New LPN, this is HARD. Need advice.

[dsomday]

I knew nursing would not be easy, but I never imagined it would be this hard. I just started a new LTC job, had orientation for 7 days, and I just finished up my 3rd night shift on my own. I am a charge nurse for around 26 patients. I do work along side other LPNs, plus a supervisor on nights and they have all been helpful. I am trying to be optimistic, but this job is so tough. It took me 4 1/2 hours last night to do my 9p med pass!! I didnt stop all night. Between treatments (3 G-tubes and 2 trachs), I didnt stop. I still couldnt get 2 straight caths done for culture and had to pass them on to 1st shift.

I feel like I cannot do anything right, everything takes me twice as long as the seasoned nurses. Everyone else seems to be taking their time, hanging out at the nurses station socializing, and meanwhile I am walking my legs off, rushing to get everything done on time. There are treatments that I just cant get done, and nevermind the fact I cannot possibly keep an eye on 26 patients at a time.

Sometimes I have moments when I wonder what I have gotten myself into. I will get cussed out by a patient, or a supervisor says I did something wrong (already have had a error). They have all been more than patient with me, but I wonder when their patience will run out. Everyone keeps telling me it will get better, but I just dont see how from my perspective.

Am I being too whiny and impatient? Does anyone have any tips on time management? I appreciate any advice you can give.

[Forever Sunshine, ASN, RN]

I was recently in your shoes. My first night on my own I was a mess. It took me 8 hours to give meds to 25 patients. I was nervous, I got cursed out, I needed help with the g-tubes, I couldn't find some of the meds. But I did not rush. It was 11:40pm when I finished.

Your feelings are completely normal. I gave it time, stuck it out and now I can pass meds to 50 residents.. and i'm even getting better at that(most of them are late. but.. they get it).

Let the state surveyor try and pass meds to 50 residents in the allowed time frame(1 hr before.. and 1 hr after). Lets see how much they get done.

[christie25]

Thank you all for your advise. I am a new LPN. I just got my first job in LTC I had two nights training and now am on my own with 26 residents. It took me until 9pm to do my 4:30 meds the first night. My second night I finished sooner and did not need quite as much help. so far the other nurses have been very helpful. I did not realize all the things nurses do besides give meds. I hope I will catch on Quick

[BreeLPN2RN]

It is so unacceptable to have such a short orientation for a new nurse!! Our LTC facility gives one whole month of orientation to new grads and 2-3 weeks for experienced new hire nurses. I work the 3-11 shift and if anyone of our nurses see another one struggling, they jump in and help. We don't even have to ask for help, it's there! I love my job.

Hang in there, I promise it gets easier!!

[kcochrane]

I agree 7 days is just not long enough - I had 16 weeks and I was still lost for a long time.

Keep taking it one day at a time and do the best you can. You will eventually get a routine down. You will get to know the residents, who you should do first, what you can combine toether, what can wait and what you can pass off.

LTC is great to learn how to organize your time. Good luck!

[SuesquatchRN, BSN, RN]

You're gonna be rockin' it in no time. Seriously.

[Reese17]

Im in the same boat, Im going on my 3rd week and work the 2nd shift at an LTC facility. I only received 3 days training as a new grad. Its only been 3 weeks but it feels like I have been there for 3 months!!!! The stress is unreal !!! There are some nights where I stay over 2-3 hours. Some nights I dont take a break at all! Everyone I work with are really nice and supportive, some more than others. What makes it even worse is I dont have a regular set, they float me from the 1st floor to the 2nd floor different units so I'm not able to become familiar enough with the residents. There are sooo many frustrating things about working in an LTC facility, but like the other posts have mentioned we must hang in there. It will get better!:) I have some days where I feel like I did an ok job...also what I have found that helps me is I have a clipboard that I keep at the nurses station and on it I have a schedule written out, for example (2-3:15 get report, count narcs, load cart, get labs and pull charts, do rounds 3:15-5 do bgms and pass meds, etc)...this schedule has allowed me to stay on track and do more than just pass meds, such as call doctors and fax to pharmacy. In the beginning all I had time to do was pass meds, when I would finish my 4pm's it was time to do the 8's but with my schedule it keeps me focused. Maybe you could give something like this a try...I think we have to find something that is going to work for us or we will drive ourselves into an early grave. Good Luck and keep us posted!

[dsomday]

Thank you to all who have responded. It really makes me feel better. Reese17, the clipboard idea is great. All of the med carts have clipboards, and I will definitely take your idea tonight and put it to use. 3 days training!!! That's worse than me!! Good luck!!! Thanks again. You guys are great!!!

[hotlpn]

@dsomday

It is hard!!!! I too am a new lpn grad and in 2nd week of working in LTC. I have about the same number of patients as you and am getting frustrated that it's taking me forever to pass meds, let alone complete treatments and doctors orders, and do other tings. One thing that I noticed is that the other nurses who have been there sometimes pass meds to residents while just glancing at the MAR or not even looking at it at all. They also pre-set up all their meds in cups and set them in their drawer and just hand them out as they go down the hall. But this seems dangerous in my opinion because of the risk of med errors. I guess it takes me a long time because I don't know who is who and I have to hunt down the residents that aren't in their room so I can give them their meds. I'm scheduled to work a floor by myself with one RN supervisor and 2 aides in the building. I'm afraid I might have to constantly page the supervisor for simple questions while I'm only nurse the floor. I'm just frustrated because the work seems a bit overwhelming. I need advice.

[hotlpn]

And yes I also like the clipboard and schedule idea. I will be sure to do that. Thanks fro posting that!

[TheCommuter, BSN, RN]

It is so unacceptable to have such a short orientation for a new nurse!! Our LTC facility gives one whole month of orientation to new grads and 2-3 weeks for experienced new hire nurses.

You're blessed and extremely fortunate to be working in a facility that bestows adequate orientation time to its nurses. The nursing homes and LTCFs in the city where I live routinely offer 2 to 3 day orientations to new grads, and management will laugh if your face if you dare to ask for more time. The facilities in my area view lengthy orientations as "milking training time."

[dsomday]

I definitely wouldnt prefill cups just to save time. Im like you, too afraid of med errors, petrified actually. I would rather take forever and be safe and right than try to be fast. I watch the other seasoned LPNs also and try and remember the good habits they have that I would like to do, not the bad ones. I still dont see how they have so much time to socialize when Im running my legs off.

And as far as your supervisor goes, that is what she is there for, to ask questions and supervise. I wouldnt hesitate to ask any and all questions you have, that is the only way that I learn. Some of the other nurses I work with and have to give report to act like I am such a pain in the a*** because I am new. They walk away when Im trying to give report and totally ignore me, and just treat me like I am plain stupid. I guess they have forgotten what it is like to be new. Hopefully your supervisor is helpful, mine are.

A lot of the nicer nurses tell me it will get better, and I believe them. Just keep your head up and like the other posters have said, every day remember one positive thing that happened during your shift, and dont dwell on the negatives.

Good luck, and remember you are not alone!!!!!!

[SuesquatchRN, BSN, RN]

They also pre-set up all their meds in cups and set them in their drawer and just hand them out as they go down the hall. But this seems dangerous in my opinion because of the risk of med errors.

It's also illegal.