New LPN in LTC

LPN1974, LPN · Apr 28, 2005

Well, I just started LTC on Monday. Today will be my third day on the floor and I find myself crying every night after I get off. I am still orienting with a nurse and I can't imagine what it will be like after she is gone. I only get 6 days of orientation which just doesn't seem like it will be enough. I know it will be better when I get a routine down but for now I am stressed beyond belief. I have 30 patients, 2 have g tubes, 1 new colostomy and a few diabetics. Last night I was doing a g tube feeding for the first time by myself, and thought that I could handle it but as soon as the other nurse walked out of the room the lady starting acting like she was choking. The fluid in the tube came up and started spilling all over. I immediatly panicked and thought that I had done something wrong. I ran to the hall to get my nurse and she wasn't around so I yelled down the hall and got the other nurse on duty, she came in and said that was normal and that she wasn't choking it was just (sp) choric movements. As soon as my nurse came in the room I just started bawling, and I think she felt really bad for leaving me alone. I just hope this gets better with time. I am so scared.

How far out of school are you? Is this your first job?

It seems you have about the same load I did when I worked a part time job in a LTC.

After your orientation is over will there still be another nurse in the building, that you can consult with?

That's what always helped me, just knowing there was another nurse available, in the building.

It will get better and you will do fine.

Chin up, girl, you're going to be okay.

txspadequeenRN, BSN, RN · Apr 28, 2005

Being a new nurse can be scary :sofahider and you will get into your own routine in a few weeks. What I have always done on a new floor is make my own list of things I have to do and the times they are to be done then mark them off as I do them. This way I dont forget anything. You should do the diabetics first before they eat. When your doing the tubes always check your residual first. If a patient is not processing the last feeding they can choke. But more than likley they just coughed and when that happens the formula is pushed back up into the syringe. So take it slow ,let it flow to gravity . Always make sure the head of the bed is up at at least 30 degrees. If it is the first thing in the morning ,I always ask the night nurse when the last feeding was. Sometimes she gets behind and if it was due at 4am but she gave it at 6am and the next is due at 8 am ,you need to wait a little longer before feeding that patient again.Does that make sense? You will always get back on track with the feedings. Who is passing the meds, I hope you have somehelp with that because that can be overwhelming if you do it ALL. My routine is diabetics first, then pill pass if I have one, then Gtubes. As Im doing my meds I do the assessments (if they are Medicare). I always do my charting between 10a and 2p then I start treatments are 2p. ( we do 12hr shifts) . By that time it's around 4P and time to do the BS again. I take care of my patients first and dont bother with who is at the desk or who is on the phone. It is hard to get it all done when so-in-so expects you to stop what you are doing for their emergency which is "Mom lost her blue pants and you need to find them":rolleyes: ... All the crap admin hands me to do ,I shove off to the side to do between 6-7 (if I have time). Of course it is not always like this and I sometimes have to jumble up my routine to make it work. And Ill tell you it does not work as well if I have to do that:banghead: . If I get an admission I do what I absolutly have to ,the nursing assessment, physicians orders ,papers signed by the family , verification of orders then everything else goes in the 6p-7p file. At my job we pass the things that didnt get done to the next shift (paperwork). It always get's done. I am the only one that works 16 hour shifts so I do alot of playing catch up for folks. It is hard to get used to and 6 days of orientation is better than most places give. I wish you luck, I do alot of nurse orientaion and watch their faces:eek: when all goes wrong. they look at me and say "How do you handle all of this " I go with the flow ,do what I can but get the most important stuff done first. I also do a whole lot of damn laughing ,sometimes that's all you can do.LTC can sometimes get utterly ridiculous.......You will get a routine down and do just fine. :)

Well, I just started LTC on Monday. Today will be my third day on the floor and I find myself crying every night after I get off. I am still orienting with a nurse and I can't imagine what it will be like after she is gone. I only get 6 days of orientation which just doesn't seem like it will be enough. I know it will be better when I get a routine down but for now I am stressed beyond belief. I have 30 patients, 2 have g tubes, 1 new colostomy and a few diabetics. Last night I was doing a g tube feeding for the first time by myself, and thought that I could handle it but as soon as the other nurse walked out of the room the lady starting acting like she was choking. The fluid in the tube came up and started spilling all over. I immediatly panicked and thought that I had done something wrong. I ran to the hall to get my nurse and she wasn't around so I yelled down the hall and got the other nurse on duty, she came in and said that was normal and that she wasn't choking it was just (sp) choric movements. As soon as my nurse came in the room I just started bawling, and I think she felt really bad for leaving me alone. I just hope this gets better with time. I am so scared.

April_LPN · Apr 28, 2005

How far out of school are you? Is this your first job?
It seems you have about the same load I did when I worked a part time job in a LTC.
After your orientation is over will there still be another nurse in the building, that you can consult with?
That's what always helped me, just knowing there was another nurse available, in the building.
It will get better and you will do fine.
Chin up, girl, you're going to be okay.

I am about a year out of school and yes this is my first job. And yes I have to pass all the meds myself.

nurseinmo · Apr 28, 2005

I know what you are going through, I am about a year out of school too and work in LTC/MRDD and have about 35 to pass meds to on average and depending on which cart I take we also have 6 with G tubes, one with a (feeding) pump, and 2 colostomys. It all sounds a little overwhelming, esp. when you are the only nurse in the building but you will fall into a routine and things will get better! Don't get me wrong, you will probably still have a bad day now and then, but you will have that anywhere. Just try to stay positive and relax, you can do this. You are after all, a nurse! :)

CoffeeRTC, BSN, RN · Apr 28, 2005

It will get better :) Will they give you more orientation time if you ask?

It does help to have a routine..I do things more like the other posters. Diabetics first, tube feeders last. Ask the nurse training you what the best routine is for her. Ask questions if you have them...there is never a dumb question.

Oh...be careful of residents with g tubes when they are coughing. I was doing a bolus feeding and it was like a volcano :uhoh3: Hint...pinch or kink the tube.

We all have a few bad days.

Mandylpn · Apr 28, 2005

I am new in LTC also, give yourself a couple of months for sure, do not give up. It takes time just to remember the resident's names. Come here for support any time, we will be here for you. Do you have friends who you went to school with who you could talk to? I agree with the other posters, a routine is very helpful to stay on task.