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New Grad LTC Seeking Advice

Well I am a RN new grad I work at an ltc of course,I usually work on a subacute rehab floor. I work 7p-7a. From 7-11 Ihave to float to other units I was never oriented to but whatever. From 11p-7a, I have 46 residents, I have to take these ppl bs checks, there are ivs, tfs (9+), treatments, skilled charting etc. I have to make out an assignment for the aids, call docs (labs,iv issues,xrays, ),wound vacs. I have to check in drugs, do the census, change over. I'm just not sure if it's the facility or me,other nurses are doing it. It's very hard and god forbid a new admit, readmit or fall I might as well spend the night. I am very frustrated andI am thrilled I don't have to go back to the hell whole until wednesday. This other nurse enjoys making my life hell (but forget her).

I'm just not sure if I'm a wimp or what and often at times it doesn't feel safe. I get in trouble alot for not doing things, but I was never trained or told about certain things . Ppl ask me stuff about residents and idk I have to look in the chart. It is very unorganized papers are always every where. Ijust don't know....

I understand being a new grad is not easy I cry a lot but do I have reason, or is this really hell. Also veterans if you can help me out with a routine,it would be helpful. If I stay on one floor I can get out on time, but if I float I easily stay over 2hrs. I have been employed at this facility since July 3, I really want to quit, but I go back just to make sure I want to quit. I have talked to the don, managers, supervisors,nothing is changing. My unit manager quit, and the person who oriented me quit soI don't have them anymore. I'll quit babbling bc I'm so flustered, tonight was badbc the supervisor called off,this guys midline came out, andI was on a floor I never been on Yikes. I apologize that my thoughts are all over but I hope someone can get my drift.

Muffy5 specializes in Acute rehab, LTC, Community Health.

No, it is not you. I am a new grad RN and also work in a sub-acute rehab facility. I however, do not have nearly as many patients as you. 46, really? Well, that does sound really unsafe. I would say it took me a year to feel comfortable, not have panic attacks before work and not cry after...It will get better. Do you absolutely have to float? You could speak to staffing/the DON and request that you do not float until you have a little more experience.Pay attention to the experienced nurses that you trust and model your work after them. It is best to do something when it comes up (put in orders, charting, etc...), don't save it until the end of the night, because this will end up adding extra time to the end of your shift. You'll figure it out, after about 6 months I guarantee you'll feel different, don't give up yet. It is hard, but so was school right? You made it through that! Good luck to you!

itsmejuli specializes in Home Care.

Oh heck no!

Other people quit, you should too. Its unsafe and your license is at stake.

NamasteNurse specializes in Pediatrics, Geriatrics, LTC.

Both previous posters have good points. You will get used to it if you stay. It takes about 4 months to become proficient at a job like that. Try to be focused and do one thing at a time then move on. BUT-there are plenty of jobs for RN's if you truly feel unsafe start looking elsewhere.

No, it is not you. I am a new grad RN and also work in a sub-acute rehab facility. I however, do not have nearly as many patients as you. 46, really? Well, that does sound really unsafe. I would say it took me a year to feel comfortable, not have panic attacks before work and not cry after...It will get better. Do you absolutely have to float? You could speak to staffing/the DON and request that you do not float until you have a little more experience.Pay attention to the experienced nurses that you trust and model your work after them. It is best to do something when it comes up (put in orders, charting, etc...), don't save it until the end of the night, because this will end up adding extra time to the end of your shift. You'll figure it out, after about 6 months I guarantee you'll feel different, don't give up yet. It is hard, but so was school right? You made it through that! Good luck to you!

Yup I spoke with her about not floating. And she said it was impossible for me not float.....mind you the scheduler is a stna who knows nothing about acuity. I was a reck the first time I floated so I spoke with the DON immediately, bc I was never trained on the units I float too, I was never even trained on the 3-11 shift. I got orientation 7-3 and 11-7. There are really no nurses for me to look at there is me and another nurse who spends most of her time on the phone (7p-11p), 11p-7a I'm all alone and call the supervisor if necessary. The role models I have are one supervisor and the one who oriented me (she quit though).

Muffy5 specializes in Acute rehab, LTC, Community Health.

If that's the case, I'm with the other posters...I think you should look for something else. If you don't have the support of other staff, it sounds like a miserable situation...Good luck to you.

I too work a 7p to 7a shift but I am a seasoned nurse. You need to prioritize your work load. Meds have to be out on time focus on getting that done. Paperwork can be prn. Keep great notes as you go. Times, names everything. When everything is done on the floor you can sit down at the desk with your notes and chart and make sense of everything. If you come across a change of condition remember your ABC's. Put one fire out at a time. Keeping organized and developing a routine helps. Anticipate your residents needs before they ask. It does get easier as you get to know your residents. Don't give up you constantly second guessing yourself will make you and keep you a good nurse. Even when you think those around you with experience seemed to have it together they are second guessing decisions they have made.. Don't ever become overly confident those people scare the hell out of me. They kill people. LOL

I don't have it nearly as bad as it sounds, but I understand your pain, I don't have 46. I hope it will get better for you, its hard when you can't set a routine for yourself, but also a routine isn't nursing, one of my preceptors argued, you have to be flexible. Hang in there and stay safe and try to remember it will get better, thats what I've been trying to do as well.

Thanks but I quit. It wasn't getting any better and I hated my life. After I put in my 2weeks notice it really started getting unbearable so I just decided to not come back. Maybe I

ll have better luck next time if I get a next time.

I feel like I wrote the original post!! I am a new grad, on the same shift and started around the same time, floating, and same amount of residents. The facility I work at has the highest turnover of any place I have seen. I don't have a supervisor for the 7p to 11p shift and I am usually the only RN on. There is paperwork everywhere and there is no rhyme or reason to how the paperwork is filed. I feel like I have been thrown to the wolves and that no one has my back. I am debating on quitting myself but everyone is telling me that have to stay 6 months in order to get my experience. I feel unsafe at times but I am just trying to keep my mouth shut and just go with the flow of the place. Other nurses throw each other under the bus so I am waiting for my first warning.

I feel like I wrote the original post!! I am a new grad, on the same shift and started around the same time, floating, and same amount of residents. The facility I work at has the highest turnover of any place I have seen. I don't have a supervisor for the 7p to 11p shift and I am usually the only RN on. There is paperwork everywhere and there is no rhyme or reason to how the paperwork is filed. I feel like I have been thrown to the wolves and that no one has my back. I am debating on quitting myself but everyone is telling me that have to stay 6 months in order to get my experience. I feel unsafe at times but I am just trying to keep my mouth shut and just go with the flow of the place. Other nurses throw each other under the bus so I am waiting for my first warning.

I tried to hang in the for a couple months but I had to jump ship and I'm never looking back. Or atleast I know what I don't want if I ever pursue ltc again. Money will come if I'm supposed to have it, I'm in a position where I saved a couple mos, worth of cash. Yup we must work at the same place. No papers are filed correctly, everything is just thrown in this drawer in no particular order. I was thrown under the bus and written up during my first 90 days (maybe 60 bc I didn't make it 90)..... someone asked me about a lab req one day, and I was like what is that (no one ever showed me a lab req before, I usually just fax what I want to the lab). Tried to go in the policies and procedures manual one day (what a joke unorganized foolishness). It's good that you have the strength to endure sister, I hope you make it your 6mo-1yrand enjoy what you do.

Thanks but I know I am not going to stick it out that much longer. I feel like the place is so archaic and there is so much room for basic human error. I have never had a warning in my life so I will be so dissappointed when I get one, which I am sure I will get one. I also they management try to get people fired for stupid reasons. I understand that the residents are stable but ltc nursing is hard work. I love geriatrics but I don't love ltc. I live in the Boston area so the job market for new grad RNs is tough. I did work as a nursing assistant in a Magnet hospital while in school and they had a new grad program. I got an interview, which was intense, but unfortunately they wanted the BSN and I had my Associates. So here I am hundreds of job applications and no response. I went to this ltc facility, got hired on the spot, no questions asked, and they didn't ask for references.

So good luck to you and hope you find a job that you love and feel comfortable in!

Thanks but I know I am not going to stick it out that much longer. I feel like the place is so archaic and there is so much room for basic human error. I have never had a warning in my life so I will be so dissappointed when I get one, which I am sure I will get one. I also they management try to get people fired for stupid reasons. I understand that the residents are stable but ltc nursing is hard work. I love geriatrics but I don't love ltc. I live in the Boston area so the job market for new grad RNs is tough. I did work as a nursing assistant in a Magnet hospital while in school and they had a new grad program. I got an interview, which was intense, but unfortunately they wanted the BSN and I had my Associates. So here I am hundreds of job applications and no response. I went to this ltc facility, got hired on the spot, no questions asked, and they didn't ask for references.

So good luck to you and hope you find a job that you love and feel comfortable in!

Likewise :)

b_m_prosepct specializes in Med-surg.

Hang on there guys. I'm a new grad RN working in a LTC for 3 months. I have to care 30 residents on one shift, in the beginning it is terrible and the idea of going to work sometimes make me scared. But 3 months later I already start to feel comfortable. I think the trick for me is: stay in one facility and gradually know all the residents, what their meds are, their preferences, etc. Even for the subacute, these pts generally stay for at least a couple of months, so I got to know them after a while.

Good thing about LTC nursing job is that it is getting better and better as my nursing skills are improved, and job opportunities are plenty - though it is tough for new grads in recent years, still much better than lots of other fields. I love my nursing job more and more as time goes by, because my confidence level has gone up as my skills build up, I have learned a lot of new things, and money is not bad either, and I know it is just to get better as my experiences are build up.

Some of my learned new skills to survive are: keep a record of cruical things on the notebook, like an important lab schedule to make. Keep a special eye on the unstable pt /or pt that I do not know well. Know the family, especially the demanding family members, just to list a few.

So my advice is: hang in there, learn skills to survive, you will get there.

Edited by b_m_prosepct

DizzyLizzyNurse specializes in Peds Medical Floor.

I'm a LTC nurse on a floor of 46. I've worked there since I was 19 so I decided to try out other jobs just for something new. I worked at a nursing home just like the ones you guys are describing. Yeah for 2 days. Then I quit. If people aren't helping you and you feel unsafe, leave. It's not worth it.

I would have loved to hang in there. Nobody wants to resign during this recession, but when your gut tells you to RUN, then RUN.

My only regret is that I still have to finish out my notice, I can't get out fast enough.:eek:

b_m_prosepct specializes in Med-surg.

Zergasaurus:

Good luck, sometime you got to do what you guts tell you to do. Nobody knows your individual situation better than youself.

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