New agency nurse, please help!!

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I start this next weekend at my first agency assignment. I have been a LPN for 10 months now and have had three jobs. One in a nursing home, one in assisted living, and one in a pediatric office. I will be working 3rd shift in a nursing home for most of my agency assignments. I'm very nervous and can really use some advice.

Anyone who has worked agency, do you have any suggestions about what to do in order to succeed? (I am also 18 years old, which has caused me some problems recently with people treating me as though I'm less of a nurse because of my age) so I know the fact that I look young will probably add some hostility.

What are the typical things that go wrong in nursing homes, and what are the typical solutions? Please, any help that anyone can give would be greatly appreciated. Thanks so much

Megan H.

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

When I worked 3rd shift at a local nursing home, I had 70 patients by myself. You'll simply need to manage your time extremely well.

The fact that you are an agency nurse might compound the issues, because the staff who are actual employees of the facility tend to not like agency folks. They figure you're being paid more money than them, so many of these people will purposely not answer your questions or assist you. You'll need to be a strong nurse with a strong personality who is willing to jump in there and figure out things for yourself.

Good luck to you!

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I agree with The Commuter. I have seen agency nurses mistreated by and run off by the regular employees. Make up your mind before you walk in the door that you are there to take care of your patients and be paid for your work. If you can't get your questions answered by your fellow nurses, then take them to the nurse in charge. She is obligated to see that you have the info you need to do your job. Another thing to watch out for is the CNA behavior. They give new nurses and agency nurses a hard time to the extent that they get away with it. Be firm but fair with them. If you have a CNA who thinks their job is to sleep all night while their patients go unattended, write them up if you have to. Don't allow them to walk all over you because you are young. Some of them will surely try to get you under their thumb. Remember that you will be the one on the hot seat if the CNAs don't do what they are supposed to.

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AMEN!!!! I have done agency for almost 19 yrs. I expect my staff to DO THEIR JOBS!!! (and some CNAs do not like me for that reason LOL....) I try to jump in and help where I can, but if it comes down to doing my job or helping them.... my job comes first.... I can do their job, but they cannot do mine.

I try to talk to them first, and give one verbal (between me and them) the first time... after that, I write them up.... even if it doesn't get counted because I am agency it is a paper trail (and I keep copies for myself, and email the pertinent info to my agency)

Good Luck.... one thing I always ask for is a "map" --- tell me what needs done, and a time frame to do it.

Faye

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Bump.

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Thank you all for your help. I'm still wicked nervous, but I'm a very nervous person. I've heard from a lot of people that agency nurses are kind of hated, which I think is sad. But I will try my best not to let people bother me.

My biggest worry is all the different medical problems that can happen. Death is one thing, but there's also so many other medical crisis situations that can happen. I've never dealt with an emergency before so I'm wicked scared now because I'll be new and alone all night :(

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Whenever you have a resident who is starting to go downhill don't hesitate to ask for advice or assistance. If you can't get cooperation from the nurses who are most familiar with the resident, then go to the supervisor. It is the supervisor's job to see that you handle a change of condition appropriately. Don't feel bad about asking for help. It is expected. What is important is that the resident's needs are taken care of correctly. Not whether or not you handled everything by yourself. Keep your eyes and ears open. You will pick up a lot with each shift successfully completed. Eventually you won't feel so scared.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I've never dealt with an emergency before so I'm wicked scared now because I'll be new and alone all night :(
Nursing homes are not appropriate places to manage emergencies. If one of your elderly residents is afflicted with an emergent condition, obtain a telephone order to get them sent to the nearest acute care hospital. Also, don't hesitate to wake the doctor up in the middle of the night if it is a true emergency.
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So if someone goes hypoglycemic or if someone falls and then they end up ok, do I still call the doctor or wait until 1st shift comes in?

And if someone does need to be sent out what do I do? Call 911, then the doctor, and then the family?

I'm so scared something bad will happen because if it does I have absolutely no idea what to do.

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Specializes in Nephrology, Cardiology, ER, ICU.

I'm sorry and I may be way off target here but agency nurses are suposed to be able to hit the ground running and KNOW what is an emergency and what can wait. I think that you are setting yourself up to fail by doing agency so early in your career. By your own admission, you have had 3 jobs in 10 months. That is a lot of jobs for so little time. I doubt you are comfortable with your own skills let is alone supervise and decide what is going on.

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Maybe I am getting in a little over my head here, but I know that I can succeed. Knowledge isn't just knowing the answers, it's knowing where to find the answers. Through advice and good reference resources I know I can handle anything. That's why I'm here asking the advice of my peers.

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Specializes in Cardiac, Med-Surg, ICU.
I'm sorry and I may be way off target here but agency nurses are suposed to be able to hit the ground running and KNOW what is an emergency and what can wait. I think that you are setting yourself up to fail by doing agency so early in your career. By your own admission, you have had 3 jobs in 10 months. That is a lot of jobs for so little time. I doubt you are comfortable with your own skills let is alone supervise and decide what is going on.

I'm in agreement with Trauma. I don't want to say that you won't succeed, and certainly you made a good point in that knowing where to find the answers is critical. However, I've done agency and I can tell you there are some steep obstacles. I've walked into facilities that where the off going nurse did little more than hand me the med cart keys and then wave a cheery goodbye. It is often overwhelming and intimidating for the experienced nurse, let alone a virtual newbie, and at this point in your career, that is what you are, no offense meant. You MUST have strong assessment skills, instinct, and time management skills to survive. You will be on your own a lot. Some facilities and staff will be better than others and maybe you'll be able to get help, but don't count on it. Especially at night when there is skeleton staff. I wish you luck and hope for the best, but it would be my advice that you get more solid experience so that you don't put yourself or the patients you care for at risk.

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