Recently started my first nursing job in a LTC (3 shifts off orientation) and while I don't dislike it, I'm weirded out by the total lack of support or supervision for new hires.
I had four orientation days in which I was paired with a nurse but there was no kind of structure to the training, let alone anything on paper that was geared to getting new hires familiar with the specifics of how things are done. I was shown how to log in to the charting software, but that was it. What I find equally strange is that the nurse managers haven't once checked in on my training or transition to working alone.
The lack of communication and organization on the nursing side of thing astounds me. There is no hand off report between shifts, just written summaries that tend to just carry over info from the previous shifts. The nursing desk is just a deposit of papers. I have no way to tell if an x-ray order form or an abnormal lab result has been faxed and taken care of, or ignored and left for me to be responsible for. Sticky notes would pretty much solve the problem but I have yet to see this simple form of communication utilized.
If I weren't running around managing med admin for every minute of my 8 hour (never under 9 hour) shift, I wouldn't have a problem having to do some investigation on the administrative side of things. But after I get the major morning meds done, I spend the rest of the day tracking down residents for various treatments and nutritional shakes that seem to be staggered every half hour.
I just need to know.....is this normal? Even if it is, just knowing it is will allow me to pick my jaw up off the floor and get on with figuring out how to do my job.
I know you didn't ask me, but in my experience new hires in these cases quit because they are overwhelmed. It's hard to get fired from a facility that has a hard time keeping staff as it is.
Recall four nurses getting fired from the LTC facilities where I worked. One, after another nurse's assigned resident died after this nurse entered the room (all agreed it was unwitnessed homicide), another who was fired when he got on the bad side of the nurse in the facility with the "power", a third witnessed elder abuse by the wrong nurse (DON's pet), fourth was the house supervisor who crossed the wrong LVN by criticizing her for sleeping on duty. The LVN did in fact, sleep on duty, but so did the house supervisor. The LVN got angry that she was criticized and ratted out the house supervisor, who was fired, while the LVN survived, to sleep another shift. Then there are, usually the new, nurses who get overwhelmed and quit. LTC is not always a good fit for the newly graduated nurse. It takes a somewhat strong personality to survive the working conditions in these places.
My first job as an LPN was in a LTC facility. That facility had 6 weeks of orientation/training. You could request more. Most felt ready at 2-3 weeks to go on their own. Very few wanted or requested 6 or more. We were doing 40 hrs per week for the training, all on the unit working along side another nurse. We did the majority of it on the day shift (regardless of the shift you would be working) and the last few weeks on your shift. I liked that because I could see a lot more of what went on during the day shift. I worked 3p-11p.
Our change of shift was always verbal and many nurses (myself inclued) would write up a shift report to go with that verbal.
The pile of paperwork wouldn't fly where I was. Everything had a particular way it was handled and where it went. Nothing was just scattered on the desk. When you would come in, if the off going nurse wasn't able to do something, she/he would start off report with that...Mrs X labs came in a few minutes ago, the doctor needs to be called..blah blah, or Mr Ts doc ordered an xray, could you call and schedule that..or whatever the case may be. Not often did things get pushed off on the next shift, so it wasn't a big deal to do something on my shift that was recieved/ordered on the previous on.
I'm sorry you're in a bad spot. While there are some crummy and disorganized LTC facilities, please don't let that leave a bad tasted in your mouth for all of them. There are some very good ones that are run like a tight ship and staff is given all the tools necessary to be a successful nurse at the facility such as the facility I started my nursing career in.
Specializes in Gerontology, Med surg, Home Health.
We are constantly tweaking our orientation process so we keep the nurses we hire (and let them keep their sanity as well). Two days in the classroom with the mandatories and computer training. Twelve shifts on the med/treatment pass with the mentor by their side. Two days at the desk with the resource nurse learning the ins and outs of ordering labs, faxing, you know, the stuff we all take for granted because we've been doing it so long. Then they go to the shift they'll be working and have at least 3 more shifts with a mentor. The supervisors spend a day with the ADON and a day with me (lucky them!) so the expectations are clear.
We've spent a considerable amount of time picking our mentors. Being a good nurse does not make you a good teacher. I meet with every new hire at least once a day during their orientation and ask them how it's going and how I can make it easier for them. Unfortunately, they don't always tell me what we can do better. We keep asking and trying to make it better.
Recall four nurses getting fired from the LTC facilities where I worked. One, after another nurse's assigned resident died after this nurse entered the room (all agreed it was unwitnessed homicide), another who was fired when he got on the bad side of the nurse in the facility with the "power", a third witnessed elder abuse by the wrong nurse (DON's pet), fourth was the house supervisor who crossed the wrong LVN by criticizing her for sleeping on duty. The LVN did in fact, sleep on duty, but so did the house supervisor. The LVN got angry that she was criticized and ratted out the house supervisor, who was fired, while the LVN survived, to sleep another shift. Then there are, usually the new, nurses who get overwhelmed and quit. LTC is not always a good fit for the newly graduated nurse. It takes a somewhat strong personality to survive the working conditions in these places.
Did I read this right? Did you say an unwitnessed homicide? Yikes! If all agreed I sure hope the police were involved.
Sounds like the LTC I started at...three days training, on the third day , the trainer left at 3 (shift was 2-1030), I was on my own and protested, but the unit manager said "Oh don't worry, I'll be here if you need anything". when I DID "need something", I discovered she had left at 5! The VERY next shift, a new nurse showed up and said, Hi, "I'm xxx and I'm supposed to shadow you..."
The residents, though, . There's nothing like the love you'll find in LTC. Best wishes and hope you stay to try to make it a better place.
. There's nothing like the love you'll find in LTC. Best wishes and hope you stay to try to make it a better place.
JustAdmitToObs
51 Posts
In terms of sink or swim, is it that the new hires quit or are fired?