New LPN in LTC, questioning my career choice

[catdad12]

I've been in the nursing field since my senior year of high school. Through my high school I took the first of a 2-year LPN program and got my CNA. I loved the course and decided to defer my admission to university (for nursing) to finish getting my LPN. Due to COVID and other personal circumstances, I wasn't able to get my license in the state I now to go university in until now (my second year of college). I was however able to get my CNA license moved over pretty easily, so I've been working in facilities as a CNA for about 2 years, with 1 year home healthcare experience from before I moved here. 

Right before getting my LPN license here, I was finally starting to feel competent as a CNA in any facility. I felt like I was knowledgeable and had the perfect attitude and people skills, and my residents and coworkers told me often how surprisingly good I was at my job (because I'm only 20 years old). I had a great reputation at my last facility, and the DON practically begged me to stay there when I got my LPN license. I told them I'd love to, but I had just moved and a 2 hour commute each way was really taking a toll on me, and my grades were dropping as well. So I moved to my current facility by my new apartment.

In the interview, the facility seemed pretty good (I have experience from both great and horrid facilities) and they told me that LPNs are the medication nurses on the floor who work alongside an RN "coordinator" who handles paperwork, wound care, etc. essentially everything else. Well, I take the job and start training just to find out that was a LIE-- nearly all of their RNs had quit, so only a few floors had coordinators and some of those didn't have LPNs. Basically, they had 1 nurse on each floor doing the work of 2! The nurse/patient ratio is usually 1:40, and I've never seen more than 2 empty beds on a floor. Also, many of the nurses are so burnt out and overworked that they are extremely rude and inconsiderate to the new nurses. One said straight to my face that she didn't want to train me and basically just made me watch her work all day and didn't answer most of the questions I asked. 

Now I'm entering my second month of floating at this facility. I work 7-3 but essentially stay until 5:30 or 6pm every day and have never taken a lunch. I'm exhausted, and I've cried more than a couple times in the med room or bathroom due to stress. I work the weekends and 1 weekday due to school, and nearly every day I'm on a different floor. I don't feel competent, no one in the building seems to pick up their extensions, and I've heard of sooo many people quitting in the past month (DON, ADON, many LPNs RNs and CNAs). I fear for my license every time I walk into the building. It feels unsafe to be tasked as a brand new nurse with overlooking the care of 40 people with virtually NO help! One floor had CNAs who really knew how to work in a team, and that was the one day I actually felt safe and left work on time, but they already have a regular nurse so I can't work there unless she's off. The other floors have some of the craziest CNAs I've ever encountered-- one of them got in a screaming match with another because the other changed *her* patient while she was on lunch.....?!?!?!??! I would be THANKING that CNA, not yelling at her to not touch my patient, WOW!???

I'm freaking out and really don't know what to do. I'm supporting myself through college and really really can't afford to just get another job because most facilities only do training on 7-3 shift during the week, which means I could only train once a week (it took a month to finish my training at this job and now I'm in debt $1500 because I couldn't pay rent that month). It feels like just a matter of time until I make a med error or some other kind of really bad mistake because there is just way too much going on to focus or do an actually good job. This stress is affecting my mental health, schoolwork, eating habits, and personal relationships. 

Does anyone have any REAL tips for being faster at med passes (I usually don't finish my 10am pass until 1pm, even when I start at 8am. and by then it's time for 2pm med pass and I haven't done any neb Txs or wound care) or prioritization or convincing residents to take their medications(this takes a lot of time out of my day as many have dementia). Or especially tips for using PCC, as I never really got an in-depth training for it, just other nurses showing me little things on it.

Please, I've been reading entries on this website for over a month now and have seen many people in my position but not many actually helpful responses. I don't want to give up on nursing before I graduate, because I worked so hard to get my LPN and gain experience while being in school for my RN. But at this point I'm wondering if I should just work as a barista or server until I'm done with school. 

[mangobrains, ASN, RN]

1 to 40 in an unsupportive day shift environment is too much. I worked a year, evening shift on a supportive LTC and  most of the time I never got out on time. I never figured out a safe "trick" to the med pass with all the extra stuff like families, and falls.

Life is too short to be that stressed. I would suggest trying pediatric private duty nursing. They welcome new grad lpns. They have various types of cases and you only focus on 1 pt, and many times the families are very knowledgeable on their care and equipment. My favorite case was going to preschool with a kid with a trach who was pretty much stable.

[JKL33]

12 hours ago, catdad12 said:

But at this point I'm wondering if I should just work as a barista or server until I'm done with school. 

I mean, it isn't the worst idea IMO.

No way you need the ridiculous risk and stress of what you have described. You don't have to give up on nursing, you're going to be an RN.

I've never worked private duty home care as suggested above, but that sounds like a viable idea, too.

You could also get into a hospital (as a tech or possibly if they would hire you as an LPN--there have been some mentions of that coming back into play now that hospitals are struggling for staff). Anyway, getting into a hospital now may help you move into an RN position quickly after you're done with your program.

One thing is 99.99% certain: The woes at your current workplace are NOT going to be solved by you doing more and going faster and magically getting better and more experienced overnight. It's very possible that the reason you haven't read any good solutions for a shitshow is because there are none. It isn't your fault. But it does mean that you're going to have to think outside the box.

Keep your longer-term goal at the forefront (your RN program). Be careful with your budget to avoid any and all unnecessary expenses. Find a job that can keep you afloat until you graduate, even if you have to buy ramen in bulk.

You can do this. ??