kak85

Thank you all for the advice. Quite a bit of it makes sense to me, about the med times and insulin and such. However, I will be resigning from the position tomorrow. I talked to my former clinical instructor today about my worries, and she agreed. Her advice to me was to quit immediately. I do not feel comfortable signing off on the e-MAR that medications were given when they weren't or charting things that were not done/assessed. The charting IS a full assessment, including whether their bowel/lung sounds were normal, what their pupil reaction is, etc. I will NOT chart something I have not done/assessed. I will NOT pull meds, put them in a drawer, sign them off, then give them later. I understand where some of you are coming from, and I understand this is accepted as the norm in LTC, but I feel like it is a ticking time bomb for medication errors, and I do not want to be a part of it. Overall, I feel uncomfortable with this facility, I do not feel like I am able to ask questions without just being waved away with a "You'll be fine, don't worry." Again, thank you for your advice! I do not want to come across as a rude/unappreciative person. I know I have to start my nursing experience somewhere. But I cannot work at this facility.

Hello everyone! I am a newly licensed RN and just got my first ever nursing job! I was super excited to get started, but now I am so worried about harming a patient and/or losing my license! Many of the things I am told to do at work goes against everything I was taught in nursing school! I am trying to decide if it is as bad as I am thinking it is & whether I should quit or not. First off, it is a LTC facility, on a dementia/alzheimer hall & I only had 3 days of orientation before I was on my own. I have about 20 patients to care for. I oriented on day shift & began my first shift alone on nights (which I have never oriented on). I am the only nurse on my hall, and there are only 2 other nurses in the building after 5pm. Here is my list of things that worry me: #1: Not double checking insulin. My preceptor told me not to worry about doubling checking. "We just draw it up & give" since there are lack of nurses around. #2: Not following the MAR. There are patients who get meds a 1800, 2100, and 2200. The patients usually go to bed after dinner, around 8, and I was told that "you do not want to wake them or your night will be ****." So I was given a list of patients to give all their meds (both 1800 & 2100) at 1700 & the other half of the residents, I am to give all their meds (again, both 1800 & 2100) at 1900. If this isn't scary enough, I have to pull the 1800 meds early for those patients & sign them off the eMAR so they won't be past due, was told to put them in med cups, label the cups & put them in the drawer until I am ready to draw up the "1900" meds. The ADON agreed with my preceptor that this is how they want to be done. I did it on my first shift, but it made me so nervous! I think this is very very wrong & puts me at high risk of not only giving wrong medications, but doubling up or missing medications that I am signing off on giving! Also, by the time I was giving those "1900" meds, I don't even know what I have in the cup any more! Once you sign off on the meds, there is no way (or at least, I wasn't shown how) to go back & look at the medications list. #3: Charting "the usual". My preceptor fills out the charting with the patient's usual, sich as "active bowel sounds", "no adventitious lung sounds", etc. I was told not to worry about assessing them & was given the "answers" to fill out their charting. I have been there a total of 4 days & never once seen anyone assess the patients heart/lung/bowel sounds! With the crazy number of patients & their medications, I only have an hour that I could spend assessing them anyways! #4: Not wearing gloves for anything! I've seen me preceptor & other nurses draw accuchecks, give insulin, and eye drops with no gloves on! She told me not to worry about it (I did not listen to her, I refuse to give injections or draw blood of any sort without protection!) So adding all this to the fact I am brand new, on my own, and no one to ask questions to, I am pretty sure you see how uncomfortable I am. I cried the whole way home from my first shift, terrified I am going to harm a patient or get my license taken because of the things they expect me to do. I tried to talk to the ADON and other upper level managers about my worries & feeling like I am not ready to be alone after only 3 days, but I'm just told "you're fine. It'll be ok." I really think it is in my best interest to quit, but my husband is worried because I need a job & he doesn't understand how bad these things are. I need advice, please!!