OMG I feel so overwhelmed

TheCommuter, BSN, RN · Mar 10, 2008

This post was split into its own separate thread to accrue more replies.

Sabby_NC · Mar 10, 2008

Bless your heart my dear I just want to encourage you.

Do not give up on yourself or your abilities.

Mind you that patient ratio made me :icon_roll

Good grief that is a lot but I am unsure what the 'normal' rations are.

Oceanmoon · Mar 11, 2008

:bugeyes:Oh my gosh. What a ratio for a new grad. Did you ever think about maybe starting out at the hospital so you have a lower ratio. I am so afraid you are setting yourself up to fail. That's a load. I will keep you in my prayers. Hang in there but not so long as to burn out.

eccentricRN · Mar 11, 2008

I worked in LTC as a nurse extern... our ratio varied but often it was 1:25-30. It drove me nuts when I first started that I took so long to pass meds... I too often had one med pass pretty much follow the previous one... over time I became quicker & as I learned where to look for med info... learned my residents & developed a way to know who I passed meds to, who could be difficult, who likes them before meals/after meals, who likes warm water, etc... things moved quicker... now please don't ever get in the bad habit of assuming you know the meds without checking... just know it'll get a little quicker & a little smoother going. You will however, have nights where you will be far behind... when caring for that many different people things happen. Just learn to go with the flow & have a sense of humor & realize it is what it is... it takes a special type of nurse to work in LTC:bowingpur & I wish you the best of luck!!!

Lovely_RN, MSN · Mar 11, 2008

I am a new nurse too so trust me when I say that it will get better!

I have been on the job less than two months and I am learning every single day but it's definitely not as bad as it was a few weeks ago.

These days I even have my moments when I am enjoying work.

You will be able to do your med pass faster as you get to know your residents. During my first week I was starting my pass at 5pm (one hour early) and I was not finishing until 9pm! Just in time to give insulin and do the smaller 10pm med pass. I was staying late to do wound care and paperwork; it was crazy.

I am learning that LTC is all about time management and people skills. I learned pretty quick that I have to stay on a tight schedule to get all my work done. Also all that stuff about prioritizing your work is very true. I have had moments when I have to ask myself if what I am doing now is the most important thing that needs to be done.

The CNAs can also make you or break you. The regulars on my floor are good but sometimes when they are off I get people who are not so good and I have to stay on top of them to make sure their resident's are getting good care. I am respectful to them but I do not let them walk over me. Also, I do not get too involved in doing their work because they cannot do my work and they can help each other but no one is there to help me. This doesn't mean that I will let a resident pee on themselves before I will toilet them but if they are around and I am busy then I will not stop what I am doing to do something they can do. This is important to remember because sometimes the CNAs will give you attitude about stuff like this.

Aside from that take a deep breath and have faith that you can do this. Accept that it's not at all like what they taught us in school and don't be afraid to ask questions. If the nurse's on your floor are not willing to teach you things then talk to nurse's on other units when you are on break and make them your go to people.

kayleighac · Mar 13, 2008

thank u everyone for the replies and the encouragement. its so difficult still and i hope it gets better.

eldragon · Mar 14, 2008

I feel your pain, also.

I just finished my 10th day in at my first nursing job. I have had a ratio of about 22 patients to me and my orientator. All I do is meds and a few other things, we have treatments nurses.

But the CNA's don't do vital signs, which really bothers me. I need that time to pass meds!

Anyway, today I got to work at 6:45 and left at 3:45. I did not have a break, in fact, I did not even sit down once during that time!

And they are going to dock me for lunch, so they got that for free. I couldn't help it, there was no way I could go to lunch and catch up at the same time.

As I said, today was my 10th day, and another girl was with me. It was her 5th day, and I was told to let her do the morning med pass, and me do the afternoons. I knew that was a huge mistake.

She was WAY behind, even though I did her vitals for her and helped her all morning. I also called the pharmacy and ordered things, pulled dc'd meds, etc. So we are supposed to be done by 10, but at 11 there were still 3 patients left. I did them for her, while she did something else.

Then the CBG's were late. I did them, and charted and everything, and meanwhile, our lunch was over. She went anyway.

It was such a horrible day, and we both almost got written up for documentation errors. And yes, we're in orientation, but two days this week, it's just been us!

The DON is a peach and told the nursing supervisor not to write us up. The new girl was about to quit, and I started my period, and my back felt like it was breaking in two. And I was dehydrated.

So it was a bad day for me, too. I feel your pain.

Hang in there. With time, it should be better.

TheCommuter, BSN, RN · Mar 14, 2008

But the CNA's don't do vital signs, which really bothers me. I need that time to pass meds!

I have never worked at a nursing home, LTCF, or SNF that utilizes their CNAs for the purposes of obtaining vital signs. Hospitals do this, but nursing homes do not (at least in my area). The LTC nurse must do the tasks that the hospital nurse can delegate to other staff members, which is why superb time management skills are crucial.

Good luck to you!

eldragon · Mar 15, 2008

The long-term care facilities I did my clinicals at, the CNA's took vital signs.

I raced around from patient to patient today, taking their vital signs, often having to switch cuffs from different sizes, re-check a low pressure with a manual cuff, etc., and it took me an hour.

I was very efficient at it, but I thought it was time-consuming for me to do. And I also thought I was only taking the vital signs to make sure the medicines were given safely, but after I was done, I was told (for the first time in my entire 2-week orieintation,) that I had been expected to take O2 stats and temps, too.

But that's the way it goes.

Brownms46 · Mar 16, 2008

OMG I feel so overwhelmed, I just got a new job at an LTC and the nurse to patient ratio is 1:30. I felt like crying last night, it was my first night alone as a new grad, and it was a Sunday, so it wasn't even busy, but it took me so long to do my med pass that by the time I was finished with my 5 p meds, it was already time to start my 9 pm meds. Another LVN even insisted to help me last night, and I still got out of there an hour late. I can't imagine how it would have bene without her help!! Any suggestions or tips?? I feel like I'm doing something wrong...

You know kayleighac,

I have been were you have at one time or another, even though I rarely worked LTC in my 27 years of working as an LP/VN. And one day I said I have had enough!!!

I walked away from bedside nursing, and entered into Information Services (I.S.), and I the only time I have looked back, is to thing...why did I stay so long. I got sooo tired of being used and abused by staff, family members, not to mention the low pay for the hard work I performed.

Do not get me wrong, I LOVED caring for others, but the number of patients and the conditions I worked in, too many times had me at my wits end at times!

I grew tired of not being able to take my break, or go to the bathroom when i needed to, or have to stay late due to a new admission, or to give report for the second or third time d/t assignment changes.

When I came into nursing, I LOVED it and couldn't work enough, but over the years things changed and I hated going to work. I worked as an agency nurse and then a traveler for over 13 years as a way to have some control over my life, but after a while even that did work.

One day I saw an ad that asked if I wanted to make a career change, and the rest is history. I have a career I love, and I finally feel I am very well paid! My only regret is that I did not find this career sooner!!

There are many opportunities out there for healthcare workers, and it may take time to find what is right for you, but do not allow yourself to stay in a position you are not happy in. Use the internet, and discover what you need to do to find the kind of work you would enjoy. I did and could not be happier!

:redpinkhe

Earthygal · Mar 18, 2008

I think all of the LPN soon to be grads in my class want to be RN's and work in the hospital. But the truth of the matter is that hospitals DO NOT utilize LPNs in my state. It's LTC/rehab/subacute or bust. I hear story after story about new grad LPNs being thrown to the jackels at their first job. (Think 1:50 ratio on midnights, 1:30 on days!) I'm trying to carefully research for my first job, but I'm oh so very frightened!:uhoh21: