Overwhelmed...advice please?

[HLMRN]

I finally got my first nursing job at an LTC/Rehab nursing facility 6 mos. ago. I had 2 days of "training" which essentially was supervised med passes, before being thrown out on the floor alone. I am assigned to a wing with 22 residents. I do AM and Noon med passes, including pre-meal blood sugar checks and insulin administration for 5 residents, all treatments and all wound care. 2 of the residents have complicated wound care that takes at least 15-20 minutes each. we do not have a separate "dementia unit", so I have to handle the behavioral issues, as well. I also must handle contacts with the providers,family members,and outside agencies such as pharmacy and clinics. Typically, I have 2-3 CNAs to help on the floor. Most days I do not have time for a break, sometimes don't sit down until 3pm when I start my charting. The charting must all be done while sitting in the nurses' station. All charting is done by free-texting narrative notes. Only quarterly observations are done by checking boxes that apply. Much of the documentation is still on paper, and alot of the required charting is redundant. My shift is scheduled to run from 0630 to 1500. I punch out between 1600-1700 most days. I feel that the resident's are getting enough attention, and they'd be better off if I had time for more thorough assessments. Yesterday the DON told me my job is "in jeopardy" if I don't start getting my responsibilities completed by 3pm. The other nurses I've talked with say my wing is alot to handle, but the DON says it's just me who has this issue. I am dedicated and work hard, but now questioning my competence, my nursing abilities, and feel unappreciated. Can anyone help make this easier for me?????

[Nola009]

Well, if it were me, Id tell that old crusty DON of yours that be it as it may, a job "in jeopardy" is better than having a license in jeopardy, and that if she can't focus on all you have done with so little btw, to take the job and shove it. Then again, Im a new nurse too. I resent how little orientation a lot of these places give!!!!

[heartsgal, ADN, RN]

Well since my first job was in SNF/LTC, I will say what you're experiencing is being thrown in the deep end and being told learn to swim or drown. So you learn the best you possibly can with little to no instruction and a very heavy patient load. I loved my patients, but hated working under those conditions. I came home often feeling terribly guilty and knowing I had not remotely offered top notch patient care, because I simply couldn't with 22-26 of them and 1 of me. Sometimes I did ok and sometimes not. If your job is in jeopardy the best advice I can give you is apply at hospitals like crazy! Anywhere and everywhere, because after working SNF for 6 months you should get some call backs and interviews. I hated working at my SNF and the nurse mgrs, while some helped me tremendously, others were despicable and didn't care at all about the clients, just filling beds for reimbursement money. I've been rejected time and time again the past few months, but finally got a hospital position. You have been through the ringer, but all the things you've experienced there will help you immensely in landing a better job. When you interview you'll be able to think of many situations you had to think on your feet and prioritize to care for so many clients and that is desirable to hospitals. Hang in there it will get better. :thumbup:

[HLMRN]

I really appreciate your response, validation, and encouragement. So glad I found this site!

[iaejd]

I am you right now! Yes to this. I've been at the LTC for 2.5 months and dread going into work every morning. I have 29 residents on my hall with all the insulins and nebulizers and dressing changes and falls it's impossible. Having competent CNAs is rare. I have to spend time managing CNAs because they can't get along and will refuse to provide care to residents because "that's not my patient. She should have done it." And there are never supplies available, and I have to spend an hour in a the dining room and get in trouble if I don't take my 45 minute break and the NP hangs up on me when I call to clarify orders and there is a ridiculous amount of double charting. I don't feel like I'm providing good care. So I don't have any advice for you, just wanted to say, you're not alone.

[ProgressiveActivist, BSN, RN]

Now I might be a little jaded but I would not tolerate this for 2 seconds.

Your managers are scum.

You are being abused by incompetent *******s.

Since this job really sucks I would not stress over it.

having been in that circumstance I would provide the very best nursing care humanly possible.

I would blow off the non essential extraneous paperwork. You can make more waiting tables.

dont cave to a bunch of stupid threats from stupid people.