LPNKY2012

I am in the same boat - just starting out in a large Peds clinic with 5+ Doctors. Our clients are the wealthier demographic & I've found it a bit intimidating so far - mainly in learning the vaccination schedule & how to document it all on the fly. I definitely agree with the comments made - keeping the rooms full & in order keeps the Doctors happy, & courtesy & respect with the parents keeps them happy. Those two things have been the key to my sanity thus far.

This is absolutely real. Years ago before I was a nurse, I worked at UPS. Scanning packages on a line of 4 or 5 trucks. My line beeped every time I scanned a package, & the other 5 did as the other workers scanned packages. It sounded much like the checkout line at the grocery store. It didn't bother me until I would start to drift off to sleep at night - the phantom beeping would start & I'd be right back on the line scanning packages in my sleep. Several years ago I spent 4 months in the NICU with my daughter & listened to apnea alarms & other alarms dinging all day & night. When I did sleep, which wasn't often, I would immediately hear her alarms dinging & jump up in a panic. Thankfully, I work in a clinic now & there are no alarms. :) Nice.

WOW...I realize how completely horribly insensitive & moronic my comment about my CNAs sounded. I really did not mean they "only" turn, change, bathe, feed, etc, etc. That is terrible, & I really did not mean it that way. What I meant was I was not expecting to spend my day rushing & running, & my expectations of what the CNAs do was different than what it turned out to be at that facility. I have worked as a CNA in a LTC facility, briefly, & my job was different - perhaps because it was on a different shift, or just a difference in facility policy. I had a list of patients & got routine vitals for my nurse, helped out with certain treatments, etc. Our jobs were a little more geared toward helping the nurse - maybe because it was a small facility, maybe because everyone there just felt like kissing ***, or who knows why. That's just the way we were trained. My point is, I absolutely respect CNAs. They have a back-breaking job, believe me I know - the stress & strenuous work I did as a CNA threw me into early labor.

I'm not questioning whether or not this is "appropriate," & yes, I absolutely know better. What I was questioning, in my lack of experience is whether or not this kind of stuff is the reality of the workplace in LTC. Thus far, my only experience has been in the lab & in a choice few clinical settings, & therefore I really am ignorant as to what the real work environment is like. My gut told me that this could not be the reality everywhere - & that is why I wanted input from real nurses who are out there working in real LTC facilities, to tell me whether or not this is the norm - meaning this is what I will find wherever I go in LTC, or if this is just an exceptionally poor facility. I appreciate everyone's input & advice. I did resign from my job, as my gut told me that my license was in jeopardy - I haven't been able to get malpractice insurance yet, so it was definitely a bad idea to stay. You live, you learn. I definitely have learned my lesson - as much as I love geriatric patients, I cannot work in a facility that is so poorly run, ethically, morally, & legally.

The scary & disappointing part is I didn't find out until I'd been hired & got in there working....State is ALREADY crawling all over this place. Thank you all so much for the input. I have a part-time seasonal job that doesn't start until mid-August, & I am looking into clinics for positions that are a little more low-key. I just had to find out if this is what I'm going to face everywhere, & if it's worth it to stay & try to get my year of experience so that I might find a better position. Not worth it.

I meant at our facility they have told me not to ask the CNAs to get vitals if I need them. Like on a patient who has had a fall, I may need vitals every 30 minutes, every hour for so many hours, & then so on for 72 hours. If 3 or 4 patients have had a fall, which did unfortunately happen, it gets very overwhelming trying to accomplish my med pass, treatments, accu-checks, & vitals in the midst of all of it. I feel like I can't keep it all straight, like I'm doing too many things at once. I guess I just have to learn to organize myself, but I didn't foresee not being able to depend on my CNAs to help me with that.

Also, I understand it's coming from nurses who have experienced 30 or more patients at a time. I can't imagine that, I'd probably politely resign. But I'm new to this, so 20 is difficult for me & it can be overwhelming, no matter how easy a more experienced nurse thinks it is. I'm just trying to do my best in a place where I don't really have CNAs to help. They do their thing, we do our thing. Unless it involves transferring or changing a patient, they don't really help us. It doesn't make sense to me.

Thanks. I guess I am pretty fortunate to have a report sheet with all of the residents, room#s, how they take their meds is abbreviated by their names, & diabetics are flagged as well. The overwhelming part for me is having CNAs who do not really do anything but change, turn, feed, & bathe/shower patients. At my facility I was told they don't do vitals for us. So when we have a patient (or in my case this week, multiple patients) who has fallen & is now on 30 minute vitals, then 1 hour vitals, etc., we can't ask our CNAs to do those to help us. The other nurses have made it clear that for some reason we don't ask the CNAs to do things like that, or anything at all not pertaining to changing a patient. I'm confused by that, but...guess I'll have to roll with it, as that is the way this facility operates. Perhaps I'll find out why later.

Hi everyone, I'm a new grad, new LPN, on my very first job, at a LTC facility. I love the people, like the facility, but I feel so unorganized & after my first stab at the med pass I am terrified. I know it's going to take some time to get familiar with the names & faces of my residents & get to know who is up first, whose meds I can knock out quickly, & who I will have trouble tracking down or getting to cooperate, etc. I'll be on day shift 7am to 7pm, with about 20 residents. My very first preceptor has been a LTC nurse for a really long time. She is great - she makes everything look so easy, she's so light on her feet, such a bubbly, positive attitude, great with all of the residents & all of the other nurses & CNAs. I call her the "people whisperer." She is so efficient, she seems to whiz through her morning med pass, do some treatments, takes time to stop & interact with her residents, helps other nurses when needed, & even has time for breaks & lunch. I guess all of this comes with her many years of experience. I'm learning a great deal from her, but after my first test on the car myself, I felt like an utter failure. Like I was spinning my wheels & ended up 2+ hours into my med pass, missed some treatments, & two other nurses ended up helping me. Thank God for them! Would any of you have any advice/experience to offer on time mgmt, tricks to help a new nurse be more efficient, etc? I feel like I just can't hurry any more than I already am or I'll risk med errors. Any advice for taking/giving report? I don't seem to know enough about my residents to give a full report & not just read off of their chart, but the oncoming nurse seems to look at me like I'm a moron if I tell her there were no changes, vitals were WNL, a certain issue has been resolved, or just report the MD orders that were given during my shift & changes to care plan. Also, any tips for dealing with CNAs who are testing to see how little they can get away with while the "new nurse" is on? Thanks!

I'm a new grad, new LPN, new orientee to my first job in a LTC facility. Friday was my 3rd day on the floor, & my first time on the med cart. I am a bit frightened by what I saw & what I ended up having to do under pressure. Maybe I'm just a rookie, naive to the reality of what goes on in this type of facility & what you have to do to operate from day-to-day. Please tell me... Is it the norm to have patients run out of meds & to have to borrow/steal from another patient's meds? Is it the norm for a facility to run out of testing/treatment supplies & not be able to do proper treatments & tests on dozens of patients for the entire day? Is it normal for nurses to sign off on whole med passes & treatments & not actually do any of them? Is it common for nurses to skip vitals on multiple patients & then just "come up with something" to put in the chart? Is it common to meet what seems like an excellent nurse only to have to do a double-take when they sneak a pill out of the patient's cup of meds on the way down the hall & pop it into their mouth - slide of hand? Is it common to have a policy of "Here's what you're supposed to do, but in reality here's what we do to get by. I'm not telling you to do this, I know you're going to do it because you gotta do what you gotta do...but if you get busted it's your butt on the line." To be honest, I like the facility I've been hired at. I like the people. I wanted to work there. But, after the last few times out on the floor I feel like I'm putting my license on the line. I'm hoping with all my heart that this is not the reality that's out there & you guys tell me to turn tail & run like the wind. I have a part-time temporary seasonal job lined up to start next month, but I don't want to burn bridges - I had connections to help me get this job. Any advice for a newbie? Thanks!

Hi Charisma, Chin up, my friend - I am in the exact same boat as you! I graduated in April & just started my very first job as a LPN. I've been on orientation for about 4 days & just took my first stab at the med cart by myself. I felt like such a failure on Friday - I only had the cart from 2-6pm, but I had to ask for help & two other nurses were helping me finish the med pass at 7:30. There were some other factors involved that I can't elaborate on without identifying my facility. Fortunately, I finally got out of there around 8. The CNAs are testing me, the other nurses are testing me, & I tend to be soft-spoken at first, so I'm probably getting a little snowed by some people right now. But anyone who knows me knows I'm confident in my abilities & my decision-making, & I am straight-forward - & once I get my bearings in a setting, I evolve into the alpha female. I left very discouraged & overwhelmed, feeling like HOW am I going to do this? HOW can I possibly end up doing this for 12 hours when I can't even manage 4 hours? I felt like an idiot when it seemed like every one of my patients was somewhere other than their rooms & I was trying to do a med pass. How was I supposed to go & track down each one? Whenever I need something or need them to go get someone, the CNAs always say - "Well, you can always go get it/them," The first time, I fell for it. I bought their "busy" demeanor & I sprinted off to go do it myself, but I realize now that I've got to put my supervisory hat on & ask for what I need. They may be busy or look busy, but I've got a job to do & I can't go hunt down every little thing or every patient that I need. Sometimes they have to help me. The part about trying to figure out who is who from the pictures in the MAR cracks me up - don't they know nobody looks like their photo? I've even had 2 or 3 patients look like each other - thankfully they are on opposite ends of the hall or I'd be in trouble. Hang in there, my friend, & know that there are others riding the crazy wave with ya. Here's to finding a mentor - a competent, compassionate, knowledgeable, experienced nurse who will not eat us alive. :)

I'm sure there are plenty in the city, but I'm wanting to do this in my own little town/community/neighborhood. They could really use it. There's plenty of opportunity for it, as I have numerous contacts - the mayor, community centers, etc., but I just can't find anywhere that tells me for sure if I'm allowed to do this, or if it is a liability of some kind. I think I'll refer back to my school. They will probably know.

Hey there, I am also a recent grad (April 2012), & I just got my first job. I get to choose my own schedule & if I can't find a schedule that fits well, I can switch over to working as a contractor & making my own hours. This is just for the summer, through December, & when my kids get back in school then I'll probably start applying & interviewing more seriously. If this kind of thing works for you, I'd definitely suggest you check it out. As long as you have a 'Walmart' in your area, I'd pretty much guarantee you could get a job with this company & they pay well! Good luck!

I cannot find this specific information anywhere, so I'm hoping someone else may know where to find the answer. I am a new grad, living in a small community where a lot of people do not have great access to health care. A lot of people in my community avoid the doctor unless there is something serious going on, & by then it's too late for preventative measures. Does anyone know, as an LPN, am I allowed to get a table at our community fairs & do BP screenings, Accu-checks, etc.? I want to set up with some educational materials on nutrition, exercise, diabetes, etc. Am I able to do this on my own, or do I need to be in conjunction with a medical practice or employer?