Should I go back tomorrow morning or not??!

Nurses General Nursing

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Any advice at all would be helpful!

My situation: I started a LTC prn position as RN this week. I have never worked in a nursing home as a nurse before, and I told the hiring manager this. She said I'd get as much orientation as I needed. (I didn't expect much more than a week.) I do have prior hospital experience.

Well, on my second day, when I was just supposed to be doing my first med pass, (I don't know any of the residents,none of the employees, how to use the phone, where anything is, including charts, resources, etc.) they had a call off and instead of the nurse manager working one of the wings, like she was supposed to, she did chart review somewhere in the facility while my preceptor was taken to another unit and I was left to fend for myself. Needless to say, I was trying to do the best I could, but I did make a lot of mistakes based on not knowing where things were and also not knowing policy, etc. Even the d.o.n. came up to say she was sorry, but since no one offered to help me, I don't see why she bothered.

Anyway, I get the impression that the staff here is overworked and not supported well by management. I told them I may not be back, and they said that they would understand if that was the case. Since they hired me on the spot, I assume they're pretty desperate for help.

I am supposed to go tomorrow morning for another orientation day but truthfully, I'm angry and worried about losing my license at this kind of place. Am I over reacting? Or should I follow my gut?

Sorry this is so long, but I started this prn job to try and find an area in nursing to call "home", and I don't think this is it!

Please reply back asap, anyone with advice!!!

I started a prn RN job at facility closer to my house. Even though I've been doing LTC for 10+ years, I expected a day or so or orientation. Yep...I got a day of shadowing (2 days of classroom/ paperwork stuff ) The next day I was doing it all. I can see/ feel and understand your frustration 100%. Being new to LTC, I'm not sure how you even stayed afloat. LTC is 100% diferent from acute.

What I would have done was go in a bit early, ask about staffing and your orientation and if they said you would be working by yourself etc, I would have thanked them then left before you accept an assignment etc.

This is no way for you to be introduced to LTC.

BTW...I eventually left that place I was doing prn work at. Not worth the aggrivation, seems like it was always short staffed. The day that did it was when I was told I was splitting an other unit (45 pts on 3-11) had two admits one on my unit and on on the other and of course had a few res who decided they would get up and walk for the first time in years. I was having contractions, dealing with a UTI and of course my 5th month of morning sickness AND...no one from mangagment could get out of their office to give me a 15 minute break.

So sorry to have to break this news to you ,but this is your welcome to the world of LTC. You can go just about anywhere in LTC and find the same exact scenario. Sad isnt it?:o

sadly i concur- our place brings in new folks - be they new grads or experienced and they are lucky to get one day of orientation - some havent even gotten that!! our facility refuses to use agency and the DON and the one other who are supposed to work the floor when short do not do so on a regular basis- exampole - we are to have 4 nurses and 10 aides on pms - we ofetn are stuck with 3 nurses if we are lucky ( many time 1/2 nurse as they come for 4 hours to help thats it or a med tech whom in our facility can do nothingbut pass meds ) and 6 aides - talk about dangerous staffing!! and they wonder why the first day one is orienting and hear they will be alone the next day run off and never come back..... sad state of affairs to say the least.

not going back would be understandable

but the items that you've listed can be solved: you can get to know the residents by name in a few days, you can get to know the staff as well,

you can learn how to use the phone, you can do a search to find where things are, etc

If this is a job that you would still consider, why not arrange to spend a couple of days making your own orientation (if they won't pay you for the days) - that way you don't get caught up feeling responsible for doing the "job" - you spend YOUR time getting the part of the orientation that you should have.

It would be great if they would pay you for orientation days, but I had also been hired (in the past) for casual relief employment and was told that my orientation would be on my own time (unpaid).

Just an idea.

anothjer idea is - when i was hired i took a complete blank admission set home an studied the papers and "practiced" at home at my lesure to get familiar with the paperwork needed.

Specializes in Geriatrics and emergency medicine.

Not meaning to sound crass, but being agency in LTC, this is what I face most everytime I walk into work..It takes extreme patience, and hardened organiizational skills. Give it a week. LTC is known for call offs, working with no staff and being tested each time you walk in the place. :pumpiron:

This thread is the story of my life. Call offs are the norm. I guess it's something you learn how to deal with. Two nights ago was the worst for me though. We started out with 2 nurses, me and a new girl. I took the rehab and sub-acute halls. The other nurse did her med pass and decided she didn't feel well enough to finish the shift, so she was gone. I was supposed to get someone else, but no one came in until 06:30am, so I was alone on all four halls almost the entire shift. One resident went ballistic that I was in her room to give her immodium after 15 minutes. She came to the nurses station and yelled at me and the aides for over an hour. Nice! Makes me want to quit. Management doesn't seem to give a crap, except to point fingers at whose fault it is that the residents are unhappy.

Specializes in LTC, Psych, M/S.

And so the theory goes - 'there is no shortage of nurses, just a shortage of nurses who are willing to put up with the horrific working conditions.'

Specializes in LTC, Psych, M/S.

And one more theory that I have - the nurses that work in administration of these places are just there b/c it is a 8-5 M-F job. Maybe not all of them - but most of them that I have known. If they had to 'work the floor' they wouldn't last 15 min, and they know it. So they hide in their offices.

And one more theory that I have - the nurses that work in administration of these places are just there b/c it is a 8-5 M-F job. Maybe not all of them - but most of them that I have known. If they had to 'work the floor' they wouldn't last 15 min, and they know it. So they hide in their offices.
I just had to respond to this post,even though it may be stealing the thread a bit.Please excuse me,but does anybody else out ther in LTC have a theory about what happens to nurses when they become administration in LTC?I have worked with nurses who were great nurses, ethical, hard working ,loyal to fellow nurses, BUT when they became part of the administration, OMG they CHANGED! I have lost friendships due to this type of thing. I wonder what types of pressures or threats or even bribes( I dont mean money bribes) are used that transforms these nurses so drastically, even to the point of them outright LYING to cover the butt of their fellow administrators. Im perplexed and dismayed.:uhoh21:

Have you ever researched the reasons why a nurse loses her license or is suspended at any state licensing site? Alot of them are LPNs who probably worked in a nursing home. Do you think they will support you if you make an error that may cause them a liability? Or a potential lawsuit? I would think twice about going back. But remember employers can now research where you have worked and for how long and with whom. And if you continue to start jobs and then quit. You will soon become what the nursing community considers "a temporary hire". Someone that will not stick around if it gets rocky. They will use you for the short term. Hire you, train you. But if you don't meet all expectations, they will rid themselves of you eventually. Or find a way, anyway of making you miserable until you quit. And your temporary employment with institutions will continue, over and over again. You can report it to the department of health. Even anonymously. They should be hiring temps thru the various agencies and not short staff the staff on a daily basis. Causing and inflicting you to feel as if your license is on the line. This is what happens. They don't want to pay experienced nurses in the field what they deserve. So they hire inexperienced nurses until they quit from abuse. The cycle just continues. There is no nursing shortage. Just alot of fed up, capped pay experienced nurses that would never have put up with that sort of situation to begin with. I bet you not even making what you previously made while working in the hospital to boot? LTC's are not known for paying a nurses worth. Even though there owners are making a sizable profit off of medicare reimbursements for care, gauranteed. I suppose I am stirring alot of things up today. But it is something to think about.

Have you ever researched the reasons why a nurse loses her license or is suspended at any state licensing site? Alot of them are LPNs who probably worked in a nursing home. Do you think they will support you if you make an error that may cause them a liability? Or a potential lawsuit? I would think twice about going back. But remember employers can now research where you have worked and for how long and with whom. And if you continue to start jobs and then quit. You will soon become what the nursing community considers "a temporary hire". Someone that will not stick around if it gets rocky. They will use you for the short term. Hire you, train you. But if you don't meet all expectations, they will rid themselves of you eventually. Or find a way, anyway of making you miserable until you quit. And your temporary employment with institutions will continue, over and over again. You can report it to the department of health. Even anonymously. They should be hiring temps thru the various agencies and not short staff the staff on a daily basis. Causing and inflicting you to feel as if your license is on the line. This is what happens. They don't want to pay experienced nurses in the field what they deserve. So they hire inexperienced nurses until they quit from abuse. The cycle just continues. There is no nursing shortage. Just alot of fed up, capped pay experienced nurses that would never have put up with that sort of situation to begin with. I bet you not even making what you previously made while working in the hospital to boot? LTC's are not known for paying a nurses worth. Even though there owners are making a sizable profit off of medicare reimbursements for care, gauranteed. I suppose I am stirring alot of things up today. But it is something to think about.
Well said!! This is a universal truth in LTC.I have read SO many posts that encourage nurses to just "quit, go somewhere else", but this is the VICIOUS cycle spoke about in NurseMMM's post.The salaries are kept depressed as well as the working conditions by this very practise of job hopping. You can run , but you cant hide. I know its hard to stay and fight, but how about siking a good strong union on their heels?
Specializes in Brain injury,vent,peds ,geriatrics,home.
Any advice at all would be helpful!

My situation: I started a LTC prn position as RN this week. I have never worked in a nursing home as a nurse before, and I told the hiring manager this. She said I'd get as much orientation as I needed. (I didn't expect much more than a week.) I do have prior hospital experience.

Well, on my second day, when I was just supposed to be doing my first med pass, (I don't know any of the residents,none of the employees, how to use the phone, where anything is, including charts, resources, etc.) they had a call off and instead of the nurse manager working one of the wings, like she was supposed to, she did chart review somewhere in the facility while my preceptor was taken to another unit and I was left to fend for myself. Needless to say, I was trying to do the best I could, but I did make a lot of mistakes based on not knowing where things were and also not knowing policy, etc. Even the d.o.n. came up to say she was sorry, but since no one offered to help me, I don't see why she bothered.

Anyway, I get the impression that the staff here is overworked and not supported well by management. I told them I may not be back, and they said that they would understand if that was the case. Since they hired me on the spot, I assume they're pretty desperate for help.

I am supposed to go tomorrow morning for another orientation day but truthfully, I'm angry and worried about losing my license at this kind of place. Am I over reacting? Or should I follow my gut?

Sorry this is so long, but I started this prn job to try and find an area in nursing to call "home", and I don't think this is it!

Please reply back asap, anyone with advice!!!

Hi fellow Clevelander!Akroner !Im sorry you had such a rough day.I think you need the proper orientation to do safe nursing care.Ive been through the same situations at numerous facilities.I felt I wasnt practicing safely in that environment and certainly not in a timely manner.I mean how can you do a safe ,timely med pass if you dont know the patients,no aids or nurses to guide you?Ive been there ,done that.I went into another area of practice instead of ltc.I love it.There are group homes,homecare ,Doctors offices and other areas you might find less careless.Try them.Im sure youll find your niche.You dont want to injure someone or lose your license.!Good luck! Keep us posted:o

A union would definately stop the nurse abuse out there. A strong one.

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