New LPN in LTC

[Imma_new_LPN]

Hey all. I just started my 1st lpn job. I'm an RN grad, failed my boards. So I got a job in LTC. They have a treatment charge nurse and meds charge nurse. I'm on the massive struggle boat of charting, faxing, calling, noting notes that have been noted or need to be noted. I've been on meds for 4 days. And am able to do that. But I'm really worried about my rotation as treatment nurse. The facility is less than stellar and majority of CNA'S are incompetent. I don't remember ever being disrespectful to my nurses as a CNA.

Help. Help. Help. Help

[Blackcat99]

Welcome to the wonderful world of LTC!!!! Yes, in the old days the CNA's treated the nurses much better. In the old days, when I was a CNA, if a nurse asked me to do something I did it. Nowadays, it seems if a nurse asks some CNA's to do something they get a lot of "bad attitude" or a big argument from the CNA in return.

[amoLucia]

Win them over early! Try a box of DD or bagels and just say that you appreciate any of the help they give you. I did it every payday - I was Unit Manager and it was my 'Thank You' to my staff.

[NurseSpeedy, ADN, LPN, RN]

Welcome to the wonderful world of LTC!!!! Yes, in the old days the CNA's treated the nurses much better. In the old days, when I was a CNA, if a nurse asked me to do something I did it. Nowadays, it seems if a nurse asks some CNA's to do something they get a lot of "bad attitude" or a big argument from the CNA in return.

I noticed this when I went from working in hospitals to working in LTC (briefly). Granted, most of the aides were not certified, as it was an ALF so it wasn't required by law.

I noticed that in this setting the staff really didn't know much about different conditions the residents may have as most had some knowledge base working in acute care. They would ask me a question about the resident and I realized I had to go back, start over, and explain it the same as I would to a patient's family member, not a coworker. The lack of understanding what was going on with the resident and why I had to do what I was doing to care for the resident at any given moment just increased the confusion. Just because I'm not running around answering lights does not mean that I am not working. I am at the desk, searching the chart to find the doc/family contact info, calling the doc, getting orders to treat the new issues with the resident, calling the family, and trying to get them to send the resident to the hospital for a quicker evaluation than could be done outpatient. The whole time I have a med tech and an aide talking at the cart in the hallway and rather than answer a call light they get on the walker and ask me to answer it! Um, I'm busy doing part of my job, which is trying to get this patient to the ER before they deteriorate further. Now I need you to go answer the light. My point is, many of the aides did not understand the other aspects of my position and that as a nurse it's not just medications and care that I am responsible for, but monitoring, noticing changes in conditions, calling doctors and POAs, incident reports, and the endless documentation. The importance of the documentation seemed to be the most frequently misunderstood aspect of my position I think.