Quit?

[kl148]

I just came off orientation at an LTC (15 days- originally 12, but I had to beg for 3 more). I mostly trained on the rehab floor and only 3 days on the long term floor.

My first day on my own on the long term floor was Saturday and I'm completely overwhelmed. It's the weekend, so of course the ADON and DON aren't there. I have 20 patients and had only 1 aide for those 20 patients for most of the day due to callouts and no one to replace them.

The blood pressure machine was completely busted and the other nurse from the other hall keeps the only thermometer on the unit in her locked cart which I had to beg her for (after I spent 20 minutes looking for another thermometer she swore we have). I asked this nurse if it would be fine to go to the other unit for a second to borrow their blood pressure machine but she said no, just do a manual. I go find the manual and this frail, elderly woman's blood pressure is so faint that I feel I don't hear much of anything (thankfully, the other nurse agreed to double check it for me).

We use a paper mar and I'm very afraid to miss anything. Most of these people take an average of 7 meds each. The way it is setup is the med is listed in one column followed by the times in the next column (8,12,2,). Even after double checking, I look back sometimes and see that I missed one so I have to go back and give it.

For 12 and 2 pms, I have to look through the entire MAR to see who gets what-- I wish the mar could be organized by times for each patient so I'm not constantly flipping through the whole book.

I have to answer the phones and answer questions about things I have no clue about (like on what unit is someone's mom located), pass out meal trays, take patients to the bathrooms, do all the UDAS/ computer work due for that day....all of which I really don't mind if I had time to pass out medications and do treatments in the first place. Not to mention just getting people to take their meds is such a struggle.

I'm afraid I'm going to make a mistake just because staffing is inadequate. If I have to ask the other nurse a question, I have to go hunt her down. I just feel like management threw me to the wolves.

[LeChien, BSN, RN]

That's most rehabs/LTC. Sorry to burst your bubble. They don't have the best reputation. My advice would be to run far away.

[RNator]

That's most rehabs/LTC. Sorry to burst your bubble. They don't have the best reputation. My advice would be to run far away.

Pretty much.

[tsm007]

Yes, all LTC jobs are kind of like that, but I'm going to disagree with the PPs and knock off the run far away stuff. You'll read plenty of that here. I've been a nurse about a year now, but I have learned a ton this year.

First advice would be stick with it. You are going to feel overwhelmed at almost any job you go to.

Now, second advice will be specific to LTC. Stop stressing about the med pass. Stop worrying about that 1 hour before and hour rule. You WILL be slow at first. Oh well. You'll get faster. Here's how I roll with it on a busy day. I mark my resident list with who has insulins. You can't budge much on those med times. I then mark who has BP meds or antibiotics twice a day (or 3 times a day). Guess what if you don't get your 8am BP meds given until 11am it's going going to be hard to give their 12pms on time. Right? So I mark those on my sheet. I look through meds if they are given once a day, worst case scenario they are given two hours late. I don't give BP meds without checking my BPs. I won't lie, sometimes if it's a crazy day I will get my CNAs to take my BPS for those BP meds. I do try to take them myself, but sometimes I ask for help.

Treatments look at those at the start of your day. Yes, they should get done every day like they are supposed to, but trust me you won't be the first LTC nurse not to get their treatment done. You'll eventually get faster and be able to do it all, but for now write down which treatments absolutely have to be done. ACE wraps put on before getting out of bed. Guess what you're SOL if you didn't get that done in the morning. So those kind of things I write down. I'm not going to lie, I don't lose sleep if I miss a biofreeze treatment. In fact, it annoys me that they aren't written PRN. All that being said, I've gotten pretty fast now and usually I get all of my treatments done and med pass done on time. Be nice to yourself. It's hard. You're new. You'll get it. Just put one foot in front of the other and don't think about it but getting through one shift at a time for now.

[middleagednurse]

Get report over ASAP. Start your meds ASAP. Give 2pm and 12pms at the same time. Figure out who will need pain meds and just pull them with rest of meds. Eventually you will have the meds and treatments memorized. When you give someone their meds make a mark across their name, on your brain sheet. Then after giving the 2nd pass make another mark to make an x. Glance at your brains and if you see any names not marked out go back to see if you gave their meds. At end of shift go through MARS real quick to make sure all meds were charted. If there are any treatments you think may be unnecessary ask MD to DC them.

[heronurse]

Yeah me too im working in a ltc and feel like giving up. Its too much stress right now.