Really disappointed

[aldeur]

I'm a new grad, and have been having a tough time finding a job in my region. I started at a SNF/LTC facility less than a month ago, and ended up quitting 2 weeks later. I was only given 2 days on the floor orientation, and only one 8 hour shift on my unit. It drove me crazy the things I was doing because there was only one blood pressure machine that worked properly for the entire facility, and while I only had 21 patients, many of them had 21 meds, almost all crushed - and I kept the BP and heart meds separate in order to save time. I ended up having to buy my own wrist BP cuff just so I wasn't risking the lives of my patients! We were constantly out of supplies and forms/treatment supplies/meds were so disorganized it slowed me down so much. I didn't have time to call the Dr. about patients that needed a change in medication and that just made me so sad. There was no one around to help me, either... if I had questions. It felt so unethical.

Not to mention nurses at the facility were telling me to just "sign off" treatments that I didn't have time to do and make up vital signs. We were also asked to clock out and keep working, sometimes 2 hours past the end of our shift. I would come in half an hour early and leave 2 hours late and only get paid for 8 hours. And the DON accused us of chit chatting and how we obviously had enough time to be doing everything we were doing, when every one of us was extremely overworked and being forced to cut corners because we didn't have enough time to do things right.

It was a no restraint facility, and the worst came the day I quit. An elderly patient had been agitated and aggressive all night and grabbed another RN around the neck among other things. No one was called and when I came on shift I didn't know what to do, calling the DON and shift supervisor... and they told me to wait and not call the police (probably because an ambulance ride cost them money? we had no security of course, it's a small facility). He ended up grabbing ME around the neck - the CNAs had to pull him off of me... and the shift supervisors response was annoyance that I was upset and I was near tears! Eventually authorities were called but seriously? They acted like I was making it up, or that I should have to put up with being treated like that because he was just an old man (he was strong, ok). The management didn't talk to me about it all day and the DON wasn't even notified until the end of my shift. I told them later that I was not comfortable caring for him and was told that I had no choice. I was so proud of myself for not walking out, even though I wanted to so bad. How is being assaulted ok or is that something that you just have to "put up with" in SNF/LTC and hospitals?

I'm just really disappointed, because I had high hopes, liked my patients a lot, and really enjoyed finally working as an RN after everything I went through to get my license. Reading the boards makes me think that this kind of thing isn't all that abnormal, so even if I got to the point that I wanted to work at a SNF/LTC again, I might encounter the same types of things. Please tell me this is an anomaly!

[RNstokes]

I am sooo sorry you encountered this. I am a new grad as well and even though the economy is bad right now, it is for that very reason that I refused to even apply to a SNF/LTC. It seems as though it is all about politics and making money that administration lacks regard for it's employees. I know some hospital jobs have issues but this takes the cake. To turn your head to staff abuse is unethical. Have you reported them?

God speed in your next search!

[classicdame, MSN, EdD]

So sorry this was your first experience but you did the right thing. Their admin. must have their heads in the sand. Next time ask for a tour of the facility so you can see how patients are being treated and how they are treating the staff. No, you should not have to suffer any abuse. Texas now has a law in Congress, not yet passed, that would make assualt of a nurse a felony. Not sure if it includes other healthcare workers.

Hang in there. Something better is coming.

[jammin246RN]

Wish I could say it was.... But I just got assaulted night before last. It was an older gentleman and was completely out of it.... It just happens. We are not allowed to restrain patients d/t possible complications for the patient. Next time you have a very agressive patient you may want to contact the doctor for some ativan/haldol/geodon. Report it if you have real physical harm, if not you will just have to find ways to deal with it. What really gets me isn't the old person who is out of it...hell anyone of us could be that person at some time... but the A&Ox3 patient, or family member who strikes out at nurses. Thankfully this happens fairly rarely. Although even though this happens rarely the administration won't back you up.... for 2 reasons one "it isn't good customer relations" and two "it must have been your fault that they assaulted you". For some reason this sounds alot like you must have deserved that rape because you wore a skirt....

[Black Jade, BSN, RN]

I'm sorry that this happened to you, especially being your first experience as an RN. What perplexes me is that I read so much negative comments about working in the SNF and LTC facilities. Why is there only one nurse in charge? Can't they hire more RNs? That's a recipe for disaster for both the facility and the RN in charge who always needs to worry about losing her/his license. I'm not surprised that nurses don't find working at those type of facilities very appealing and are out the door sooner than you think. That is sad, because the patients are the ones suffering as well. Also, some supervisors and managers are getting hired without healthcare experience and unfortunately nurses don't get any moral support from them, because they lack understanding in the clinical area. I think if there are positive changes in the subacute setting, more nurses will be willing to work there for a long time instead of only to acquire the "one year experience". I know I would.

Don't consider yourself a failure. You did the best you could and the most important part is that you cared. Better that you left now, than seeing yourself as part of the nine o'clock news or be involved in a lawsuit. Next time be sure to find out what the protocol of being assaulted is. If they turn the other cheek, run out of there as soon as you can. You want to work in an environment that is safe, not to be on guard all the time.

[freebirdRN86]

i'm sorry about your experience. i'm a new grad and was offered a job with a ltc facility and turned it down because of the 2 weeks of orientation they were offering. no way was i going to be the "nurse supervisor" with 30 patients with only 2 weeks of orientation as a new grad. i was told to "take whatever i could" but i just knew i would be put in an unsafe situation. keep your head up and don't give up. you just have to be super assertive and you'll find a good job. good luck :)

[MouseMichelle]

Firstly I am really sorry for your experience, that's terrible. However please take this from a person who loves LTC there are bad ones and good ones out there. Although my boss isn't very nice, I do have good docs, good equipment, enough staff, etc. There are good and bad snf's out there. It's not an easy job by no means, and from what you wrote the place you worked at should be closed down.

[FocusRN]

I'm so glad you left that place. I really wonder how administration would feel if after that pt had attacked some else, then attack you, if you just said the hell with it and let him have it. I mean are we really expected to just take abuse and hope we are not killed? Life preservation is a natural instinct, after all. With that said, I really think you should sue the facility. It is not apart of your job description to be put in harms way and abused. This pt had just attacked someone else and you were not notified, then you were attacked, and expected to still work with that pt. That is willful negligence if I ever saw it.

Negligence - the failure to exercise that degree of care that, in the circumstances, the law requires for the protection of other persons or those interests of other persons that may be injuriously affected by the want of such care.

[debRN0417]

There are places that are sh#t holes and places that really try and care about their residents and employees. Things happen everywhere and there is no perfect place, but hang in there because you will find the place that is right for you.

[CapeCodMermaid, RN]

I've worked in at least 8 different facilities and at NO time would this have been condoned. If a resident attacks another resident or a nurse, they win a free trip to the hospital. If the police have to be called to help the EMTs get them onto the stretcher, then that's what happens. All the staff have been told this. We call 911, tell the operator we need an ambulance and the police and do the best we can to control the resident until help arrives.

We use restraints if we have to. We use many antipsychotics. We try to treat increasing anxiety and agitation before it gets to the point of physicality. Sometimes if a resident is over the top, we remove all the other residents from the area and do the best we can to protect ourselves until the police come.

As far as a short orientation....my first day on the floor as an RN at the local hospital I was put in charge...because I was an RN. Sometimes you just put on your big girl underpants and get on with it.

[iwillbanurse08]

As a fellow nurse I am sorry you had to encounter that experience. I find it appalling the they hired you as a new grad and only gave you 2 days orientation. I dont care how small a facilty is that not enough time to feel comfortable. I started as a new grad as well in a LTC and was given 6 weeks orientation. By the end of orientation I felt comfortable enough. Also was that a regular behavior for that resident because if it was maybe he needs to be evaluated or have some sort of protocol in place for him. That is not a safe environment for staff or other residents.. Come on grabbing the neck (thats a no no!!) could do really bad damage. I will keep you in my prayers:saint: for you to land a better well suited job for you. We go through enough h#$%, we dont need to add being assaulted to that list as well.. Wish you all the best