!st LPN job nightmare

[Ultreya816]

I am a newly graduated LPN., not afraid of a heavy workload or extra hours. I have always worked with the elderly in some capacity and am a great advocate. My first job, a large LTC facility . My first day on the job, 3 days ago, I was informed that I would be placed as charge nurse and given a float position in this facility of over 300, after orientation. Orientation consists of 5 days. Each floor will have 30-40 residents. My first day after 12 hours I left in tears. The residents were awesome but the practices of the staff I witnessed, and was told to participate in were unacceptable to me. I was taught in school to never ever chart something that I didnt do and to DO everything that was included in my residents plan of care. My first day I was told that we dont have time to actually check that each resident has the required safety equipment, alarms, hip pads, etc so we just check off that they have them. I was told to check off that a resident has her heels floated when in bed. This person has breakdown on her heels which are never floated because they said we didnt have time to babysit her and make sure that she keeps them in place. If the state was due to come in, then we would put all of these required devices in place. I found another lady in bed covered in blood because she had scratched and dug holes in her leg. I was told to treat it but not to document it due to the time consuming paperwork involved. I have been told to take meds from other residents because there was no time to order new ones for a res that had run out. On my third day, no new meds were yet ordered and when I asked to be shown how to place the order I was told that my orientation nurse would get to it one of these days. I attempted to give a res her meds last night but she wasnt in the mood to take them. Her son was with her and insisted that I leave the meds with him to give to his mom later. There were narcs in that cup too! When I refused to do this, suggesting that Id come back in a few minutes to try again, the son complained to my trainer and my nurse GAVE him the cup of meds and shook her head at me! I told this nurse that I worked too hard for my license to jeopardize it and that I needed to witness my res taking their meds, not leaving them with family members. This nurse also laughed at me when I insisted on taking a res back to his room to flush his PEG rather than do it in the dining room. I have seen tube feedings not hung and documented that they were. I have seen res crying in pain and being ignored as "complainers" while having standing prn orders for narcs that were signed out but never given. Before I left last night I went back to check on an actively dying woman who had earlier held my hand and cried and was told we didnt have time for this. So my nurse escorted me back to the nurses station where she joked around with another nurse for 45mins and I sat there until it was time for me to leave. Then my nurse complained to her friend that she'd be staying over a few hours again to do her paperwork.At the end of my first day when my nurse checked my charting, she shook her head and initialed all the things I refused to because I was told not to either do something or check on something. My third day finds me still not knowing how and where to chart because my nurse insists on waiting until the end of the shift to do it all and then complains about having to stay 2-3 hrs over, without pay to finish up. Alot of the nurses here told me that this is normal and they dont get paid for it.I have only a few days left of my orientation before they float me all around this huge facility and I am not ready. I was told that Id catch on but each station is different so Id have to see how they manage on each unit. NO, I dont get a different nurse to train with as SHE is the "best" I was told. I was told that I would be well trained. What they have taught me thus far is that I will never allow a loved one of mine to enter this facility as a patient. There is chaos and nurses quitting or just calling off at every station everyday! A 20 yr veteran nurse who was hired with me quit yesterday. If I were an experienced nurse Id probably want to stay here and try to make changes but I feel as a new nurse I wouldnt survive here. I have classmates who tell me they LOVE their new jobs! I leave my 12 hr shift knowing that I have not done all I needed to do for my res and that is unacceptable to me. It concerns me that the facility would allow a new inexperienced LPN to take charge of a 30 - 40 bed unit that is already in chaos and short of aides. Sorry this is so long! I am not a quitter, but I do feel like going elsewhere. I feel that my license may depend on it.I want to learn to be a good nurse from someone who takes their own job seriously. Id like to hear from anyone caring to comment, as to my post. Ive been told by other nurses here that its the same in any LTC facility. Thanks.

[Lovin' my job!]

i definitely understand what you are saying, dlsgroovymom. i also worked for several years in nursing homes and now thank god i am in a different nursing field. a few years back i accepted a position as a prn staffmember in a national nursing home chain to make some extra money on top of my full-time salary in outpatient general surgery. i thought since i would be in control of accepting a shift or not, i would able to handle it. i was soooo wrong. the minute i stepped foot on the floor to orient, the sights and sounds brought everything back. i worked one shift and never returned. it actually made me physically sick to my stomach to remember the stress, the responsibility for the 60 patients that i had previously had. many non-medical people don't understand how frail, helpless, and ill (chronically or acutely) these patients are. between the myriads of medications and treatments, you also have g-tubes, ivs, pca pumps, ventilators, oxygen, accuchecks, and tpn feedings. you have copders, patients with fractures, brittle diabetics, patients with dementia, post mis, etc. and again, you have 60 of these patients. the paperwork is long, tedious, and repetitive. i took the nursing home jobs fresh out of nursing school, and i felt the tremendous weight of the responsibility bear down on me. quick assessment skills for rapid-fire judgement calls are needed, but many of the nurses hired are young and not very experienced. and then they make these nurses 'charge nurse,' with little orientation, and very little other nursing assistance available when they work. it's no surprise that so many of them get ulcers and burn out. i also worry about the state of nursing homes and our growing elderly population. the elderly deserve so much better. most of the nurses do their very best, but it's like bailing out the titanic with a teaspoon. sorry this is so long, but trust me it is very cathartic. and may i say, god bless you to all of the ltc nurses and cnas that do this work. they truly are angels, and i hope they have a special reward in heaven. (i'm sure not all nursing homes are like this, these are only my experiences.)

i worked my first lpn job fresh out school at the same facility that i did one of my clinicals in. as i wish.. listed above, all the resposibilities and medical conditions we must tend to, it was very intimidating and stressful to say the least. but, thank god this facility was under the health authority umbrella, not privately owned. did this make a difference? probably. were there problems with unacceptable care. sure. but nothing compared to what you have encountered. at that time they were things like staff not wiping the jam and crumbs off the residents hands, tray, and face, and letting the toast go cold and still in front of them for 2 hr. to me that's unacceptable. i did my best to make a difference where i could. but all these "little" things kept adding up. but this was a great facility. education all the time, more staff than not that cared, clean, changing things that mattered where they could, kept current ect. there where days my best friend (lpn) said, 'you can't cange the world' so i to everyday one at a time. but the things you described are horrendous. i would have done exactly what you have. my line was very small so i also worked casual at the hospital. lpn's were not permitted to do meds or injectables. at least not on that ward. so i was more of a "glorified nursing assisstant" as some one once said. but, if i hadn't worked in the ltc (dementia - my favorite :) ) i would not have had acquired all the knowledge of disease processes, meds requried/effects, everything, to do my job on that ward to the best of my ability to help these pts. i worked at this ltc for almost 4 yrs and can't begin to describe all i have learned.i have recently moved back to vancouver and am looking for that same type of facility. as a matter of fact i did my first day today of orientation at a ltc. i was not impressed. my last job has set a very high standard. this new job is a privately owned. this is the 2nd private facility i have experinced and there both the same. why??? thank god it's only casual. i know there are places out there that care. health care members that care. i do. i couldn't be happier (ironically) when i read your story. you care. i glad you won't conform to others' bad habits. as you will experience, many older staff become complacent. you seem strong in your convictions. good luck to you and the rest of you who want to make a difference and advocate for those that can't for themselves. thank you.

[Lovin' my job!]

Just in addition to that :) --- There were many days that I decided to sit with a resident who needed my comfort in any capacity, or get them a drink, change their shirt, walk with them to the chapel, instead of going to do that charting I was on my way to do. I stayed a half hour/hour after my shift to finish charting etc. and I never claimed overtime. I made a difference in someones day. That's why Im there.:) And yes, there were nurses that also perceived me as having bad time management because I was staying late to finish my work. Oh well. I once heard someone say 'you're not there to make friends'. True. I'm there for a resident. For every resident I help, I know there is one out there being neglected or abused. Sad.