Well, this is my issue. I just started as a LPN in a LTC facility on May 8. I had 7 days total orientation on 5 different teams. Not enough time to remember who the residents are, especially if most of them don't have their identity bracelets on and their pictures in the MAR are either not there or to old to recognize.
I started this past Saturday on my own caring for an average of 22 patients. I am suppose to pass meds, chart, call doctors, write orders, do my own admissions/discharges(when they arise) and do my own treatments.
I kind of feel that this place is not organized, supplies for the treatments and other things are usually not in their rightful place/not stocked.
The days that I was on my own I came home, elevated MY feet and went to sleep:zzzzz .
I feel so rushed when I go to work. I am so focused on getting my meds passed that I start around 7:30AM and have been getting finished with that first round around 10:00-10:30. Then it's time for me to get ready for the second round. I'm on my feet from the time I get there to the time I leave just about, except for my 30 minute break.
I have learned that you organize things yourself and you delegate organizational tasks to others if that is an option. At the beginning of the shift, I pass the emergency oxygen tank room. That is when I pick up a couple of bottles because I know I will need them within the next hour. If I know a CNA is headed toward the main supply room, I ask them to bring something back. Before I go down the hall to do the majority of my treatments, I know I probably wont have enough 4X4's, normal saline, tape, and abd pads. These are the things I grab automatically before I start treatments. Things will get better!
As a new grad, I had two days of day shift orientation. Then I came to work to orientate on the evening shift but the evening shift nurse didn't show up. I was told it was up to me. I didn't know what else to do so I did it. I always say, I knew that if I could survive that night, I could survive anything. I think maybe I have. It's not a perfect world. I still love LTC because I get to care for people that I have had time to develop a relationship with. If my med pass is late because someone needed me to just listen to them, that's okay because I care about them. Most of the time, I think listening to them is doing a lot more for them than any pill I give them.
I just want to first say thank you to all those that took time to reply. You were right in saying that it'll get better and I will find my groove. I am really learning the swing the things and things I can do to make life easier for me at work.
The short time that I have worked as a nurse in LTC as been such a joy, meaning, my interaction with the residents. I feel so blessed and honored to be able to serve people that have put in years on this earth(meaning alot of them are in their 80's and 90's). I enjoy hearing their history and legacy's they have passed down to their children and grandchildren. But sadly, you run into some, whose children or other family for whatever reasons never come to visit:o. I try to make it a point, to make especially those, feel valued and special. Maybe God will bless me to have a long life also.
just had to add my two cents worth here. the nursing school i attended was run in cooperation with our local hospital which is a small rural facility with a 111 bed ltc facility attached. as you can imagine, our course work was geared towards geriatrics. we got maybe a week of peds, a week of or, ob, etc. and the main emphasis was ltc. as an 18 year old brand new lpn, this was definitely not where i wanted to be. now i'm 35 and can't imagine working in any other area. there are times i've daydreamed about working somewhere with more decent hours, weekends off, etc., but still i stay. in a lot of cases, we're severely understaffed, overworked, and of course, underappreciated but then, just when you're ready to throw in the towel, a moment happens that makes it all worthwhile. today was a good example. i've always worked 3-11 (i hate alarm clocks lol) and i knew that today would be hectic. we had a feisty little lady who was on her way out but she'd been stubbornly hanging on when most would have given up and gone on. last night she spiked a temp of 106.1r and we knew then that it wouldn't be long. at 1530, with her son holding her hand, she took her last breath and slipped quietly away. her daughter arrived not long afterwards and i met her in the main hallway. even though i had meds to pass, calls to make, and a million other things to do, i walked up to her and she hugged me as if she'd never let go. "all i can say is thank you." needless to say, we both shed more than a few tears and i spent the rest of my shift knowing that to one person at least, i had made a difference.
i just realized that it sounded as if i was unconcerned with the death.. i wasn't. the supervisor was handling the details and making the calls and the room was filled with family and staff who were close to the woman. i'd leave the room occasionally, give out a few meds to keep from getting too far behind (i have a 35 resident unit to care for), and then i'd go back to see if the family or supervisor needed anything. it's just that after re-reading my post, it sounded a bit calloused to me. mental note... preview first... then post.
i agree...in ltc it's definitely the little moments that count. they can last a few seconds, a few minutes, but they make your day.
just had to add my two cents worth here. the nursing school i attended was run in cooperation with our local hospital which is a small rural facility with a 111 bed ltc facility attached. as you can imagine, our course work was geared towards geriatrics. we got maybe a week of peds, a week of or, ob, etc. and the main emphasis was ltc. as an 18 year old brand new lpn, this was definitely not where i wanted to be. now i'm 35 and can't imagine working in any other area. there are times i've daydreamed about working somewhere with more decent hours, weekends off, etc., but still i stay. in a lot of cases, we're severely understaffed, overworked, and of course, underappreciated but then, just when you're ready to throw in the towel, a moment happens that makes it all worthwhile. today was a good example. i've always worked 3-11 (i hate alarm clocks lol) and i knew that today would be hectic. we had a feisty little lady who was on her way out but she'd been stubbornly hanging on when most would have given up and gone on. last night she spiked a temp of 106.1r and we knew then that it wouldn't be long. at 1530, with her son holding her hand, she took her last breath and slipped quietly away. her daughter arrived not long afterwards and i met her in the main hallway. even though i had meds to pass, calls to make, and a million other things to do, i walked up to her and she hugged me as if she'd never let go. "all i can say is thank you." needless to say, we both shed more than a few tears and i spent the rest of my shift knowing that to one person at least, i had made a difference.
I've been in LTC for about 1 1/2 yrs now, my first and only nursing job. I know exactly how you feel. To help myself with remembering stuff I need to do, I make a "TO DO" list in a small notebook that I carry with me. I also keep up with the things that I need to chart on in this notebook. Also, if I see there is something that needs to be put on the med cart, or needs to be ordered, I jot it down. This way when I get a few minutes of spare time, I can work on my list and hopefully get things done, then mark them off the list. Also, don't be afraid to ask the CNA's, esp the ones who have been there for quite a while and who usually work the same hall all the time. Believe me, they know the residents better than you ever will, and love and care about their resident's well being. A good CNA will never steer you wrong. And last, keep praying every day. I think I've prayed for strength, courage, and guidance more in the past year and half than I ever have in my life. LTC is a tough job and that's putting it lightly, and not meant for everyone. I like to think only special hearts are led to do LTC.
Hang in there, you'll do fine, sounds like you have a special heart. :balloons:
oh yeah i definitely agree. give me a floor with good aides and i am one happy camper. luckily i'm on a unit like that now. the two "regulars" are top notch and when they're there i know that it will be a good evening. that's why i know tonight will be good because i know that one of them will be there and our "fill in" is a-ok too. never be afraid to say i don't know and never hesitate to ask for help. i started out as an aide and nothing made me feel more unappreciated then when an lpn or rn felt "too good" to ask an aide for help. i'm not saying that that is what anyone here is doing... i'm just saying that sometimes, that's how it's percieved.
:monkeydance: Hello everyone, just me again. Thanks again for the replies, I'm reading and taking in all the tidbits that you all are adding. To the person that said that LTC is tough, you know your right. But to kind of change the subject of my post a tad bit, I wanted to get feedback on something else. Okay, here goes.
I am a new grad(10/05) and have only worked in LTC for a couple of months and it has been annoying to hear the nurses who have orientated me that the reason I'm so meticulous and careful in my way of doing things, for example the way I prepare and pass meds, and check over things is because I'm new.
I am the type of person that I strive to do things the correct way, I've been like that in every job I've had. I don't think I am a perfectionist, I just like to be organized and No, I don't cross every I and dot every T but there are just some things I just can't stand, especially in nursing because I am dealing with people's lives...things they take into their bodies. Another example, touching residents pills with my hand while popping them out of the bingo card, or giving pills that were dropped on the floor(I've seen this done before).
I've been told that I'm kind of slow by those orientating me. Well what would you expect from a nurse that's new to a facility and doesn't know the residents. I prefer to learn my job first, then I find what corners I can cut and still practice clean and safe nursing.
Can anybody share with me, what has been your experience in the orientated/orientator role.
One of the most important things I can advise is to get in a routine of always doing things by the book...it makes it much easier when state shows up or when your manager is breathing down your neck or whatever. One of the nurses I work with always pre-pours her meds and she is going to end up being sunk when state shows up because she isn't used to doing it the right way and it will show.
Also learn to set priorities. It is more important that your residents get meds and treatments ordered than it is to finish monthly summaries or do cleaning duties or whatever.
Keep notes on your report sheet or census sheet or whatever on who needs their meds crushed, who won't take meds without milk, who prefers jelly over applesauce, or whatever.
Learn to love the CNAs you work with and rely on them. I work with an amazing bunch of CNAs and they know the residents better than I ever will...if they tell me something isn't right, I believe them.
Specializes in Gerontology, Med surg, Home Health.
BlessedbyGod-
I've been a nurse for more years than I would care to say, and I STILL do things by the book when it comes to med pass. You're right...if we make mistakes with meds we can kill someone. Don't let anyone give you a hard time because YOU do things the right way and they don't. I will always try to have the state surveyor do a med pass with the newest grad because they do things by the book and haven't developed bad habits along the way. It is sometimes frustrating to orient new people because they are slow, but we ALL were new at something once and we need to remember that. If you are doing things the right way you'll be fine. And so what if you're a little slow. Better to be slow and get things right than make mistakes.
stef.RN
2 Posts
I have learned that you organize things yourself and you delegate organizational tasks to others if that is an option. At the beginning of the shift, I pass the emergency oxygen tank room. That is when I pick up a couple of bottles because I know I will need them within the next hour. If I know a CNA is headed toward the main supply room, I ask them to bring something back. Before I go down the hall to do the majority of my treatments, I know I probably wont have enough 4X4's, normal saline, tape, and abd pads. These are the things I grab automatically before I start treatments. Things will get better!
As a new grad, I had two days of day shift orientation. Then I came to work to orientate on the evening shift but the evening shift nurse didn't show up. I was told it was up to me. I didn't know what else to do so I did it. I always say, I knew that if I could survive that night, I could survive anything. I think maybe I have. It's not a perfect world. I still love LTC because I get to care for people that I have had time to develop a relationship with. If my med pass is late because someone needed me to just listen to them, that's okay because I care about them. Most of the time, I think listening to them is doing a lot more for them than any pill I give them.
Good luck in whatever you decide!