I am a new grad LPN. I just started my 1st nursing job at a new facility on Tuesday. Tuesday was an all day orientation in the classroom. Wednesday, I had 3 hours in the classroom watching videos and then the remaining 4 hours I was suppose to be following a LPN. The nurse I followed showed me a couple things, but she pretty much just checked the meds off and had me to give them to the residents. The DON had me scheduled to orient 2 night shift days on the floor. Then on my own after that. I just dont feel comfortable. I am a new grad with no nursing experience and she wants me to orient 2 nights and set me loose.
I left her a message telling her that I am not comfortable and that I dont feel it is safe. I have actually left 2 messages within the last 6 hours. I am scheduled to orient one Saturday and then on my own on Sunday. I feel comfortable with going in and orienting on Saturday. But if I dont hear anything back from her by end of the day, I will call out on Sunday and resign on Monday. Do you feel that is too harsh. I feel that im being thrown to the wolves. I know that nursing is a field in which you must be able to adapt to situations quickly and hit the ground running. But I dont feel this is safe.
Does anyone has any suggestions or comments, I would greatly appreciate it.
Specializes in Community Health, Med-Surg, Home Health.
Unfortunately, I keep hearing that this is the norm for LTC, which is why I avoid them like the plague. How can it be that there is one nurse covering a shift in an entire facility? I don't even like the idea of working alone on a floor! I have heard of one LPN working with 60 patients in a unit alone, with 2 or 3 CNAs. It makes me get the willies just thinking about it, and this also shows me just how much they devalue the elderly and helpless.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I hope I can disagree with everyone, without being too disagreeable. :)
I have spent my entire short career in LTCFs. In my metropolitan area, the typical orientation period in nursing homes is 3 days before the nurse is cut loose to start working the floor on his/her own. At my first job right out of school, I received a whopping 8 hours of orientation before being "thrown to the wolves" to work on my own.
Here are the realities of nursing homes. They are extremely desperate for staff, and they typically do not have the time or money to train nurses for extended periods of time. A 4 to 8 week preceptorship is simply not within the budget of most LTCFs.
In addition, it is assumed that licensed nurses should have learned basic nursing skills in school. The orientation period in LTCFs is primarily used to familiarize oneself with the paperwork, residents, facility layout, and routines. The nursing home is paying you in exchange for your labor. They're not offering you a paid practicum period.
This is why I have so much respect for charge nurses in LTC. They started with virtually no support or training, accrued knowledge and experience on the job, and are able to do amazing things for their residents. You need to be an independent, motivated person who is willing to "jump in there" if you are to succeed in the caustic environment of the nursing home.
Specializes in Informatics; Labor & Delivery; Med-Surg.
I hope I can disagree with everyone, without being too disagreeable. :)
I have spent my entire short career in LTCFs. In my metropolitan area, the typical orientation period in nursing homes is 3 days before the nurse is cut loose to start working the floor on his/her own. At my first job right out of school, I received a whopping 8 hours of orientation before being "thrown to the wolves" to work on my own.
Here are the realities of nursing homes. They are extremely desperate for staff, and they typically do not have the time or money to train nurses for extended periods of time. A 4 to 8 week preceptorship is simply not within the budget of most LTCFs.
In addition, it is assumed that licensed nurses should have learned basic nursing skills in school. The orientation period in LTCFs is primarily used to familiarize oneself with the paperwork, residents, facility layout, and routines. The nursing home is paying you in exchange for your labor. They're not offering you a paid practicum period.
This is why I have so much respect for charge nurses in LTC. They started with virtually no support or training, accrued knowledge and experience on the job, and are able to do amazing things for their residents. You need to be an independent, motivated person who is willing to "jump in there" if you are to succeed in the caustic environment of the nursing home.
I am not speaking of nursing skills. I have no problems with wound care, labs, pegs, giving meds, etc. Its the paperwork, not knowing the unit or the residents, etc. Im sure there are those that will hit the ground running and dont care whether something happens and they are reported to the board and it comes back to the DON saying, well she never said she needed more time. I have worked very hard to get my license, and I dont want to lose it because im expected to handle a 33 pt unit alone with 2 CNA's after 2 nights of orienting on nights. Last night, I was able to handle 18 patient on my own. But I prefer to feel comfortable. I dont want to be one of those nurses that are thrown in to sink or swim, and end up drowning.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I dont want to be one of those nurses that are thrown in to sink or swim, and end up drowning.
If you feel that uncomfortable with large patient loads, perhaps it is time to start submitting your applications at acute care hospitals where the patient loads always tend to be much lower than those being presented at nursing homes. Bouncing to another LTCF will, unfortunately, bring more of the same: more patients, short orientation periods, and so forth.
If you feel that uncomfortable with large patient loads, perhaps it is time to start submitting your applications at acute care hospitals where the patient loads always tend to be much lower than those being presented at nursing homes. Bouncing to another LTCF will, unfortunately, bring more of the same: more patients, short orientation periods, and so forth.
maybe it's that way in your immediate area, commuter.
here around boston, new grads get anywhere from 3-4 wks of orientation:
Here in WI , its the same as Commuter describes,lucky if you get a week of orientation and if you have experience a night or two, or none, as in my last place of employment.I worked there over 5 years, 67 patients and 4 CNAs ,night shift. One supervisor that was so busy helping on the acute care unit that she often never made it up to my floor.
Specializes in Informatics; Labor & Delivery; Med-Surg.
If you feel that uncomfortable with large patient loads, perhaps it is time to start submitting your applications at acute care hospitals where the patient loads always tend to be much lower than those being presented at nursing homes. Bouncing to another LTCF will, unfortunately, bring more of the same: more patients, short orientation periods, and so forth.
Well, my first day on orientation, I was able to handle 18 patients. Maybe on my 2nd day, I will be able to handle more. I am not a quitter. I just dont like the way they treat the new grads. Im not bouncing around. I actually interviewed at this other LTCF before I got this job. Another influence in me taking the other position is that I live 2 minutes away from this other LTCF instead of 25 min.
I dont bounce around. The position I held before as a Tech in the hospital was for over 6 yrs. I believe in a challenge, and I love being pushed. But not being pushed off the cliff. If im equipped with the information I need, I can do anything.
And im sorry that you feel I should give up because I came here for opinions on my 1st week on the job.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
And im sorry that you feel I should give up because I came here for opinions on my 1st week on the job.
I don't feel strongly one way or the other regarding the issue of staying at or leaving your current place of employment. I don't know you personally, and I frankly do not possess the emotional involvement to have strong feelings about the decisions that you face.
You came to these forums for suggestions, and you are receiving them. :)
Specializes in Informatics; Labor & Delivery; Med-Surg.
thanks to all of those with positive comments and feedback. most of what was said is how i was feeling. i feel that in order to be a good nurse, i should be trained properly. im not winging it, too much is on the line. one mistake could cost me my license. being that im still in school and am due to finish the rn program in december, i am not taking any chances. thanks again to all of you all that responded with positive or constructive comments without being negative.
thanks to all of those with positive comments and feedback. most of what was said is how i was feeling. i feel that in order to be a good nurse, i should be trained properly. im not winging it, too much is on the line. one mistake could cost me my license. being that im still in school and am due to finish the rn program in december, i am not taking any chances. thanks again to all of you all that responded with positive or constructive comments without being negative.
shawn
i'm with you all the way.
even if all orientations were only a few days...
that is unsafe and i wouldn't be willing to jump in and risk drowning.
Specializes in Informatics; Labor & Delivery; Med-Surg.
i'm with you all the way.
even if all orientations were only a few days...
that is unsafe and i wouldn't be willing to jump in and risk drowning.
i need to know i'll swim...not either or.
best of everything to you, shawn.
don't let anyone persuade you differently.
stay true to yourself.
leslie
thank you!!!!!!!! at least im not alone. its scary to think you are expected to hit the ground running with one or two shifts of orientation...... good luck to you as well leslie.
Thanks for all of the responses I received. On top of no real orientation, she wanted me to work 5 shifts a week. I thought, and thats what I get for assuming, that it was 8hr shifts. She wants me to work two 8hr shifts and three 12hr shifts a week. I also left my concerns with that in the voicemail.
She said she was willing to work with me. That I can orient until I feel im ready and that I can tell her what shifts I can work.
But I also have another job lined up. Ive learned from this experience. I ask questions and tell them what I expect now. Ive always been the type person that just takes what ever is dealt to me and deal. But I realized that if I dont speak up for myself, I can lose what it took me so long to get, very quickly, by being ignorant.
Thank you to everyone for voicing your opinions and helping me out.
at least im not alone. its scary to think you are expected to hit the ground running with one or two shifts of orientation...... good luck to you as well leslie. 
pagandeva2000, LPN
7,984 Posts
Unfortunately, I keep hearing that this is the norm for LTC, which is why I avoid them like the plague. How can it be that there is one nurse covering a shift in an entire facility? I don't even like the idea of working alone on a floor! I have heard of one LPN working with 60 patients in a unit alone, with 2 or 3 CNAs. It makes me get the willies just thinking about it, and this also shows me just how much they devalue the elderly and helpless.