New LPN: Working Assisted Living and Not Learning on the Job

[Nurse Beth, MSN]

Dear Nurse Beth,

I've been an LPN for about 4 months now and work in an assisted living facility. I'm still learning how to paperwork but the work is way too easy. All i do is pass meds. I was hoping this job would improve on my fundamentals but it doesn't. At the same time, this job pays better than a skilled facility does so i don't want to leave this job. I'm afraid that when i go back to school and they see that I don't know what i'm doing,it'll be a huge problem.

What should I do?

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Dear Not Learning on the Job,

Congrats on achieving your LPN!

As far as staying at a job for higher pay that is not challenging....it's a tough decision only you can make, knowing your financial needs.

Could you possibly negotiate for a higher starting salary in a skilled facility?

"I would love to work here but it would cause a decrease in income I can't afford at this time."

You have nothing to lose is what I always tell myself when I go after jobs I want and don't think I'll get :)

You would learn so much more in a skilled nursing facility. If you can possibly make it work for you, I recommend it.

As far as going back to school, if you mean bridging to an RN program, you may or may not be judged by others for not having recent skills experience. If you are judged, simply say that your job did not include passing NG tubes, or starting IVs.

But in reality, your classmates are more concerned about their own (perceived) inadequacies and lack of experience. In a way, no one knows what they're doing, so you will be in good company:)

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

[Ruby Vee, BSN]

If you're a new grad, four months in and you're not learning anything you must be doing it wrong. Even if all you do is "pass meds," aren't you learning about the meds? The correct use, correct dosages, the drug interactions, the side effects, signs and symptoms of toxicity, and off-label uses? Aren't you learning anything about the conditions these meds treat? Frequent co-morbidities and what you would look for with those disease processes? You can be learning how to talk to patients, visitors, physicians, co-workers, ancillary services. How to pop your head in the door and do a 30 second mini-assessment to make sure your patients' condition isn't changing? There is SO much you can learn where you are. You may not be doing "skills", but hopefully you're learning to look for changes in your patients' mentation and physical condition.

[stella789]

I agree with Ruby Vee, there's always something to learn no matter where you are. In AL, there are sooooo many regs to learn that are necessary for compliance. I'm in St. Louis and you may not have these options where you are but we have several facilities that provide the whole continuum of care from Independent Living to AL to SNF to LTC. This week I started as ADON in one of these facilities and the LPN's are kind of shuffled between the different level of care so they do see more of a variety. These places also tend to pay higher than the stand-alone SNF's.

[BeverlyMeetze]

Dear Not learning on the job, I know exactly what you mean and agree with Beth! I have been in the nursing field for 26 years and started out in Assisted Living! In my case, though I wasn't Certified (didn't have to be back then) and learned so much hands on with the patients and their meds. You are learning more than you realize. One thing I have learned over the years is that you will learn so much more in every job you are in. You take some new information or perspective with you when you move from one job to another. What I can suggest, and This is just a suggestion, is try a PRN agency job. This will allow you to stay where you are, try other facilities, get the pay you want, and the experience. I will warn you though, agencies are not for the faint of heart! Most want you to have 1 year of experience, but some will take New Nurses. And, also when you go back to school PRN work will afford you some flexibility your current job won't. I worked agencies for 14 years as an LPN, and did everything from hospitals, prisons, detention centers, psych to long term skilled facilities. However, Beth is right, with all those years of experience, at school or at work, there are still days I feel totally inadequate!!!