Platypus

I was hired out of nursing school by a LTC facility for Night shift supervisor. Granted, I was a 40 yr old woman, but I was shocked and asked why they would hire a brand new nurse to supervise a night shift. Their answer "we just see something in you." The DON told me she was available by phone if I needed anything, and she was. I was given 1 week orientation and was nurse on the alzheimer unit as well as Supv. I was TERRIFIED! Every day I would pray everything would be OK. I did that job for a year and learned so much. I would NEVER put a new nurse in that position.

Not at all. It has happened 2 more times and I have been really lucky to find someone at the last minute. They keep putting nurses and CNAs on the schedule who are repeatedly calling out. FIRE THEM!! Im sorry, but calling out or no call/no show 7 times in 1 month is grounds for termination IMO. Why hang on to deadbeats, even if they are good at their job..they are no good if they do not show up!

I am currently on light duty (work related injury) and am a shift supervisor. I have been working primarily on the desk, assisting staff where I can. Recently, we have been given the schedule book and call off phone and I track when people call off and try to fill the openings (previously this was held by an on-call nurse. admin.) One night, we had 4 admissions. I had one CNA leave early due to family issue another CNA called out and an RN called out. This is STR and LTC, there must be an RN in the building at all times. I started calling staff about the open shift. I was able to get the CNA openings filled, but no luck on RN. I called the staffing agency and let the DON know she needs an RN for overnight. She asked me for CNA numbers, tells me to strike off a CNA for the next day. no response to the nurse issue. I called her..no answer. As the end of the shift approached, I called her again. I called the unit managers who also did not answer the phone. I called the administrator, who also did not answer the phone. The two agency nurses (LPNs) for the other units needed to get sign ins for the building. These had not been taken care of, so I spent over an hour dealing with that. The two nurses who were left without a replacement were very upset. One did finally say they would stay if taken off the sched. for the next day. I stayed until 4 am to help get as much of the 4 admits completed as I could. I am very angry with the admin, particularly with the DON whose license is on the building. It is her responsibility to the patients to ensure staffing is in place. In the past, they have actually come in themselves or arranged to have a unit manager come in. I felt abandoned and just amazed at the lack of accountability. Would the nurses that were here at the end of the shift been in their rights to just hand me the keys and leave? I cannot physically be on the cart at this time. I did end up calling the corporate complaint line because of the ridiculous amount of time I spend trying to get sign in and passwords for agency staff and that nobody was responding to my calls. What if there was a fire, building collapse or active shooter incident?

I am beginning to think I need to sew my own scrubs. I am perimenopausal in the summer. I am suffering from the heat and cannot drink enough cold water to cool me off. I have a little fan that helps a little, but polyester just makes me hotter and every solid navy uniform comes with a poly cotton blend. so frustrated. at the end of my shift I am dehydrated and sticky from sweat and exhausted. There are apparently others like me that need cooling scrubs.

Yes - I use gold toe mild compression socks with new balance sneakers.. I am a big lady and it has made a huge difference with how I feel at the end of my shift. BTW, I was worried they might feel hot, but they really don't.

I hate that everything has mostly polyester. I get very HOT at work and need cotton. I like the stretchiness with spandex.. but need to cotton to keep me cooler. I am a bigger lady 5'9 265 lbs and perimenopausal (hot Flashes) so polyester fabrics cause me extra cookery I don't need.

I felt that way working in LTC at first too. I was given 3 days orientation and expected to run with it. But, I did the best I could and stuck with it. I found nurses who were willing to give me answers before and after my shift. Most nurses remember how it was when they first started out. I remember the first time a pt was dying, they were DNR and the CNA said they thought they had passed when they went in to check on them. I had no idea what to do. I called another unit and asked "what do I do?" I had not been taught this. They took the time to walk me through it.

Sigh - just wrote a long post and it never went through. I know about the coumadin issue because I work with this patient 5 of the 7 days every week and was off 2 days and knew exactly how much she gets ( 2- 4 mg tabs) and how much was left before I was off for 2 days (3 -4mg tabs). This Pts INR is usually 2.2 and 2.3. That Thursday, when I returned, it was 1.6 and there was 1-4mg tab left. The nurse in question was on the cart both days. I have talked to the nurse, suggesting night shift is a slower pace and might help her learn the computer system and how to enter orders better as there are less distractions. She wasn't interested in working night shift. I also suggested that she might want to take notes that she can refer back to if she is stuck on what to do, like for admissions or putting in orders. She didn't feel the need for that either.

In LTC and rehab, I have seen up to 40 patients per nurse. It is crazy!! I work evening shift. On my unit, we have 8 to 14 pts per RN, We can have multiple admissions ( which takes 3-4 hours just to get into the system and assessed) This is a short term rehab unit that takes care of patients post surgical, IV antibiotics, dialysis (manual and cycler), TPN, PEG tubes, NG tubes, cardiac rehab, and trach care among other things. I get there and I go, rarely get any break. The only "quiet" time when we can get a break is spent calling doctors about lab results and pt issues. Often I am there 3-4 hours after the end of shift to complete treatments and write notes. God help us if there is a fall or an emergency..and all the documentation that follows. we have to do vitals on all the patients (many LTC only do vitals once a week) and we have to write notes on every patient (most LTC only write when needed). On top of this, there is no building receptionist after 7, so we also answer calls and respond to the door bell. All this, while providing excellent customer service to patients and their families. I work hard, walk about a mile every evening and have a good team to work with. we help each other out as best we can. That being said, admin piles more and more expectations on nursing. we can't keep a unit manager because they see how hard we work and try to help us and get frustrated by the unwillingness of the admin to recognize that. The patients even see how hard we work and tell admin we are short staffed. Per their numbers and the state regulations, we are not short staffed. Changes need to come from the state regulators...staffing based on licensed nurses in the building, including DON, ADON and Unit managers in the building is not accurate when they are in meetings and not actually doing patient care.

I helped to orient a nurse at my facility. She is an older nurse that had many years of experience, but had been out of floor nursing for several years. I was looking forward to working with her because I thought I could learn a lot from her. However, after orienting her for several weeks, it became apparent there were some issues. She was forgetful, did not pay attention to details and often either didn't listen well, was forgetful and/or just didn't understand or "get" what she was being told about the way things needed to be done. I found myself having to repeat the same things to her over and over. I was not the only one with concerns and she stayed on orientation for nearly 3 months. I wrote a lengthy note to HR about my concerns. The nurse said she hated the job and put in her 2 weeks and quit for what she thought was a better job. 2 weeks later she was back and said the other job had one nurse to 40 patients. Our unit might have 1 to 15 ratio, but it is hard work with the acuity of the patients. Apparently the note I wrote was either ignored or forgotten about. She is off orientation and I have heard that patients have complained about her and do not want her providing care. Recently, I worked after her after my being off for 2 days and saw that the incorrect coumadin dose had been given to a pt for 2 days. I told the unit manager and she said there was no proof other than my word. There have been some more serious issues which have come up and I don't want to detail here in the event someone recognizes the issues. I feel my patients lives are in danger due to this nurse's incompetence. I have made my concerns known to administration and they have seemingly brushed it under the rug. I truly feel they are more concerned with having a warm body with RN than having someone who knows what they are doing. Anyone else see this going on or have any advise?

I have never had anyone ask for my GPA for a nursing job. The only ones who care about GPA are the learning institutions in my experience. I think they realize that once you are passionate about what you are learning you will excel. Good Luck with your goals

Some people are just difficult. I have many that I have to deal with daily, they stress me terribly. I leave their room and I sing kumbaya to myself and take deep breaths to keep them from ruining my night. Each time I deal with a difficult patient / resident / customer (whatever they are considered at your facility), I think I learn something new about how to deal with difficult people with every encounter. I once had to deal with a very difficult family member when I started working at a new facility, Everyone was afraid to call her and I soon found out why. She verbally yelled at me for calling her and telling her that her mother had no clean clothes (which is what she wanted per orders), and when she arrived at the facility, She berated me for steadying her mother when she angrily was putting clean pants on her while standing and having nothing to hold onto. She made official complaints to my bosses. Believe it or not, we ended up being friendly and she would only call to talk to me when she had some issues with her Moms care. I have co-workers who are difficult as well. I had a narcissistic boss once...that was a stressful 6 months. Our country is very focused on customer service and the customer is always right mentality. This creates entitled customers who feel they have a right to do or say whatever they like.

I work at a company that requires RN and LPNs wear navy blue scrubs. Scrubs are nice, comfortable and look like pajamas. I would like to find navy scrubs with a collar, I think the collar looks more professional. The only ones I have found come in white. Anyone have any suggestions? I saw some "Johnny collar" scrubs but they do not have them in navy. Thanks!

I work night shift and we are required to chart on certain rooms/patients (rotated between shifts) so there is at least one note a day on the patient. They don't want "patient slept all night". They want to know how the patient ambulates, treatments they get, if they are doing OT, PT, ST, are they continent, incontinent etc. Sometimes, I may never see a patient ambulate, go to therapy, how they are eating/drinking ... but I still have to chart on it. I rely heavily on report, previous notes, doctors notes and my CNAs who actually spend more time with certain patients than I do. I don't like it, but Admin is happy and state is happy.

Keismers, see my other post on this topic -but other stuff I did to get through nursing school was pray and go to church regularly. My church was very helpful to me - often youth group activities provided me with time to go to the library to study. I got a job tutoring at the community college, which also afforded me time to study. This college was great because they had so many computers and a video library. I could work on the weekends, bring my kids and set them up to watch movies, or play on the computer while I worked. It was a great set up and my girls were well behaved! This college also had a child care center for students, but my kids were too old for it. I can tell you, every semester I had a point I was ready to quit. But, I kept plugging away and before I knew it I was done with the semester.

I agree with all! After my divorce and apparent inconsistent child support payments (3 kids) , I went back to school. I was 38 when I started my prereqs. Graduated from nursing school when I was 43! However, that first job was hard to find so I went back to school to get my MBA. Got a job through a classmate and got those "magic" 2 years experience. Take advantage of everything our government and non-profits provide to help single parents! Apply for housing assistance (housing choice vouchers), heating oil assistance, unemployment office can help with edu expenses as well as help find a job. There is assistance for child care; if you have a disability check out the office of vocational rehab; when I was going to school, the food stamp program had a program to help pay for transportation and books. In this area, there is a program called "Keys to Success" to help single parents procure a car for school or work. Apply for scholarships! At the local community college where I went to school, I got a total of 30,000 in scholarship money because I worked hard to get good grades and was on the deans list every semester. I got a $10,000 scholarship from another program I enrolled in. You jump through a lot of hoops to qualify, but it is well worth it. Good Luck to you!

I work for Johnson and Johnson as a Community health nurse doing telephonic customer service/triage for one of their products. RNs are part of a team of individuals that are committed to ensuring great customer service, continuous product monitoring and improvement. Every complaint about a product is documented and malfunctions/defects are examined on returned products. The facility is clean and well-run. Some shifts can work from home. I think they are a great company and proud to work for them!

Try LTC/ Skilled Nursing facilities. They will hire new grads. I just hired 5 new nurses because those with experience have jobs already.

Miranda, I have tried to talk to her about this. She is arrogant and doesn't respect me (or most people) at all. She gets very upset and says she is "not going to talk about this now" and leaves the office. I tried to write down everything I do, but I only got to about the first 4 hours before I got busy and didn't have time to write things down. She did hire a very experienced nurse to be a floor supervisor -but this nurse goes in and changes things without telling anyone and actually causes more work and miscommunication. I had to work night shift again last night after working a full 9 hours, I drove the hour home and managed to get an hour of sleep before having to return. I am so over it - I would like to see her do the 9am med pass for the 38 residents and see what she has to say about it. This is why nurses leave the profession. To corp big wigs, we may be a "cost" to their bottom line...but without the nurses you have no business to give you a bottom line! 38 residents to 1 nurse is really pushing the limits! I found out that a job at a closer location might be available and yes I am actively looking for another job. I may not have made as much money as a floor nurse, but at least I could go home at about 8 hours, feel like I accomplished something (my shift/med pass), got overtime if I worked longer, and wasn't required to be "on call" when I got home. Thank you again for your input!

I have been an RN for 3 years in LTC and was promoted last year to a dual ADON /DCE position. I have survived a year, but I am completely burnt out! We got a new DON 3 months ago who is very good at delegating and very critical. Since I have the dual job role, I am given a lot of nursing admin tasks, on top of doing infection control, education, interviewing, hiring, orienting, write-ups (HR Functions). About a month ago, she said "we are going to take over scheduling. Now she says it is my job to do scheduling. The morning is filled with a lot of meetings, so it takes up about half the day. If i work an 8 hour day, that leaves me only 4 hours to get my work done. I work my butt off just to keep up. Most days I work 12 hours and still fall behind. If I don't get something done, she asks me why - I tell her I did my best - but she doesn't want to hear my "excuses." Labor day weekend is upon us and we have a call-out. Since I am on call for the 3rd weekend in a row I have to call and try to get someone to come in. I have been calling agency and still found no one. I guess there is no other choice but for me to do the 12 hour shift. But I worked 18 hours yesterday, and went in for 2 hours today to make the calls for nurses and do some paperwork for an upcoming orientation. I feel like crying, It should not fall all on me! Did I mention I am a divorced single parent to three daughters - 2 of which are in high school and do not drive. Did I also mention I have a 45 min to an hour drive to and from work. I am a very hard worker and I am pretty flexible, but this is getting to be quite unfair and I want to start looking for another position. But I wanted to know from any other nursing admin - is this normal working hours for a salaried position?

As a person who does hiring at my facility, it would irritate me if someone walked in and insisted on trying to introduce themselves to get a job. I work in a relatively small facility (76 beds) and have two job titles Asst. Dir of Nursing and Dir. of Clinical Education. When I walk in, I literally hit the ground running and the work is NEVER done. I am innundated with calls all day long from hopeful employees. Someone dropped off their resume yesterday wanting to know the status of their application - Umm still sitting in my when-I-get-to-it file. I am not "HR," for the building, I am a nurse administrator with multiple job tasks. I try to be patient with people, but don't you think I would call you when I see your resume might meet our staffing needs. You want to stand out, consider volunteering for activities department. As a volunteer at our facility you would get your background check, drug test and PPD done. You could see what long term care is like and we could see what you are like. Plus, it would be something you could add to your resume.

I work in LTC Administration in Philadelphia. Our nurses are 38:1 - IMO way too many patients for the nurses. There are 4 CNAs, but still the med pass alone on day shift is grueling. Add to that Tx, calling docs, notes, keeping track of CNAs restoratives/ADLs, appointments...It is crazy! I have tried to get it improved, but corp. says we are not budgeted for it. One thing is for sure, you will always have a job - but it is very stressful and exhausting! I love the residents, and I love the people I work with - the amount of work is drudgery though!

I know how you feel. I took a job in admin. thinking it would be less stressful. At least when I left for the day as a Charge Nurse, I knew I was finished with what I was supposed to do and left the crap behind when I went home. I can't do that because I get calls at home and have "on call" weekends. I also feel like I am in over my head 45% of the time since I have only 2 years of LTC nursing experience, which was fine for the DON that hired me, but current DON has a real issue with it and never fails to point it out. I can't seem to win with this woman. I got sick for three days because my immune system was so weakened due to the stress. When I returned, they complained that stuff wasn't done. Isn't that special. Guess I thought maybe there would be some appreciation for what I do. I was told when I was hired that the last two people they hired for the position went crazy. I was also asked how long I would last. I have lasted 10 months and am just waiting for the 1 year mark to start looking for another job. Healthcare is nuts right now!! I work 11 + hours a day, commute 2 hours and am over it. I can't even get nurses to work here because they see a max of 38 residents per nurse and bolt! I have tried to do the units with 31 residents and it takes forever. I am sure if you do it everyday it makes it easier, but you don't have time to talk to the residents, you don't have time to check on the CNAs and what they are doing, and it is your license on the line. I know you are not alone. I used to be so happy in my job, so proud to be a nurse. I try to stay positive - but it is very hard lately. Maybe Hospice or home care might be less stressful.

I am an RN and got my MBA. I was promoted from a night shift supervisor to a dual job of Assistant Director of Nursing / Director of Clinical Education. It is a small LTC business, but there is really too much work for me to do it well. I have survived in the job for 10 months now, but I am thinking of looking for something different and less stressful. I had tested the waters a few months ago and every place I sent my resume wanted to interview me. I thought I would give my job another go, and keep trying. I think an MBA makes me very marketable.

As a new nurse, my first job was in LTC. I was given a charge assignment on an 18-bed locked Alzheimer unit as well as being supervisor of the whole 140-bed (3-story building) facility. I was given 3 nights of orientation and the person orienting me was fired for drug diversion. Fortunately, the LPNs on the other units were wonderful and often it was 30:1 ratio on other units. It was trail by fire and the worst nights were those when it snowed overnight. I had to call in replacements for people who were stuck in traffic or couldn't get out of their driveway, on top of census paperwork, passing meds, and making sure the facility looked good and patients ok before dayshift arrived. All this time, I was working on my MBA. After getting my MBA I was promoted to nurse admin. at a smaller facility but, I am in a dual role of ADON / DCE. I have been here 5 months now and quite frankly work harder than ever. I am in meetings from 8:30 to 11. These meetings are meant for the team to discuss and care plan resident care based on nursing reports/charting, with social services, dietary, therapy depts. input where needed. Often, we are rushed thru these leaving me feeling like we are often missing something. Then we have an all department meeting where often, the nursing dept. gets more and more piled on them. We do follow-up assignments for nursing and take them to each floor where the nurses have up to 36 residents. Every week there is a lengthy report that needs to be sent to corporate. Every month we have multiple reports that need to be sent to both corp. and the state. In my dual role, I am also the nurse educator and the person who interviews and hires new nursing and CNA staff. So, I get multiple phone calls from people who leave their applications who want to know the status of their application. BTW, Please don't do that. I don't even look at applications till I am ready to hire. I can't, I am too busy. If a nurse calls out and we cannot find a replacement, guess who ends up on the floor giving meds - me! I had never done a 9 am med pass for 36 residents during the dayshift. the 9 am meds took me all day because I wasn't familiar with the cart, the patients, or where stuff was kept if it wasn't on the cart. It was not fun, but I tried to be a team player and went with it. All of my regular work however,was left for me the next day. The DON is often in meetings as well all day. 72-hour post admission meetings, quarterly resident meetings, meetings about residents with significant weight loss or falls, care conferences with families, etc. Lets add to this corporate conference calls every week that pile even more on our plate. Please don't think that floor nursing staff are the only ones understaffed and overworked. We are all feeling the sting of the decreased medicare and managed care payouts. Truly, only the strong will survive this. I have been at my job 5 months and nearly was ready to walk out friday after working a full week of 12-hour days. Add to this a 1 hour commute each way and essentially having to be on-call all the time. I am just venting here a bit, but I get tired of people blaming admin. for their issues. I have been on both ends. Charge nurses can go home and forget about their jobs until their next shift. I can't. I get paid ok but govt takes out more taxes resulting in only $400 more a month than I had made before. $400 does not go that far when you have an hour commute every day - it pretty much covers the gas.