910hope

Jess (and everyone else)--- I appreciate your beautiful words and totally agree...I cried while reading it. Thank you for saying it like it is.

*Hunting down more isolation gowns 3 times in one shift. Grrr. Then hunting for more masks. *Dilaudid q 2hrs. ("is it time for my Dilaudid yet??!!) Get the patient on a PCA already. *Getting Stool samples *Accuchecks with the patient that says "I'm gonna eat later on"----like when??? *Admission paperwork...sticking the patient stickers on 1,000 different spots.

I drive one hour each way to work (12 hour shifts) and I hate my commute...especially the long drive home. The worst part? If you want to work consecutive days it means less and less sleep during those days. I'm new...I often finish late...get home after 9:00, eat, shower, unwind, grab some sleep and leave home at 5:30 the next morning. Also, if I lived closer I might start to sign up for an extra shift or two a month but I haven't done that because of the long commute. I plan to find a way to move closer to work...own my place and I can't sell and pay off the mortgage at this point. If you can eliminate some stressors in your life before you start work as a new grad you will be thankful later on...just my 2 cents.

Thank you for sharing your experience and your strength. Very inspirational! And Congrats on your new job in Oncology.

I'm a new grad working in an Onc unit and i'm starting to feel that I need to find a way to process the grief i feel. over several admissions in and out of our unit i got attached to a patient and her family too. when i met her a few months ago she could walk and she was such a fighter. not even 30 y.o. I could see she was getting worse but i didn't expect her to pass so quickly. I hope you find comfort in the fact that you comforted your patient. i'm trying to remember the times with my patient and her mom...being a part of that journey.

Hey! I know what you're going thru...the accelerated BSN is fast-paced and an overwhelming amount of stuff thrown at you at once...especially the first two semesters. And I hated the first month in the hospital...the smells, the poop, the feeling of being in the way in the nurses' station, not knowing the routine. After a few months in the hospital it gets better. I've been a new nurse for 6 months now...and I do cry about once a week when I'm driving home and I think about a patient...the young mom with the terminal disease wh cried to me that day about being stuck in the hospital. But I've changed my opinion about crying...I feel it's part of my life now and it's inevitable...it's a job where we connect with patients in the darkest time, during their struggle and when you take that in the stress of it has to go somewhere...it has to come out. So tears are a good thing, imo. I became a nurse to make a difference in their lives...but there's a price to pay for that blessing.

Hello All, I have the same problem and I don't know what to do about it...it's very frustrating to realize that patient care could be so much better with cooperation and teamwork from our CNAs...burn out is dangerous for the patients.

I'm a RN new grad, worked at a SNF, assigned to 32 patients, and I tried very, very hard to make it work. The nurses training me hinted that I needed to take shortcuts to do the med pass in time. I told them no, I'm going to do it right (take BP before BP meds, etc.). I never finished my shift on time...then the DON said "no overtime." So I clocked out and continued to chart for 2 hours. I did that for a month. And I had a knot in my stomach the whole time. New admits from the hospital...when I took the time to assess the new patient I was further behind with the med pass. And then things got worse over the holidays...a CNA and a nurse calling in 2 hours before their shift!! And that's when I realized...I can't do this, I can't stay here. I became attached to some of the patients, I enjoy geriatrics, but I couldn't accept the short staffing, the sloppiness, the culture of not caring---profits, profits. I know there are better SNFs out there and I would advise any new grad to check the medicare.gov rating of the SNF where you're planning to work. I checked another rating and got some info but I didn't know about the newer medicare ratings until after I was working...Find a good one that respects the dignity and rights of the residents...and doesn't pull them outta bed at 4:00...Geez, that's just wrong!

How many patients will you have? And how many of those are rehab nursing/skilled...straight out of the local hospital?

Thanks for the info. Now I know the wait is over. No, didn't get an offer.

Ohhh, the wait is getting harder as we get closer...hope we find out before 24th but if not that's coming up soon. All I want for Christmas...pleeze Santa. :)

I'm a new grad (with no prior experience) in a SNF...assigned to 30 patients...about 12 of them recent admits from the hospital with more pain, breathing Txs, etc. than the others. I was on orientation for about a dozen days during the last month and now I'm on my own. Today I finished so late that I was just starting to chart as the 3:00 shift was arriving. I don't like the fact that I clocked out and then spent another 2 and a half hours charting. But I've been lectured about the overtime and I knew the ADON would give me grief if she knew I was still on the clock. But when I had to do the monthly med recap and stocking at the end of my shift on my 1st day on the cart last week I told myself there's no way you're not gonna get paid for this extra work, so I didn't clock out and I brought my overtime approval slip to the DON. The SNF world...I like getting to know the residents and seeing them again, but the management/ownership makes me hope I can find another job in the New Year.

sclpn, I had a short SNF rotation during nursing school at a public SNF...as a new grad I'm working at a for-profit SNF where the staffing ratio is a lot different and there's little to no equipment...no V/S machines, etc. But I am learning to prioritize and delegate. I appreciate the advice posted last week; I made a sheet of the patients, BS, Gtubes, other info that is helping. I also appreciate the support from other new grads who are experiencing the same challenges.

Thank you, thank you SouthernBeegirl for your advice and encouragement. It helps a ton!! Nothing like Southern hospitality! I will try my best to not be so hard on myself at work and make a list of things I've learned so far. And what you wrote about taking a 5 min. break...I will take that to heart. I realize that the final hour I'm passing meds to the last of the 32 patients my pace slows a lot because I"m literally running on fumes. The prioritization skills I can learn in this SNF will help me there but also anywhere I would think. When five patients are asking for something at the same time I realize why the NCLEX had soooo many prioritization questions. And thanks for the insight on Medicare charting. I know I need to learn a lot about charting. SMUgrad---we're going thru the same newbie experiences and for me it really helps to have the support on this thread. Let's all keep in touch!

I hope so...I have never felt like such a failure on a daily basis in a new job...a new grad...32 patients---combo of the transfers from the local hospital, the rehab patients, and the long term, severe dementia combative spitting-meds-out patients. No V/S machines, taking BPs, HRs, manually. Here's what I was told about the LVN/RN dynamic from the mean ADON today: "You must be embarassed because you're a RN and you don't know as much as the LVNs." I didn't respond and I left since my shift was over. But it makes no sense!! Of course I don't know as much as experienced LVNs. I"m a new grad and of course they knew that when they hired me. It's sooo frustrating and exhausting everyday. And if there are any discussions about work or patients or anything the nurses aren't speaking English so I don't know what they're saying. That heightens the feeling of isolation. Everyday I think about quitting...and then I think about all the debt I have from school and not working while I was in school full time...so I tell myself that I'll stick it out and learn more. And then the next day I go to work and around 10:30 when I'm asked "still doing meds?" I think again "Why am I here??!!" Today my preceptor for the day came to the cart as I was finally finishing the morning meds and brought up the topic of finishing late..."the state says we only have a 2 hr. window to give the 09:00 medications so after 10:00 is too late." This from a nurse who I have never seen take BP!! But documents it on the MAR. And I replied: "I know the guidelines. But I'm going to take the BP before I give BP meds." That was the end of our discussion. I really appreciate the helpful hints and words of encouragement (plus moral support) I find here. I made excel sheets of the patients and I know that helped me today. Thank you all very much!!!

It's an emotional rollercoaster!! One day I feel that I can stick it out for 6 months and learn a lot. Plus I like seeing many of the residents and getting to know them. But today was a bad one. I was orienting with the RN supervisor who they want me to fill in for in another few weeks during vacation. A new patient with severe dementia fell out of her wheelchair and hit her head. The PT had just visited and moved her from her bed with side rails to a wheelchair with nothing to keep her in the frigging chair...and then left her alone. Inside I was screaming when I saw the PT later....how stupid can you be?? A patient not oriented to time and place!! Why do the ALZ patients go to a SNF instead of an ALZ unit? I've never been in an ALZ unit but I'm guessing that's the safest place for patients with severe dementia?? Is it a Medicare issue?? I don't want to train with the RN supervisor anymore or fill in for him...though I realize that's the only reason this SNF hired me...so I may be out of a job soon then. The Assistant DON said to me today that I should know the residents before I work the supervisor desk and I told her that I agree...it doesn't make sense to me. New grad...new to nursing. New to the facillity...Guess I'll have to ask for a meeting with the DON on Monday. Any suggestions or advise appreciated!! Thankful for prayers too.

Bre, I know what you mean and I'm wondering the same thing. I'm a new RN grad in a SNF. It takes me a long time to do the meds and on my first day with a meds pass the Assistant DON walked up to me and asked "You're STILL doing meds?!" I told her yes "I don't want to make a mistake." They knew when they hired me that I'm a new grad and I've never worked in a SNF before...I'm busting my butt and giving 100% when I'm there. Here's what I've been thinking the last few days...I will continue to learn and if I'm too slow for them then they can fire me. I'd rather be safe than hurried and unsafe. While it's not great to be late with a med it's a lot worse to give the wrong med to the wrong patient...isn't it??

Congratulations!! SNF? And you're a new grad? I visited two local SNFs and the first one has asked me to come in tomorrow.

Mlok, Thanks for starting this thread and to the experienced SNF nurses----thanks for the info and your encouragement!! I am also applying to SNFs. I passed NCLEX in October and the hospitals in my area are not planning to hire new grads for some time. Most of all I want to start my nursing career---whether that's in a SNF, a hospital, a clinic,etc. And I want to keep this roof over my head. The debt from unemployment keeps growing like a virus. We didn't put in all that time, energy, money, etc. into nursing school to sit around and wait for the economy to change. I changed careers and went to nursing school to help take care of people, young or old. I realize that if one of these SNFs hires me I will most likely feel lost and overwhelmed by the number of patients and all of their needs. But if it's a decent place and I can adapt to the ratio then I look forward to that feeling of connecting with patients again...I hope to work in a hospital eventually but I'm starting to believe that being flexible is really important right now. Mlok, did you start working at a SNF? If yes, how's it going?

That's great. You both inspire me to drop by some places next week. I picked up some LTC applications recently and I haven't returned them yet. Meanwhile, here's what I did instead...okay, a waste of time, but it was fun. New Grad Lyrics to John Mayer's new single "Who Says".... Who Says I can't be a nurse Give the shots and not reheorifice Who says I can't measure up? Went to school for long enough Got the scrubs and I'm good to go Just need a chance to let it show... Who says I can't do that? Who Says I can't give meds, Change the sheets while you're in the bed, Who says I can't call the doc, Tell him the patient went into shock, Push the pressors and get 'em back, Who says I can't do that? It's been a long week of "no new grads," It's been a long week of "don't call us," I can't remember me looking any harder, But then again I don't remember much.

thanks, MissBrittany...I'm going to check with the CA BRN then. I really don't know...and I really want to work again as a CNA if the agency contacts me.

Congratulations NewGrad777, Baby Sierra, Vysecity!!!...Doesn't it feel like the biggest relief?! The first weekend without studying or testing....Yeeehah!

Are you going to start using your online Kaplan access weeks before your class starts? Then you'll be ready sooner after your class ends.

I passed!! On the CA BRN website today. Took nclex-rn on Saturday, 10/10. Relief!!

Congrats CaliGirl!! Must feel great, huh?