New Grad in LTC

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I have been at my first RN job three months and I am still floundering. There are 5 halls in my facility and I have never been on one hall longer than a week. If I pass the pills like the MAR says than I spend all shift passing pills and am ALWAYS behind. If I do it like everyone else does then I can get done in a reasonable amount of time. However, if I do it like everyone else does and something goes wrong then there goes my license. I don't know what to do. I leave there crying most nights. If I tried getting a job at a hospital, how do I know I could handle that? I don't know what to do. In the hospital you may have 4-10 patients but you have to do everything and they are unstable whereas LTC patients are fairly stable. My confidence is shot but I love nursing, I love my patients. Any advice would be appreciated

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Specializes in psych,maternity, ltc, clinic.

Talk to your DON and ask if it's possible to be asssigned the same floor every shift, that way you get to know the patients and what they take, and can develop a rhythm. It may not be possible but it doesnt hurt to ask.

3 months is not that long. Its all new and takes some geting used to.

What do you mean when you say others are passing meds differently than you??

Anyway, good luck and dont give up!

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Specializes in LTC.

I work in LTC and I know exactly what you are going thorugh. To me nursing is nursing...the hardest things is learning the pts and their habits. a little trick that helped me save some time...on my 24 hr report or even on my report sheet i would put stars by my pts who had fs at ac and hs. i would also write what insulin they used. i would make a little key (ones that i would remember) about med times. For example a circle was 4p and a triangle was 6p and so on and so forth. and i did this because not all my pts got meds at the same time. and it really helped me save some time. so instead of flipping through the mar frantically i would just go to that pt where the symbol was. this did save some time. and especially for the fs as well. i hate flipping through the damn mar who has a gluco check. and ask your DON if you can stay on the same hall for a while to get the feel of thigs. and after you make your cheat sheet...make copies of it!

and a little food for thought: i work at the hospital too! you will do fine i promise. just relax!:heartbeat

GOOD LUCK!

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hi, i would also talk to your supervisor about your concerns but if they are willing to keep you on the same hall, i think that woould help you get a routine down, also before your report, go through the mars and write things down to keep you organized..blood sugars, gtubes,etc..let us know how everything works out

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I am experiencing the same thing you are right now. I feel I may end up with bad habits or worse - make a mistake that will mean my license. I hear from some people that you'll come around, you just need practice but at what point do I admit I can't do it. Especially when I get, "hurry up, speed it up," from some people and others are more understanding - you're new, and cautious, it will come. It drives me nuts. I am an LPN and will be working PRN. I am afraid that if they don't need me to long between shifts, I will never speed up and be more comfortable. I never get feedback as to what I am doing right - just what I am doing wrong, what they see frustrates me, or what I need to work on. Its crazy. There is NO nursing shortage. What they need to do is work on retention. Revamp training to be more flexible based on experience.

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You are correct. There is no nursing shortage, just a shortage of nurses willing to work in unsatisfactory conditions. YOU DECIDE THE KIND OF NURSE YOU WILL BE. Don't let the #%$&&^ get you down. Do what you you were taught to do. Oh, you learn shortcuts...and dont let others get you down. Been there. I don't mean to judge but some nurses forget the ethics and finish very quickly....makes one wonder what was missed. Keep on. Keep your head up. Keep your values. Speed will come as you practice. Safety is always first. Look for a mentor-a rspectable honest nurse who can help you.

OH.....3 months and you dont have it all down yet!! GOODNESS! (just kidding). You are just finding out that nursing school vs reality nursing is different. I cried every night too. Keep your head up. One day at a time. Be easy on yourself---to me you sound like avaluable nurse in the making. You care. Hang in there. You are still learning and the first year is so very, very tough. Say a prayer. I will be praying for you too.

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Oh yeah....mt first job was LTC.....be strong. Go talk to the hospital recruiter. They have preceptor programs and they need nurses with integrity and caring. I know your confidence is down but think of all you have done. Graduating school and taking boards just means that you are safe enough to practice nursing, It doesn't mean that now you know it all. :) It took me awhile to realize that. It's okay to say you don't know, as long as you find the answer---let me tell you--patients and employers respect that. I think you will be a great nurse just by reading your concerns. Good luck.

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