Really depressed about new LTC job

SweetSue16 · Jun 30, 2010

I think you have been thrown to "wolves" with only 5 days orientation. Ask for more orientation.Try to identify with a nurse there that you admire, some one you think is doing a good job. Model her. If you are the only nurse in the building for 200 residents from 11-7, that's dangerous.

Forever Sunshine, ASN, RN · Jun 30, 2010

I was in your shoes not too long ago. You have to develop a routine, and know your residents. I don't like giving cardiac meds or narcotics early(except for one patient who wants all her pills at 9pm). You learn ways to save time.

Don't be afraid to ask for help or ask questions.

mazy · Jun 30, 2010

From what I'm reading it sounds like a pretty standard LTC environment, so don't be so hard on yourself. Time management is a nursing skill that you learn from experience; I think some nursing programs don't spend a lot of time teaching that realistically. I know mine didn't and my first job I felt like you, I just wanted to go home and cry. i think I spent a good solid six months feeling like that, and still there are times when I feel like crying.

But you will learn a system that works for you. I think you are on the right track, you sound like you really want to do a good job. Very important to give meds when they are scheduled, but I've known many nurses, especially in LTC, who try to take shortcuts.

I'm not sure if you feel comfortable doing this, but if they want you to work an unsupervised shift, you might tell them you're new and you don't feel comfortable doing it. I did it many times when I started out and didn't have any problems -- well, except for the begging and pleading -- but you are under no obligation to do something that you don't feel comfortable doing. Be an advocate for your patients, and be an advocate for yourself.

Just keep doing what you're doing, hold on to that determination to do your job well, and be patient with yourself. It will take a while but you will get comfortable with things, you will get to know your co-workers better, you will learn who you can look to for guidance, and you just might remember why you became a nurse.

It's a really nice feeling when that happens, and worth the hard journey to get there. :nurse:

jlbic · Jun 30, 2010

Sorry this is so long!
I just started my first job as an LPN in an LTC and I already hate it. I really don't know what to do. I feel like I don't know anything, I don't have enough time to do anything and I am always worried that I am making mistakes. Last night was my first night alone after 5 days of training. I have been trained in both out independent living area and in our locked memory care unit and I started off in the locked unit last night. I felt like I was racing to get my med pass done and was almost in tears at the end of my shift. I don't even know why I hate it, I like the residents and the people I work with well enough, I just really don't feel like a "nurse." I only have 28 residents in my unit to do med pass on (we do not do treatments) but I still feel overwhelmed. Most of the residents have meds scheduled every hour from 4-10 and I have to do 3 med passes to give them at the appropriate times. I think the other nurses that work in the unit just do 2 passes, and give all 7-10p meds at 7p. I just don't feel comfortable doing that, especially since a large % of my med pass is narcs/anti psychotic/cardiac meds. It seems as if I am only there to shove pills down peoples' throats and I'm not really using my nursing skills or learning any new skills. I feel like the nurses/aides I work with are out to get me and I'm always nervous I am going to do something wrong. Any the paperwork? I don't even want to get started on that because I feel like I am clueless about that too. I know that LTC can be very stressful, and I should give it time, but I really don't feel like it will get better. Does anyone have similar experiences? I am also worried about being "thrown to the wolves" as a new nurse. My facility has over 200 residents, ranging from completely independent to those I worked with in the locked unit, and the night shift only has one nurse from 11P-7A. I am worried about being scheduled that shift and being the only nurse there in case of emergency. I just don't feel that is very safe. My facility also utilizes "med techs" to save $ and we as the nurse are supposed to sign the MAR for any eye drops/topicals/patches that the med techs do (I guess they legally cannot do anything except PO meds) I also don't feel comfortable with that. It's not that I don't trust the techs, I just don't feel like I should sign for ANY one else but me. Am I being nitpicky? Is the way I'm feeling normal? I am starting to question even deciding to become a nurse in the first place. Any words of wisdom are greatly welcomed.

Nursing is a very stressful job. I wish I had a great answer to your problem or some encouraging words. After 3 years of working in a hospital at the bedside taking care of patients, I have lost it. I think that some people have the personality and patience to deal with the stress of bedside nursing, and others don't. If I was in your position, I would let your supervisor know that you are uncomfortable with signing off meds you didn't give. Give yourself some more time to find your routine and develop time saving techniques, you may love it after you get more comfortable. Who knows.

thekid · Jun 30, 2010

I was in your situation ten years ago..if you can tough it out for a bit, ltc and geriatric experience can lead to a job in home health or insurance (which both have their own stresses)..looking back I remember not liking ltc either, I LOVED my patients but I felt overwhelmed and it never really got any better, it was always about just making it thru a shift. Your feelings are normal, IMO .. I don't know if it helps to know that but I can understand exactly what you are feeling. You DO develop some time management skills and worthwhile experience with geriatric population ..

Finallydidit · Jun 30, 2010

3 months from now you will feel very different, I promise:) as far as your med pass and the HS meds, being given at 7p. HS is when the Res. goes to bed which could very well be at 7p. If that is the case then its okay to give it then. on my back hall BID and HS meds are sched. for 10p. I have a lady that goes to bed every night at 8p or before if the CNAs will take her sooner. She has a sched HS lortab. I give it to her right before I go to lunch at 7:30 everynight. The MAR may say 10p just to have a time, but the ORDER and the script say HS. So its okay to give at the Res. bedtime.

singingtothewheat · Jun 30, 2010

fear not. you are not going crazy

sorry this is so long!
i just started my first job as an lpn in an ltc and i already hate it. i really don't know what to do. i feel like i don't know anything, i don't have enough time to do anything and i am always worried that i am making mistakes. last night was my first night alone after 5 days of training. i have been trained in both out independent living area and in our locked memory care unit and i started off in the locked unit last night. i felt like i was racing to get my med pass done and was almost in tears at the end of my shift. i don't even know why i hate it, i like the residents and the people i work with well enough, i just really don't feel like a "nurse." no fear. it takes awhile to feel like a nurse. i've been doing this 23 years and i still learn and relearn on a daily basis. i only have 28 residents in my unit to do med pass on (we do not do treatments) but i still feel overwhelmed. most of the residents have meds scheduled every hour from 4-10 and i have to do 3 med passes to give them at the appropriate times. i think the other nurses that work in the unit just do 2 passes, and give all 7-10p meds at 7p. i just don't feel comfortable doing that, especially since a large % of my med pass is narcs/anti psychotic/cardiac meds.you are correct. that is exactly what they do. they do it because it is the only way to get it done. unfortunately, until we, as nurses, we have very little voice in how work is done. my way of dealing with that has been to become a part of a larger nursing organization that will give me more voice! it seems as if i am only there to shove pills down peoples' throats and i'm not really using my nursing skills or learning any new skills. i feel like the nurses/aides i work with are out to get me and i'm always nervous i am going to do something wrong. any the paperwork? i don't even want to get started on that because i feel like i am clueless about that too. i know that ltc can be very stressful, and i should give it time, but i really don't feel like it will get better. does anyone have similar experiences? i do not know of a single nurse in ltc who doesn't feel that way at first. you get a rhythm and things improve. you decide what demands your time and what can wait.i am also worried about being "thrown to the wolves" as a new nurse. my facility has over 200 residents, ranging from completely independent to those i worked with in the locked unit, and the night shift only has one nurse from 11p-7a. i am worried about being scheduled that shift and being the only nurse there in case of emergency. i just don't feel that is very safe. my facility also utilizes "med techs" to save $never get comfortable with med techs. they function under you and are just another way for someone to make more money off your back. and we as the nurse are supposed to sign the mar for any eye drops/topicals/patches that the med techs do (i guess they legally cannot do anything except po meds) i also don't feel comfortable with that. it's not that i don't trust the techs, i just don't feel like i should sign for any one else but me. am i being nitpicky? is the way i'm feeling normal? i am starting to question even deciding to become a nurse in the first place. any words of wisdom are greatly welcomed.

cebuana_nurse · Jul 1, 2010

To the OP, if you had read my posts when I started LTC, you wouldn't feel alone. Had the same feeling when I was on my own though I was given a 6-week orientation. But it does get better. Though I'm giving myself a deadline with LTC until September. Try to stick it out. You don't wanna be labeled as a job hopper if you quit this one. You'll get the hang of things and eventually will enjoy it. Good Luck!

itsmejuli · Jul 1, 2010

I'm also a new LPN in LTC. I started working wknds 7a to 7p in April. I only got 3 days of orientation where I actually followed another nurse. There are usually 3 of us working with 20 patients each. My assignment is the toughest with the heaviest med pass, most treatments and some of the most difficult residents. Sometimes my co-workers aren't very helpful, after getting burned I learned to go to my RN supervisor for guidance on some issues.

I had to keep telling myself that things would get better. I also reminded myself that finding a job is tough and that I needed this job while going to school for RN.

Its only been a few weeks since I've found a routine that works for me. If nothing goes wrong I can finally take my lunch break :)

I like my job, like my residents and plan to stay in geriatrics.

belle005 · Aug 28, 2010

Hey, it's been a couple months now and I just wondered if it had gotten any better for you?

Your original post could have been written by me - I started my first LPN job in LTC July 26th. I hate this job so much and I'm having the exact same experience you described. I've never worked in healthcare before, I got 6 days of orientation, they asked if I was ready to be on my own, I said NOOOOO, and they scheduled me on my own anyway. I feel like I don't know what I'm doing at all. I have no idea why I became a nurse. It was the dumbest decision I ever made. Not because I don't like it or because I don't like caring for people, but just because I'm SO stressed just trying to get through a shift, and then on my off days I'm worried sick second-guessing everything I did on my last shift or worrying that I've made some serious mistake.

Jess84 · Aug 28, 2010

Thanks for asking! To answer your question, yes it has gotten better. I only work 2-3 shifts a week (weekends) and no longer work nights. I have found a routine that works for me, saves me time and I can usually stick to it if I do not have any emergencies come up. I like my residents, my coworkers and my facility for the most part and I am happy I've stuck it out. I'm certainly not working in my dream job, but it's a job and I need it until I finish RN school next year. I still feel a bit uneasy about certain tasks, paperwork, when to call Dr's etc, but I have learned to go to my supervisor if I have any questions. I think I was worried before about going to others because I was afraid they would think I didn't know anything, was unprepared etc, so I'm over that now.

I still have some issues with how things are done, I don't like signing MAR's for med techs, I worry I'm not using too many "nursing" skills etc., but I have tried to make it a point to find ways to use more skills like manual BP's, sub q's, pt teaching, dealing with families, charting, head to toe assessments. I'm not assigned to do all that but I'm trying to keep my skills up since my main duties are PO med pass/a few insulin's

I wish you luck in your LTC setting. Like I said, I don't think LTC is my dream field, but I'm happy to take care of my residents and I'm looking for oppurtunities to learn new skills and use the ones I have.

Keep me posted!