The reality for LPN/LVN for a new graduate

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I graduated from LVN school last year..Hospitals are no longer hiring LPN/LVN..You will be working at a LTC/SNF..You will have 30 residents to care for or less if you are lucky..That is if you are lucky..Depending on the shift you get, either you get AM, PM, or NOC shift, AM shift is the hardest..If you have that shift, prepare to fight for your life to survive in that shift..It is like a war..You will have to care for 30 residents, pass medications, do treatments, take new MD orders, chart important information, prepare for the unexpected, supervise CNAs, do new admissions, etc..LTC/SNF are understaffed because of company greed and the company will not care if you lose your license if something happens....Managment will expect you to finish all your work at the end of your shift on time.The turnover rate is very high in LTC/SNF for a LPN/LVN, especially if you work the AM shift..In some LTC/SNF for LPNs, it is a revolving door and new nurses come and go more than the CNAs come and go....If you are the lucky ones, you might get an easier shift like PM or NOC shift, those are the lucky ones..Everyday when I go to work, I feel like it is some kind of war to survive with the workload in AM shift..I dont take lunch breaks and I never get out on time..Management will get mad at me for not getting out of time or completing all my work duties but I tell myself to ignore it because I am concerned about patient safety and my license..And I know that the next nurse that will replace me if I do quit will go through the same things..Nothing will change..

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Maybe you need to relocate because there are lots of hospitals who still hire LPNs. Not all LTC is the way you describe and LTC & hosptals are not the only opportunities.

Dixie

1
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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

In my area, hospitals hire LVNs, but the pay is low. Many of us willingly work at LTCFs because the pay rates are more competitive than the ones offered by the local hospital systems.

I've been doing LTC and skilled rehab for the past year and a half, and it can be challenging. I choose to work full-time weekends so I can completely avoid the difficulties of working the morning shift Monday through Friday. I don't really want to deal with rude physicians, terrible nurse managers, and the weekday clique at my workplace, so I bypass them by working weekends. In addition, the evening and night shifts tend to be a little more relaxed (in my experience).

It would be wonderful if I could work LTC with less patients, because I currently feel as if I am doing assembly-line nursing. I basically finish off one patient and proceed to move onto the next, just like an assembly line. It's sad for me to admit this...

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Specializes in Med/Surg, Tele, Peds, LDRP.

Have you considered home health/private duty? What you are speaking of is exactly the reason Ive stayed far away from LTC! I work in Peds home health and its very low stress with the one on one ratio.

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In my area, hospitals hire LVNs, but the pay is low. Many of us willingly work at LTCFs because the pay rates are more competitive than the ones offered by the local hospital systems.

I've been doing LTC and skilled rehab for the past year and a half, and it can be challenging. I choose to work full-time weekends so I can completely avoid the difficulties of working the morning shift Monday through Friday. I don't really want to deal with rude physicians, terrible nurse managers, and the weekday clique at my workplace, so I bypass them by working weekends. In addition, the evening and night shifts tend to be a little more relaxed (in my experience).

It would be wonderful if I could work LTC with less patients, because I currently feel as if I am doing assembly-line nursing. I basically finish off one patient and proceed to move onto the next, just like an assembly line. It's sad for me to admit this...

I have been concerned about this exact thing. A friend of mine works nights and she barely does anything. Ia sked her about this and she if you work days you deal with Dr.s, the family of the patients, and basically it's alot of crap to deal with. Now I'm concerned. I could not function working nights and trying to care for my family and household as well. Not sure what to do now.....

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Specializes in Knuckle Dragging Nurse aka MTA.

You will be working at a LTC/SNF..You will have 30 residents to care for or less if you are lucky..That is if you are lucky..Depending on the shift you get, either you get AM, PM, or NOC shift, AM shift is the hardest..If you have that shift, prepare to fight for your life to survive in that shift..It is like a war..You will have to care for 30 residents, pass medications, do treatments, take new MD orders, chart important information, prepare for the unexpected, supervise CNAs, do new admissions, etc..

Your asesment is correct but as new grad LVN you will be caring for 35 - 48 residents in this part of california.... There was just a post about a new grad LVN with 50 residents and 22 diabetics on the pm shift from northern california. plus you have to do all the dr calls, family calls, pharmacy orders, diabetics, G-tubes, take dr orders, transcribe dr orders, supervise out-of-control CNA's, respond to code blues, treat code blues, call the Emergency rooms, call the hospitals, call the emergency medical responders, do admissions durring your med pass, treatments and dressing changes, answering the phone all day / night, labs, and trying to complete TWO GIGANTIC med passes in 8 hours while dealing with angry family members who want to stop you and complain to you while you are trying to catch up on work.

I would of LOVED to have 30 patients... unfortunatly this is a dream and 35 -48 is much more common here. I am no longer in LTC but it was terrible just a year ago.

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Specializes in Knuckle Dragging Nurse aka MTA.

48 patients IS assembly line nursing. I hated it! PM shift was very busy were I was working, as was night shift.

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Specializes in Knuckle Dragging Nurse aka MTA.
Have you considered home health/private duty? What you are speaking of is exactly the reason Ive stayed far away from LTC! I work in Peds home health and its very low stress with the one on one ratio.

I really like the concept of one on one nursing and may get into this later in life.

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Specializes in Knuckle Dragging Nurse aka MTA.
I have been concerned about this exact thing. A friend of mine works nights and she barely does anything. Ia sked her about this and she if you work days you deal with Dr.s, the family of the patients, and basically it's alot of crap to deal with. Now I'm concerned. I could not function working nights and trying to care for my family and household as well. Not sure what to do now.....

I work night shift in a prison psych unit for the dept. of mental health.. You can function just make sure you get enough sleep. I get more sleep working night shift then I did working AM's. I naturally stay up late so I would be up til midnight and have to get up at 4:30am before for the day shift. Now I get better sleep and night works great. Lower stress easier pace.

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I work night shift in a prison psych unit for the dept. of mental health.. You can function just make sure you get enough sleep. I get more sleep working night shift then I did working AM's. I naturally stay up late so I would be up til midnight and have to get up at 4:30am before for the day shift. Now I get better sleep and night works great. Lower stress easier pace.

I seriously don't think I could. I still have a little one at home, and even when Im dead dog tired from a restless nights sleep I cannot fall asleep during the day for nothin! I don't know why. I also know here in AZ things may be alittle different than there in Cali. My friend told me she worked on an Alzheimers ( I know Im spelling that wrong)unit and it wasn't nearly as busy as the rehab facility she works in. Although I wouldn't make as much money, there is always hospitals and Dr.'s offices that employ LPN's. I will just have to see. Worst case, if I hate my options, I will just go on and get my RN.....

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Specializes in Community Health, Med-Surg, Home Health.

I do home care, and it can be less stressful, but, there are other considerations. The family dynamics, home environment, and not having another medical person to rely on in case things happen are things that a nurse must also take into consideration. All in all, I do prefer home care better, and may make that a plan for the future.

I am glad that I was not blind to nursing because I was in it as an aide and other positions for many years and see how it works. However, when the weight of it all is on you, anyone can wonder to themselves if this is what they got into nursing for...assembly line care??? I am heavily into karma, and can acknowledge another person's point of view about me as much as I can hate it sometimes. I worry about if myself or a loved one needs care and how we would be treated. I try my best to do what is right, but, the real world is not a textbook. Sometimes, our decisions are based not on policy or what was taught in school. Our decisions may be based on who else is on duty, how much trouble will we have to get through in order to get service for the patient or to get a troublesome situation out of our hands, and such. I go home with tremendous guilt, sometimes.

I am seeing that opportunities available to the LPN is based on where we are located. I have many places in my area that still hire LPNs. But, let me say that hospitals are not much better, really. I work in a clinic, and did a med-surg orientation before, and I saw horrible things go on there, too. In the hospital, there is even more unpredictability than before, and more untrustworthy co-workers that can certainly leave you in a jam if you are not careful.

Bala, I hope that you find your medium in your career, and maybe if you are able to later on, you may decided to become an RN to have the variety and opportunities that you are looking for. I have read your posts in the past, and know that you had a rough year with employment. I hope that posting here has at least allowed you to feel a bit better by venting to people that do understand. I wish there was more to say...

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Specializes in Mother-Baby, Rehab, Hospice, Memory Care.

I think every LPN who has worked LTC can relate to your feelings. I honestly think there needs to be some kind of reform in LTC. However you are mistaken about evening shift being easy! It is just as busy or busier than days, plus you have less support once the nine-fivers leave for the day and not to mention sun-downers.

In my area some hospitals are hiring LPN's but are much more selective than your average nursing home. I always seen tons of job openings for LPN's in clinics and doctor's offices. Other options might be hospice or home health. Just keep looking, you will find something!

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