One month too many in LTC

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Specializes in psych.

I passed NCLEX-PN in July. I just gave notice and left my first post-grad job after only a month. It was at the largest SNF in the region, and each nurse has 24-30 pts on days/evenings. Trachs, dementia pts that need one-on-one, tube feedings, quadrapeligics, breathing Tx's, you name it, mixed on each floor. 90% of pts on any floor needed their meds crushed or fed to them one at a time. I had 9 days of training w/ 4 different nurses, then floated on evenings.

When I was training, the nurses kept telling me that I would get my "own system", and "do as I say, not as I do". I found this was code for not doing 90% of the Tx's on any shift (but still signing off on them because you get in trouble if you don't sign), passing all the shift's meds at the same time, not giving nose sprays or eye drops, and never spending more time with a pt than needed to shove pills in their mouth.

I tried to do it right, confirming each med with each pt's MAR, doing all the sprays and drops, and assessments and Tx's, but I was too slow and ended up finishing the 17:00 pass at 20:00 or 21:00, then staying over for 2-3 hours to chart, and not taking a lunch (although they made me sign a card every time saying I "forgot to punch out").

My friend (another new grad) got written up there for getting behind on their med pass, so I knew it was just a matter of time before I got written up, too. I couldn't take the feeling of providing inadequate, and possibly unsafe, care any longer, so I gave notice.

So now, I am job hunting again, and running into the "no-experience" Catch-22.

Should I put the one month of experience on my resume, since I have no healthcare experience other than student nurse clinicals? Should I continue to keep the nursing school clinicals on my resume?

I should add that I liked the pt interaction, and hands-on skills. I got complements on my good attitude from pts and their families, and staff. I left the facility on good terms, and got along well with all the staff, so I think I can maybe be a good nurse someday, but I am discouraged. Am I just a big sissy? Or did I just get a bad break for a first job?

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Probationary status usually lasts 90 days. Many advise not to put down jobs where you leave before completing your probationary status. I would think that the 30 day job would pose more of a problem to you getting hired elsewhere. I would not put it down, but that is me.

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Specializes in Mother-Baby, Rehab, Hospice, Memory Care.

I agree, don't include it on your resume. It will probably look worse than having no experience. Imagine through the eyes of the employer: "so if we spend the time and money hiring this nurse, is she/he just going to quit in a month or two? Why take the risk?" It sounds like you made the right choice for yourself by quitting, but it doesn't make sense to put it on a resume. LTC is tough work and as a new grad you will probably be surprised about how it is in the real world vs. nursing school/textbook. Sometimes you just have to try to stick it out. It DOES get easier as time goes on.

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When I was training, the nurses kept telling me that I would get my "own system", and "do as I say, not as I do". I found this was code for not doing 90% of the Tx's on any shift (but still signing off on them because you get in trouble if you don't sign), passing all the shift's meds at the same time, not giving nose sprays or eye drops, and never spending more time with a pt than needed to shove pills in their mouth.

Sounds like my experience. I didn't stay long either. Sad.

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Ditto... exactly my experience with BOTH LTC facilities I tried... and one of them was "supposed" to be a "wonderful" place. I will never work in LTC again. I currently work in a methadone clinic. While the hours are brutal and getting up at 3 a.m. takes some getting used to, at least I am not expected to sign for stuff I haven't done.

Have a great day and good luck!

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Specializes in psych.

Thank you to all of you for the advice and good wishes, I appreciate It!

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Don't get discouraged I quit my first job after 5 months in gyn I hated my floor. Changed hospitals and stayed for 5 years when I heard we would be doing team nursing I thought not again, but here is was great team work, great staff I worked in both acute car, and long term over the years. I am now back in school after a long absence in the field, and shall be returning very shortly to nursing.

Lpn in Montreal,Canada

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Specializes in LTC.

I dont think I would put it down on an application /resume. I have a prn job kind of like the place you described. I work nights there and have 50 pts, a mixture of total care, skilled, feeding tubes, trachs etc. The load is heavy and the med passes are awful. The times of the meds are worse. Ive never seen a place where you have to wake somebody up at 2400 to give them 2 percocets, ritalin, and klonopin! Its stupid to me. the med aides on day shift often change the med times, which is a big no no because you have to have a written clarification order to do that. By the time I finish the midnight pass and do my charting, I have to start my am pass at 4am just to get finished by 640am because the mars there are soooo hard to read, they arent allowed to color code anything and its printed so lightly on there. Theres a charge nurse on nights who sits around on facebook all night long...she doesnt offer to put our meds in the cart for us or nothing. She doesnt help chart or do the I & O's. If I was the charge nurse there I would do all that xtra crap that puts others behind.

sounds like you left just in time.

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Specializes in all but OB and Peds.

I totally feel you on the LTC facility. I was hired on July 28th and on the floor training for 3 days then thrown to the wolves. I declare I spent most of my 12 hours giving meds. and like the place you worked at the only thing that seemed real important to them is that you are signing off. They didn't care if the tx's get done, the dsg actually get changed but you better make sure you are signing off. I was told I took to long to pass my meds whiel the nurse on the other side took 30 mins and she had just as many patients as me. I even had the techs that I supervised tell the "DON" that i was assisting them and helping them because we were always short staffed. But they didnt care, pt care to them was a joke as far as I was concerned. And like you when I left my patients and there families were very dishearten as well as most of the staff. I put my resingation in with no new job offer in site. While I was wainting for my 30 days ( you had to give a 30day notice) I did flu shots and then I saw a posting for a jail nurse, it was a 20 minute drive from my house and I have worked in the prison system before so I fgured why not...So I applied got the job and have never been happier

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I totally feel you on the LTC facility. I was hired on July 28th and on the floor training for 3 days then thrown to the wolves. I declare I spent most of my 12 hours giving meds. and like the place you worked at the only thing that seemed real important to them is that you are signing off. They didn't care if the tx's get done, the dsg actually get changed but you better make sure you are signing off. I was told I took to long to pass my meds whiel the nurse on the other side took 30 mins and she had just as many patients as me. I even had the techs that I supervised tell the "DON" that i was assisting them and helping them because we were always short staffed. But they didnt care, pt care to them was a joke as far as I was concerned. And like you when I left my patients and there families were very dishearten as well as most of the staff. I put my resingation in with no new job offer in site. While I was wainting for my 30 days ( you had to give a 30day notice) I did flu shots and then I saw a posting for a jail nurse, it was a 20 minute drive from my house and I have worked in the prison system before so I fgured why not...So I applied got the job and have never been happier

In most long term care settings, "quality care" is non existant. I am so glad that you found a setting that is a better fit. It is very sad state in most LTC's, that people in leadership roles "overlook" so much...I have went to do treatments days later (all the days signed off in MAR) to find my own initials and dressings that I put on 3 or even 4 days earlier...and have brought it to DON attention numerous times, can you say "fraudulent charting!??!" Unbelievable, but sadly true. Literally has made me sick.

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Specializes in all but OB and Peds.
In most long term care settings, "quality care" is non existant. I am so glad that you found a setting that is a better fit. It is very sad state in most LTC's, that people in leadership roles "overlook" so much...I have went to do treatments days later (all the days signed off in MAR) to find my own initials and dressings that I put on 3 or even 4 days earlier...and have brought it to DON attention numerous times, can you say "fraudulent charting!??!" Unbelievable, but sadly true. Literally has made me sick.

The DONs at most of these facilities no exactly whats going on. I remember one time the Charge Nurse or unit coordinator whatever she was told the nurse on the other side of the floor I was on to do my medicare charting for me, and this chick didnt even know my patients. I was like know I can do my own charting thankyou very much....She told the UC and said that I was to let her do it. Crazy...I had to get out of there. Another time I was sending one of my patients out to the ER and this same nurse butts in and calls herself taking over because state was in the building and as she is walking with the EMT out with the patient she is asking me is tis the patient that is going out. She couldnt even give them a decent report because she didnt know what was going on with the patient. Don't hink I didnt make my concerns known to state before I left that place because I did. Our LTC's are in a very very sad state of affairs and it doesn't seem as if anybody is listening.......

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