantly help but she has to be confident enough in herself to ask others for help. I'd rather her ask another nurse about the condition of his leg rather than it get worse throughout her shift. I'd rather be a safer than sorry nurse.

DG5 · Jun 25, 2005

Fuzzball, you need :icon_hug: lots of hugs. What a burden to bear. You must feel as if your heart is going to break when you go home (literally) I thing you have three choices:

1. Stay where you are but be prepared for a long hard and possibly dirty fight to get the help you need on the floor. This could be harder than the job itself.

2. Accept the situation, give up, and compromise your ethics and self esteem, your family home life. It's not worth it in the end.

3. Find another job- make sure you are not trading one pile of dirt for another. Previous post makes a lot of good sense.

You need SUPPORT during this time. Is there anyone you can turn to at this time? Let us know what happens.

nsnan_2000 · Jun 25, 2005

First off, do you really want to work LTC? Yes, it is emotionally draining and frustrating at times, but if you really have a love for the elderly, it can also be very a very satisfying and rewarding career. First off, you have to do whatever it takes to ensure the safety of your residents and your license. If you have followed your chain of command in your facility and getting no results about the CNA using drugs and endangering your residents, you have an obligation to report to appropriate authorities. What if you left there and found out she had hurt or abused someone? Could you live with that? I know I couldn't.

Sometimes it is difficult to work as a charge nurse over people you once worked side by side with as a CNA, but YOU are the charge nurse and you are thier supervisor, whether they like it or not. If they are bossing you, you may have to remind them. If they aren't doing thier jobs, you must confront them and possibly do write ups. We cannot make people respect us, we have to earn it by being just and fair. We as nurses also need to let our CNAs know when they are doing a good job, because they are often the first to apprise us of changes in our residents. With 39 residents to look after, there is no way that you can take care of them alone and see all that you need to see without the help of your CNAs. As a former CNA yourself, you know how hard it is for so little recognition. I always try to encourage and let my CNAs know how much I appreciate all they do and I find that they will work much harder and go the extra distance for me. Of course, there are some there just for the paycheck, and no amount of encouragement or praise will make a difference to them, but the majority will appreciate it.

I hope that you will hang in there if this is what you really want to do, but if it is not, then remember that not everyone is cut out for LTC.

Sincerely, Nancy LTC Charge Nurse for many years

Hi everyone. I am a new nurse with just 3 months of experience. I started at the LTC facility that I was employed as a CNA. Anyhow I feel so frustrated and disappointed with nursing. I work a LTC unit of 39 patients by myself. I tell myself It will get better, but it dosn't. The CNA's try to boss me around and management loves them. I have one aide who I think is dangerous. I suspect her of being on drugs...I have seen drug addicts in my time...she was high on coke. Anyhow this place refuses to perform mandatory drug testing. This CNA is their lead CNA and for some unknown reason the DON loves her. If is say something I know they will not do anything about it. THey look the other way in most situations at this facility. I am so overwhelmed trying to take care of 39 pts. along with med pass that is soooo tough. I feel like I am dying. My question is this: Is nursing suppose to be like this? Does it feel like a battle ?
I love my residents but dislike management and a few staffers who are unsafe. I am concerned for my license. I am a LPN but have no support from the RN who works 2nd shift. I am going through mood swings with this job and feel so depressed. Any suggestions? Thanks in advance......
LTC nurse who's going crazy:crying2:

Long Term Care Columnist / Guide · Jun 25, 2005

First of all, as you know now, the nurse role is VERY different from the CNA role, even within the same facility. I think expectations are higher too, because you worked there as an aide so you know how things are done, where everything is, and so forth. Nothing could be more wrong---you may have been there forever, but you are a brand new NURSE and thus need support in learning your new role and duties.

Secondly, people can forgive almost anything except a co-worker who's risen through the ranks to become their supervisor. I had the same problem when I went to work at the hospital where I'd been a CNA; suddenly I out-ranked the same people who had trained me as an aide, and they didn't like it. They challenged me at first, but over time I was able to prove to them that I wouldn't bully them or act like I was better than they were, and after that we got along fine.

Thirdly---and most importantly---LTC nurses have the hardest, lowest-esteemed, and most thankless nursing jobs in the universe. That's because a great number of facilities are poorly funded and managed even worse, and they are about PROFITS rather than people. LTC will suck the life right out of you and make you old and burned-out before your time if you let it........the way I see it, you can stay and try to change the system from the inside (which is an exercise in futility in most cases), or save your license and sanity by getting OUT and either trying to find a good facility, or going into another area of nursing entirely.

Personally, I recommend the latter........not only for the safety of your license and career, but also on principle. Let's face it: if nurses refuse to put up with bad working conditions and understaffing, eventually TPTB will realize they can't run those facilities without us and will HAVE to change the conditions.

Just my opinion...... :)

texas_lvn · Jun 25, 2005

I am not sure what state you are a nurse, but a facility is required to have an '800' or toll free hotline for any complaint to that states Medicare or licensing agency. You may make the report and remain anonymous!!!!! You may also contact your local state office of the DHS for complaints, and of course please contact your local authorities for any resident in danger and immediately call your state agency. LTC facilities are required to post the complaint numbers in clear view in a well seen area. The Texas number to the office of the DHS if 1-800-458-9858. They might also be able to help you with other states' numbers......

Sue7573 · Jun 27, 2005

Hi Sue, I'm glad to hear you have confidence in your nurse freind and that you are there to help her (we should all be so lucky:) )But I really hate to hear you discourage her from asking her other nursemates questions. I have learned soooo much from more seasoned nurses. That is not to say she should be totally dependent on the other nurses (I always look up procedures or meds I'm not familiar with in my own little library)but I have learned soooo much by watching and talking with my nursemates. Building her confidence will defiantly help but she has to be confident enough in herself to ask others for help. I'd rather her ask another nurse about the condition of his leg rather than it get worse throughout her shift. I'd rather be a safer than sorry nurse.

Thank you :) Well noted but to clarify.. I didn't want the one particular nurse to be asked for the main reason that I have heard her say about my friend "I knew she wouldn't be able to do this job" a couple of weeks back when my friend asked her to help her do something else.

Any way I see your point about getting help when needed.