vanilmil

Hi, I am a new LPN (less than 2months) working in LTC ~ and hating every second of it Every day I feel incompetent & frustrated. Unfortunately, I work in a facility where many nurses *do not* do the right thing (ie: pulling meds & getting them ready before a med pass, putting meds on residents bedside tables & walking out, starting med pass early ~ more than 1hr before scheduled time ~ in order to finish on time.) My med pass is slow, d/t being new & following the rules. Other nurses tell me "cutting corners" is part of being a nurse in LTC & I just have to learn to make my own system. Ugh. Last night a Res. didn't want to take all of her regularly scheduled meds at once. I said, "Ok, I'll bring the rest back later." Then she got upset & argued w/me saying that everyother nurse lets her keep her meds in her room & take at her convenience ~ she started yelling at me, calling me crazy & accusing me of trying to OD & kill her! This woman has some dementia, but not a lot. This scene went on for 20min. I finally let her keep the meds she was clutching in her hands but took the rest from the room & marked it as a Refuse. I know I should have tried again later, but she was sooo aggitated & she had the important pills (BP & psych) the ones she didn't take were vitamins & stool softener. Unfortunately, many nurses *do* leave her meds in her room for her~ so she isn't totally unjustified in being upset w/me. I have noticed that at my facility, nurses who do their job effeciently (even though they take illegal shortcuts) are thought of as good nurses. Nurses who go by the book or take their time are not respected by other nurses or aides. Experienced nurses tell me it is better to be slow & thorough ~ yet in the next breath they will complain about Nurse "X" who takes 3hrs to do a med pass. Honestly, is it like that everywhere? Stuff like that is just one example of why I am already so stressed out. Does anyone have advice for the first year of LTC? How long did it take you to feel comfortable?

I know just how you feel! I passed my boards 6wks ago & am a very new nurse in LTC. I work at the same place where I was an aide before becomming a nurse. Apparently, the DON felt that because I already knew the patients, I didn't need any orientation before working there as a nurse! After much persuasion, I was able to get only 2 days of orientation before they put me on the floor on my own. Like you, I frequently get rotated between assignments. Most days I leave feeling totally incompetent & as if my license or job is in jeopardy. Experienced nurses all say, "It's Ok ~ you're gonna make mistakes your first year." and they all encourage me to ask questions, until I ask the question, that is. Then suddenly they can't be bothered & treat me as if I am an idiot. I wouldn't mind the "sink or swim" situation the DON put me into if I had more support from my co-workers. It is difficult enough w/out all of the attitudes. For example, the other day I had to cover 2 assignments (d/t a call off) *and* the PCA quit, so nurses had to do all of their own dressing changes. The facility physician was in that day & wrote a ton of orders ~ well, orders were the last thing on my mind, what with 2 med passes & the extra PCA work. I never got the orders done, the nurse following me completed them. All night while I was running in circles Nurse "Sherry" was caught up w/her work (she only had one assignment & the nurse before her already did the PCA work for her) "Sherry" just sat at the nurses station watching me, never offering help. Two hours after my shift, when I was finally done w/dressing changes & charting & ready to leave, "Sherry" said to me, "You're only gonna get away without doing your own orders a few more times." And walked away. What the hell? #1 It was none of her business #2 I've only been a nurse 6wks #3 I had the assignment of 2 nurses & 1 PCA ~ I can't do it all! That sort of thing happens to me everyday & it's so hard to keep a positive attitude. I put in sooooo many applications & no one wants to hire a new nurse. I keep telling myself to do the best I can, & hang on till the new year. In January, when I have a few more months experience I am going job hunting again. Sorry for the long rant Just wanted to let you know that you are not alone! If this is what nursing is, then I will have to give up on nursing. I can't imaging doing this for another day, let alone the rest of my career. I just take one day at a time & am holding out hope that I will be able to find something different eventually.

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.

Ugh ~ I HATED ERI! :angryfire We had to take them my first quarter in the PN program. In order to pass we just needed to be above the national average (which was pretty low) and we had 3 chances to do so. Due to soooo many complaints, my school switched to Meds Publishing, which is better because it provides a tutorial & rationale. With ERI you never know *why* you got the question wrong. I was a 4.0 student & on the Dean's List ~ but I couldn't pass ERI w/out a little help from my friends. ERI is *nothing* like the NCLEX, only use it as much as your school requires you to. I passed my NCLEX first try w/minimum # of questions. The NCLEX prep books are most helpful when studying for the state boards.

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?