New Grad LPN Feeling Discouraged

Trauma Columnist · Aug 31, 2017

Moved to LPN forum

Scrubs&Sneakers, LPN · Aug 31, 2017

I completely understand! I remember when I started nursing (oh so many years ago, lol ) , that I actually asked my supervisor what to do if I couldn't finish everything on time! Each nurse has an adjustment period in the beginning and that creates stress, but you will find out what works for you and base your time management for each shift on your resident acuity and needs. Just remember, take it one day at a time. YOU CAN DO IT!

Cactus Nurse · Sep 1, 2017

My dear, don't stress, remember EVERYONE you work with- including your DON, the NP's, MD's, PT/OT, CNA, RN, LPN/LVN, they all had first jobs and sucked in the beginning. No one is an expert right away. It takes time.

2 weeks is still a short amount of time. You literally need time, and alone time to get your rhythm and see what works best for you.

Have a notepad with you besides your med sheets and take done all your notes. Like the faxes and what to do when you get labs, etc... write everything down and refer to it when it comes up again. Program all phone numbers in your cell- pharmacy, diagnostics, NP, your DON, unit manager and any sweet co workers you think would answer a question if they aren't working. Use this forum as a resource honestly.

Go on pinterest and read little tips on how to get by, go on IG and see what other nurses do and what tips they say.

LTC is rough, high pt load, I know, I've worked it, well only covered shifts, I work Sub-Acute.

My suggestions are:

1. take notes whenever you learn something new.

2. highlight important things

3. save those phone numbers

4. make sure your CNA has taken the vitals before you start med pass so you have all your BP's, HR and temps ( if you need to do an intervention)

5. look through your tx for the shift- write down which rooms have tx and a simple note like- sure prep to heels, packing, kerlix, etc. if it isn't a short and simple tx you will go in the chart when you get to that pt.

6. med pass- start at beginning of hall, pop all your meds, if both pt in the room are PO, take both in and label the cups A and B

7. Someone isn't in the room, pop the pills still, label it, sign it, and move on. When you see them, give them their meds.

8. round 1 med pass done- start tx. start with more time consuming ones first, if anything happens, you don't want that one to be the last one at EOS when you're running around.

9. tx done- chart if you can.

10. med pass 2- same as before

11. tx in between again

12. med pass 3

13. finish all tx, do your daily charting, change of conditions, etc.

you have to get a pace going to really master it all, it doesn't come after 2 or 6 shifts, it takes time. Nursing isn't a "same thing everyday job". everyday is different, so you just have to see how to stack up duties at certain times. Time management comes with experience.

Feel free to PM me if you need to vent or have tips. I struggled in the beginning a lot, but now I feel confident in what I do and so happy I became a nurse

3ringnursing, BSN · Sep 7, 2017

It will get easier my friend. And those residents in that LTC will thank God for a conscientious nurse such as you.

Let me tell a little secret: LTC is harder than it looks.

About 21 years ago when I had roughly 2 years nursing experience I allowed a super high hourly wage lure me to fill in at a nursing home PRN. The LPN I filled in for (who in my opinion was super Goddess nurse woman) went on vacation. They paid me RN PRN wages to fill in for the LPN.

There were pictures of residents with the med sheets, but I couldn't tell them apart as most mingled in the dining room area (plus, I didn't know them). I pushed that med cart the size of a Buick all around the place, but only managed 1 med pass in 8 hours ("Here's 1 ... 2 oxycontins for you ... "). OMG - it was HORRIBLE!

I never actually got to the treatment cart ... (sigh).

The RN (I called her Queen Bee in my mind) never once got off her scrawny rump to help do anything patient care related. She wore all white head to toe so everyone knew she was "The RN" (which she seemed to feel had royalty status - I did not).

This went on pretty much the same way for 3 days in a row. To this day I still don't see how the LPN was able to fit everything in to a 8 hour shift. She deserved a raise, plain and simple. And perhaps a standing ovation ...

The only thing I can think of is the LPN had been there for quite a while, and she knew her shiz. And one day you will too.

Rome wasn't built in a day, and an experienced nurse can't be fashioned in 2 weeks. Patience my friend ... take a deep breath, relax your frayed nerves ... ask questions, and write things down. Nobody knows everything right off the bat. You'll rock that LTC eventually.

Good luck!

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Sep 10, 2017

See below. Fill in the names only and make copies. Edit the names as discharges/admissions occur. At the beginning of each shift, grab you a new cheat sheet to complete. This will keep you organized. (I was unable to upload the document; copied and pasted instead). Hope it helps..

LTC CHEAT SHEET

0730 Accuchecks

NAME RESULT INSULIN: YES or NO

1.

2.

3.

4.

5.

0800-1000: Morning med pass.

1130 Accuchecks

NAME RESULT INSULIN: YES or NO

1.

2.

3.

4.

5.

1200-1400: Afternoon med pass.

1600-1800: Evening med pass

1630 Accuchecks

NAME RESULT INSULIN: YES or NO

1.

2.

3.

Tube Feeding (Continuous/Type?) (Bolus/Type?) Time

NAME

1.

2.

3.

4.

5.

Crush meds (oral)

NAME

1.

2.

3.

4.

5.

Unusual medication times (Ex: Coumadin, Fosamax, Synthroid, etc.)

NAME of Resident Name/Time of Medication

1.

2.

3.

Nebulizer treatments Times

NAME

1.

2.

3.

4.

5.

cockadoodie · Sep 25, 2017

does anyone remember placing straws between mar pages to keep track of insulins and odd hour stuff? those good ol straws... worked for me!

Hello_Pretty, RN · Sep 27, 2017

At my first SNF job, I had a printout of all the resident's names and room numbers. I'd have colored pens and would indicate which ones had crushed meds, g-tubes, accuchecks, etc. I really like the list BSNbeDONE gave you. So take that and tweak it to fit your facility/residents. You'll know what works for you and what doesn't. After a few med passes you'll begin to remember. Most LTCs give 3 days orientation so you are lucky to have 2 weeks. Also, do not try to rush everything. Management will know that you are new and will probably end up overtime several hours the first few weeks. Some days I went home at midnight (we got off at 10:30pm) but at least I had all my charting done and MAR signed and TX completed.

Try not to take shortcuts because YOU WILL MAKE MISTAKES and you'll feel awful that you did. All that could have been avoided had you taken your time and did it right the first time. You can start doing shortcuts after a few months once you've gotten a handle on things. Everything was computerized when I worked my first LTC job and I never had to punch meds so it helped speed things up. Not sure how things are for you. Keep at it. You will learn and you will get better!