Published Feb 13, 2009
cygnus85
4 Posts
Hi!
I am new LP nurse grad and I an currently "orientating" in a LTC facility. It's been 4 days in the morning and 3 days in the afternoon shift, for which I was hired for... Then I will be on my own.. My situation is that I feel a little scared.. I am assigned to care for over 30 patients, pass meds, (mostly PEG's... I am kind of slow on that) BS checks and insulines, breathing treatments, skin treatments, responsible for new admissions (assess them well and document), receive telephone orders, make sure everithing is ok, keep an eye on the CNA's which by the way one nurse told me they like to slack of and not do their work when there is a new nurse around, chart, familiarize myself with the paper work, and being in fact the charge nurse during my shift.. I just feel overwhelm and I am scared..
Even some of the other nurses there told me "Welcome to hell.." (think they really mean it)
I just feel a little nervous.. and honestly scared... Im worry that I will not do my job right... There are sometimes that I doubt myself of my capabilities..it is just a bunch of different emotions that overwhel me...
I talked to a friend of mine (who is not a nurse).. and told me that I am just being a chicken.. that I am exaggerating and that I need to suck it up and try to get the job done as best of my capabilities...
may be true, but still...I don't know..
I dont know what do do.. should I stay and try to get by untill I get more familiar with the rutine... or should I leave before I find out...
is it just me that have felt like this when starting a job in LTC?, Am I exaggerating..?
any thoughts will be appreciated
systoly
1,756 Posts
What a thing to say. My response: if you voluntarily work in hell, does that make you a demon?
You are not exaggerating. Starting a new job and, in yor case, a new career is a major life event. My question for you: what do you expect of yourself? Do you feel you need to be as efficient as the more experienced nurses?
If I may, I'd like to suggest the following: make a list of your goals and expectations. If possible, go over the list with the person who hired you. Offer to do this on your own time. Or, try and find an experienced nurse, but not someone who works in hell, to go over this with you. And, if possible, fill in your bio (about me), you might get better responses that way.
travel50
224 Posts
I probably should not be on this post b/c I am an RN, a director of nursing actually, of a nursing home. I came to this section b/c I wanted to post a note to brag on my LPNs. They are so very good. But I am disturbed by this posting.
At my nursing home, new graduates are given a full 2 weeks of orientation. Even after they then go to the floor on their own, they are not exactly on their own. We have 60ish residents, so 30 or so each for the 2 floor nurses. The other floor nurse is expected to look out for the new nurse and offer to help if she / he gets done first. We also have a treatment nurse who helps answer the phone, deal with families, etc. During the day, the ADON will help with a new admission or even a return admit. From 7P-7A there is an RN also. She does all the evening treatments, does assessments, new admits, etc. Yes, the floor nurses help monitor the aides, but so do the RNs. You have good reason to be nervous, and you are not being a chicken. This is something I simply do not understand. If one of my nurses makes a serious mistake, my license is also on the line. Why in the world would I put the LPN at risk or myself? Or more importantly, my resident? Furthermore, I prefer a low turnover rate. When I took this position as the director of nursing, I didn't really want it. I had worked in this facility for 6 yrs. No one else was qualified to take it. The staff wanted me to. So I did, but only b/c I love my staff, and they agreed to help me. I cannot do this alone and do it right. That was 3 yrs ago. They are exceptional, and I cannot tell you how much I value them. I will do anything I can to make their jobs easier. Just wish your facility was the same.
chevyv, BSN, RN
1,679 Posts
I too am new and got a whole 6 shifts before they put me on my own on a wing with 28 residents. I had my first physician phone call (on my own, no help from the other nurse on the other wing), a new resident whose bs was way too high and I couldnt' get it down to save my life (again all alone). I had never set foot on that wing before and never had 28 residents. I was responsible for everything from the residents, to orders, to treatments, to summaries. I was so overwhelmed I wrote here for support (A day in the life of a new lpn). I had 7 bs and insulins to give before supper (most I've had were 4). My time management was nonexistent and I felt like a huge failure. I got out of there 2 hrs late and had to pass the orders onto noc shift because I had no idea how to do them.
I emailed the scheduler and told her my shift was the pits and that I would not work on that wing again without a few days following another lpn. I was so not safe, but did the very best that I could.
I've been told that I will get better with time and to hang in there. Once you get a routine down, it gets better. I'm not giving up!
llluv2bnurse
1 Post
Wow...I am still with my RN. I am on a Med/Tele floor and started there in November. We orient with an RN for 90 days. (the entire probation period). Then you go on your own, but have so many nurses there to help. I would be overwhelmed too!! You are right to feel this way. You don't know enough to be dumped in a wing with so many patients and so many things that could go wrong. Good luck and I hope things start to get easier. :)
cmawrule
23 Posts
I used to work in LTC. The workload IS huge, you are not imagining it. That's the reason why most LTC pays an LPN better than hospitals-you have much more responsibility. Might help to ask the other floor nurse for help-a humble,"how do YOU get it all done on time?" works sometimes.
WATCH OUT for shortcuts-I have seen some LPNs pull off some doozies that are just plain illegal to cope with the workload..if you see someone giving their entire medpass in 30 minutes chances are they are not signing off the meds when given or even reading the MAR to look for new orders. DON'T let down the standards of practice you learned in school. your licence is at stake, and those patients and their families are counting on you. A lot of it is time management-you will learn to get it done a little faster and a little faster as time goes on.
the bad news is, the workload is enormous. The good news is, you can be a very significant person to a lot of older people. A good LPN makes a very big difference in LTC. The patients are what keep you coming back.
erikajk34
First off...Hang in there & don't give up!! :)
I know what you mean about being overwhelmed. I worked on a hall with 26 residents when I first started and I was scared to death, but everyday it gets a little better. You get to know the residents and you get to know the other staff. Things start getting easier.
I had a huge fear of people dying on me when I first started. I would be constantly worried that I wouldn't recognize someone's deteriorating condition, but that is also something learned with time. I look back at so many residents I sent into the ER now and think, "what the heck was I thinking?"
I think you should tell the DON that you are not completely comfortable yet taking on a whole hall by yourself. Also, you should not be expected to do a whole admission. That's nuts! The most we have to do for admissions is weight, body assessment, vs, and chart all of that. The MAR/orders are all figured out by an admission nurse.
Anyway, what I am say is don't let it get ya down. It's all a learning process. You will eventually become more and more familiar and more comfortable.
thank you everyone for your words and advices..
Im still in that facility and it seems that sometimes things start to get a bit easier.. but I am trying my best. I am still slow while passing meds, but I definately make sure that I give my meds correctly.:typing
like you all said, it takes time to pick up the rutine of work... I just waiting for that to happend. that is why I still keep trying my best..:redbeathe
once again thank you all...
kaylee3
21 Posts
I worked in an assisted living facility and probably g0t 16 hours orientation and then was thrown to the wolves------my first night alone everything that could go wrong=did. I ended up staying there prn -about 16 hours every two weeks----stayed there about 1 1/2 years then left because of the management........i can understand how overwhelmed you are-i for one will never work ltc or assisted living---the med pass alone is an impossible task in the time frame that the state mandates-what a joke.....if you ask me=every nurse is asking for med errors!
luvmy2angels
755 Posts
I know how you feel. I was oriented for maybe 3 days and then another nurse called off so there i was on my own and had over 30 pts. It was frustrating and i was scared to death. I didn't get done with my med passes on time and never even got to treatments! I was there for over an hour after my shift ended finishing up paperwork. BUT in time i got a routine and it was a piece of cake. The most important thing to remember is that it will take time. It will take time to get your own rythm and routine down, everyone comes up with thier own way of doing things. Just remember you WILL get it!! Take a deep breath and know you aren't alone! Remember that all those other nurses were new once themselves too!! Good Luck!!
itsmyturn
184 Posts
I admire ALL ltc nurses...what a freakin pt load! Thats enough to make anyone tuck their tale between their legs and run like hell!
caroline3
13 Posts
I will start too as a new nurse in LTC, I don't know how many I have, but they have 109 residents, and 3 or 4 nurses on the evening shift and 2 TMA's. I heard it is mostly med pass. I hope I will get the speed soon. I did have 40 residents with one partner on the night shift in TCU as an aide. Hopefully that will help. Any tips how to get speed safely in the beginning? Thank you