Overwhelmed & unsafe in LTC =(

[vanilmil]

Hi all ~ I am new to this forum & am looking for input from more experienced nurses =)

I just passed my boards in Aug. & have been working as an LPN in LTC since Sept. 1st. So many days I leave work feeling overwhelmed & upset that I may have harmed a resident due to negligence or a medication error. I hate the feeling of going home uneasy about my job, license or the status of a resident. For example ~

Last night a resident (who is oriented X3) was irritated by her roommate & asked for a "nerve pill" Her only PRN's are for Tylenol & sublingual nitro for chest pain. I told her she doesn't have an order for a "nerve pill" and offered her a Tylenol. She debated the Tylenol, took it, and c/o throat/chest pain. Does that warrant nitro? The Tylenol was a big pill & she was in bed, propped up on her arm when she took it. I took her vitals, which were Ok & made a note to check on her in 30min. However, I forgot all about her until I got home. Maybe her chest pain was nothing, maybe it wasn't ~ who knows? But what if she *did* want a nitro? I didn't even offer it to her, and didn't even remember to check on her again.

I discovered another resident (also oriented X3) w/a bruise on & over her L.eye at when I started my shift at 4pm. She claims she "stumbled" when she got out of bed in the am & I was the first to notice it all day ~it's hard to believe no one noticed it all day, but I heard nothing about it in rpt. & she sits in her room in the dark, and her L side is facing away from us when we enter. I noted in her chart & completed an incident rpt (per procedure) but it wasn't until I got home that I thought about the fact I should have questioned her more re: specifically what happened, implemented neuro checks (per policy ~ even though I didn't see the event, she obviously hit her head) and contacted her family & physician.

Other nurses are able to complete a med pass, orders, treatments, etc. w/in their shift. But I have such a hard time completing a med pass for 25-30 residents w/in the allotted time frame, let alone make time for all of the other stuff. So many times I have caught myself about to make a serious error ~ which freaks me out, because how many times have I *not* caught myself??

I hate the feeling of going home & remembering common sense things that just escape me when I am at work. I just get so overwhelmed with what I have to do ~ and w/the interruptions that inevitably occur. I have only been a nurse for 6wks, and although that may excuse my slowness, it doesn't excuse my incompetence or the fact that I am unsafe.

I know I should find another job w/more support from the staff, etc. But it has been tough ~ no one wants to hire a new grad. In the meantime, I need to pay my bills, so I can't quit.

Has anyone else gone through this??? I know it is a common experience for new nurses to feel overwhelmed & exhausted ~ but what about errors? Did you feel your license was in jeopardy when you started out? Any advice?

[KBLPN]

The most important thing I read in your note was that you ARE aware of the mistakes that you are making. Many nurses will turn their heads at the fact some one has a new bruise -"maybe the next nurse on duty will notice", or maybe they are trying to take meds that the maybe do not need (Manipulating you). YES, you should have evaluated the chest pain and asked more questions about the bruise. You will learn that in time. Do not fret about being late or running over time on your med pass. Most of the time.. in the case of medication passes, fastest is not the best!

Hang in there. Nursing is a very rewarding career and the fact that you can make people "better" or more comfortable, or even just give them some attention is an HONOR!

[Blackcat99]

When I worked in LTC I always felt overwhelmed and remembered stuff I should have done after I got home. I have been an LPN for over 30 years. LTC is very difficult even for experienced LPN's so don't feel bad.Just continue doing the best you can.

[vanilmil]

It is so frustrating to hear, "learn from your mistakes" ~ when mistakes may endanger a person's life. I am very detail oriented & was on the Dean's List while in school, yet "book smarts" don't mean a thing if I can't quickly recall & utilize the information in the real world.

I can't help feeling like a bad nurse because these things escaped my attention while at the facility. I realize some people may not want to give details, but has anyone else had experiences similar to mine?

Even if the situation wasn't in LTC, just knowing that someone else also had similar problems and was able to make it after all would be encouraging.

Thanks KBLPN for being honest, and Blackcat99 for your encouragement.