I just quit today after two weeks. I thought I was lucky enough to land a job at a SNF/subacute place nearby. After the first week, I was in for a rude awakening.
I had only 5 days of orientation in a 98 bed facility and was labeled charge nurse. Half the place is LTC, the other half subacute. 1st and 2nd shift have 3 nurses--usually 1RN and 3 LVN; 3rd shift usually has 2LVNs. Once I was on my own, passing meds to about 35 pts (in the LTC side) pretty much took me my entire shift. It was overwhelming and frustrating. On top of that, since I was an RN, I was responsible to hang IVs for all IV pts, no matter what side. I barely had time to document, and little to no time to assess the pts. As a friend had said, it felt like an assembly line--and that's how I felt I was treating the pts. There was no time to chat, no time to care, no time to critically think. Many of the staff members actually work on their OWN time (i.e. Not getting paid!) to chart, since many of them are afraid to get too much overtime since Administration will question them about it and may affect their performance review.
Many of my co workers were trying to convince me to stay, saying that it'll get better, that everything will become routine. But why is it that they are still taking more than their shift to do their work? It's simple: it's understaffed.
I brought all my issues up to the DON. All she said to me was, "I told you it's a lot of work and that it's a lot of patients. It wasn't going to be easy." Of course I didn't expect the work to be "easy", but I explained to her that there was no amount of training that could help me provide quality patient care if there is no time given to do that. She said she would like to hire more nurses, but Administration apparently doesn't want to hire anymore for any one shift. She just didn't seem to care too much.
I just had to vent and bring this up to all you new grads. I know I'm not the only that experienced this since I spoke and heard about a few people that experienced the same thing. I just want to give you some advice if you're looking into LTC or SNF. Some things I wish I had done before hand:
You may not see everything that goes on behind the scenes with this, but at least it's a good overview of the place. It's better than making any judgements based on how nice the building looks upfront or the nice painting and furniture in the reception area.
3) Ask the DON a lot of questions.
How many beds? As a new grad RN what are the job responsibilities? The job description? Expectations? Number of patients in your care? What is used for documentation/charting?
4)If you do commit, remember to buy some malpractice insurance (I guess that goes for any place you work at, but especially at a high liability job)
I hope this will be of some help to someone out there considering a job in a nursing home. I understand that many of us are still looking for a hospital job, but the pickings are few and far between. I haven't given up hope in finding that job, or even finding a job at another, better LTC facility in the mean time, but these are just some things to consider... Hopefully it'll save you from being burnt out or at least some tears.
I am in the same boat as you guys, work in Sub Acute+ Rehab in north part of the CA, I feel every day we put people’s life and our license in jeopardy. Some times I am wondering why there are no nursing comities to close these places. I am much worried about patients care than about my license, because I do my best to not make any mistake, but still I am sure we are all walking on the egg shells. I have seen it over and over. It is looking like that nobodies care at all.
People in this kind of facilities sometimes they do not have any families and we are the only they can trust, but with very limited support and too much work even computer will crash…….
I hope there was some place we could go and bring these problems up and get the nursing comities attention........
i feel your pain...im a new grad too...working at sub acute, rehab and LTC facility...we have alot in common about your job description...hard to be an RN...its really draining...but my advice to you is you just have to suck it up...nobody said that being an RN would be easy...or glamorous...it hard work...being new grads doesnt make us "babies" in the work area...imagine those people who works there for the longest time...be thankful that you have a job...and just think of it as experience for the next one you'll have...hopefully a better one...its a tough job...but we can do it :)
Who said being an RN means working like horse, we all need it to have fair work environment like lots of other jobs. This is not a third world country who one can not have voice and accept whatever the authority please to do. If you came from those country it could be much easier for you, because people used to be treated unfair, but this is America, and everybody have a voice...
I am in the exact same situation as you. I can't get an ED to give me a chance either. Have you tried to go for the ICU instead? If you work for an ICU as an RN for a year perhaps you could transfer to the ED after that. I also have subacute experience as an LPN and the same certs but after I couldn't get any pull in the EDs I tried ICU and a lot of them will hire new grads.
What state are you in? I am in Massachusetts or taxachusetts as it is not so fondly referred to. I have applied to community hospitals, teaching hospitals, rehab hospitals for med/surg, telemetry, ortho, ED, ICU, CCU, step-downs, progressive care units, etc. I am done. My last stab at nursing is the following: I am applying for a nursing license in a neighboring state and will do the 100+ application route again, with follow-up phone calls etc. I will give it 4 more weeks and then I will move on. I have many years of corporate and legal work behind me. I will change my master's degree program from nursing to an MBA or MPA and move on with my life. I really love nursing, but I need a life, a paycheck and some peace of mind for myself and my 17 year old son. For nurses who are still in their earlier years, some may have to go the same route and then head back to nursing. I am almost 53 (still looking good, good shape, but out of patience) so I don't have as much time to wait this situation out.
It's that way with old grads too! Only difference between SNF and Med/surg is the number of patients. When 'they' have enough staff, somebody gets cancelled so that you are still working with a skeleton crew. Today, the bottom line is more important than patient care! In my 23 years of nursing as an LPN, I've had vent patients, med/surg, nursing home, addicts...it is all the same. It just depends on whether you want to take the BS over here or over there. I'm just weeks away from my RN and my plan is to take BS from here today and from there tomorrow in the form of travel nursing. Good luck and stick with it! That's the only way to gain the experience needed to decide whose crap you wanna take and what day you wanna take it on.
Ah, another nurse discovers that America means Capitist Profit Generating Healthcare System. It will be difficult to find a reasonable nursing job. And remember this. Americans are the most over worked and efficient workers in the world. This is a proven fact. Hum, maybe this why we make more money. But yes, in the end, while higher wages means more spending money it also breeds inflation!
Specializes in Home Health; Family Practice Clinic.
I know how you feel, and thanks for posting this because it's so true! I am a new LPN, just graduated 5 months ago. I also work in LTC. I have 31 patients to myself... treatments, meds, PRNs, insulins, family questions, charting, doctor calls, etc. I'm spread so thin, and forget about if something acute happens. I had a patient with a blood sugar over 500 yesterday and spent over an hour just monitoring him, calling his doctor, writing up the new insulins orders he gave me. It gave me about 25 seconds for each of my other patients for the rest of the day!
It drives me crazy how much I have to, and my facility, like your's and many others, seems ridiculously understaffed. Each hallway has roughly 30 patients, and sometimes there's only 1 or 2 aides to handle everyone! And there's only 1 LPN on each hall, and only 1 RN in the entire building on my shift (3-11)! It's a 178-bed facility. I don't know how she does it. I, too, was given a title that, in no way, could I live up to being a new grad: LPN Supervisor! I don't really supervise anyone, besides asking the aides to do vitals or little things like that, but it's stressful to have that label on you. I'm not experienced enough or confident enough yet to SUPERVISE anyone, that's for sure!
I just went on an interview with a home health agency in my area. I used to do home health as an aide and I really enjoy the 1-on-1 interaction. You have so much more time to assess, critically think, and get to know your patient, which is the only way you'll know what works best for them and makes them feel good about themselves and their treatment. They said I need a couple of more months experience, so I'm staying where I am for now. (I've been there a month, and it's getting slightly better, but still incredibly busy.) The home health place also does staffing, so they're setting me up to do some flu clinics, just to get my foot in the door at the company, and hopefully in a few months, I can just do my current job per diem or something, and work mostly doing home health/staffing. The pay is better, and there'd be a lot of variety in terms of different settings and patients.
There are sooo many options in the field of healthcare. Don't feel badly about finding the right fit for YOU. We're new and we don't know all the different areas that are good or bad for us. It's all about your individual personality and preferences. Good for you for trusting your gut though. I'm sure it will work out for you!
Thank you for your poignant message. After reading your post, I am much relieved about not taking an RN position in an LTC that offered two 16 hours shifts and a 30 patient assignment. The DON was shifty at the interview to say it nicely and am glad s/he was a double-talker and gave the hours to someone else and was proud to say they "Contract" RN's for 3 years from Southeast Asia....is this modern-day slavery going on? Best wishes to you and you'll land a better suited RN job!
I just quit today after two weeks. I thought I was lucky enough to land a job at a SNF/subacute place nearby. After the first week, I was in for a rude awakening.
I had only 5 days of orientation in a 98 bed facility and was labeled charge nurse. Half the place is LTC, the other half subacute. 1st and 2nd shift have 3 nurses--usually 1RN and 3 LVN; 3rd shift usually has 2LVNs. Once I was on my own, passing meds to about 35 pts (in the LTC side) pretty much took me my entire shift. It was overwhelming and frustrating. On top of that, since I was an RN, I was responsible to hang IVs for all IV pts, no matter what side. I barely had time to document, and little to no time to assess the pts. As a friend had said, it felt like an assembly line--and that's how I felt I was treating the pts. There was no time to chat, no time to care, no time to critically think. Many of the staff members actually work on their OWN time (i.e. Not getting paid!) to chart, since many of them are afraid to get too much overtime since Administration will question them about it and may affect their performance review.
Many of my co workers were trying to convince me to stay, saying that it'll get better, that everything will become routine. But why is it that they are still taking more than their shift to do their work? It's simple: it's understaffed.
I brought all my issues up to the DON. All she said to me was, "I told you it's a lot of work and that it's a lot of patients. It wasn't going to be easy." Of course I didn't expect the work to be "easy", but I explained to her that there was no amount of training that could help me provide quality patient care if there is no time given to do that. She said she would like to hire more nurses, but Administration apparently doesn't want to hire anymore for any one shift. She just didn't seem to care too much.
I just had to vent and bring this up to all you new grads. I know I'm not the only that experienced this since I spoke and heard about a few people that experienced the same thing. I just want to give you some advice if you're looking into LTC or SNF. Some things I wish I had done before hand:
You may not see everything that goes on behind the scenes with this, but at least it's a good overview of the place. It's better than making any judgements based on how nice the building looks upfront or the nice painting and furniture in the reception area.
3) Ask the DON a lot of questions.
How many beds? As a new grad RN what are the job responsibilities? The job description? Expectations? Number of patients in your care? What is used for documentation/charting?
4)If you do commit, remember to buy some malpractice insurance (I guess that goes for any place you work at, but especially at a high liability job)
I hope this will be of some help to someone out there considering a job in a nursing home. I understand that many of us are still looking for a hospital job, but the pickings are few and far between. I haven't given up hope in finding that job, or even finding a job at another, better LTC facility in the mean time, but these are just some things to consider... Hopefully it'll save you from being burnt out or at least some tears.
Welcome to MY world. Let me state right up front I am not talking about YOU personally. I am an Lpn and have been taking care of this kind of patient load for YEARS. Those of us LPN's/ LVN's who have been breaking our backs in these kind of facilities, BECAUSE WE ARE NOT GOOD ENOUGHT TO WORK IN THE HOSPITALS, get tired of nurses who have only taken care of 4-5 patient's at a time & are shocked about how they are expected to perform in SNF's. Can you imagine the great job we LPN's could do, working in a hospital, after taking care of 50+ patients. And yes, when you have that many patient's you don't have time to chit-chat. You only have time to take care of their essential needs. Rn's don't want to do what we LPN's do- anymore than LPN's want to do what CNA's do. And in LTC/SNF's we only see the doctors every few days -if wer'e lucky, and since I work the midnight shift, I NEVER SEE A PHYSICIAN! We are discouraged from calling them before 8am.(I work 11PM to 7AM) since the on call NP. will be ****** off. Oh, by the way, nurse prac's handle the majority of the work load from the MD's. My only saving grace is that for years I worked day shift and most of the MDs and NP know me and trust my judgement. By law in AZ. the MD's only have to see the patient every 30days. You can't believe what LPN's do. That's why I am very sensitive to criticism from a lot of RN's who WON'T OR CAN'T do what we do. And when it is time for the State to do their yearly inspection,everything changes. We get staff, supplies, new paint, etc. A lot of us LPN's get written up for B.S. so the state thinks the management is paying attention. I just got a "written" write up today for doing what I thought was behavioral charting on a patient. I made the entry 7 months ago about a television dispute between two roommates. Although I had asked several times for clarification of the facilty policy on when TV's have to be off (if the roommate complains,) I was accused of violating the patients rights and a dignity issue, because I turned her TV off at 11pm. It didn't matter that I could show the DON that I had written on the 24 hour report sheet, several times, asking for clarification of the issue of TV's, Radio's, and Lighting at night. She has had 3 roommates in the last year and ALL 3 complained. The Social Worker was the prompter of this write up. Need I say, it was her, that should have dealt with this issue, and chose to ignore it- She's too busy! WE ARE DUE FOR STATE INSPECTION ANYDAY! ???? It used to be that people had a lot of respect for nurses. Not any more and they don't understand that we are put in these positions by the hunt for the all mightly dollar, and the cover your butt at all cost mentation. Any more the patient has the right to commit suicide as long as they do it between your 15min. checks. Just my thoughts!
Thanks for all the replies. I didn't expect to get so many or such a variety. I really appreciate all your thoughts on this issue.
To clarify, I'm not harping on anyone who works at a facility like the one I mentioned. I understand people have to make a living and they gotta do what they gotta do. But for me, personally, I did not want to risk losing my license that I spent years and thousands of $$$ on just to lose it down the line, plus I'm lucky enough to afford not having a job right now. The staff at my ex-facility was, overall, great. It was team work; we each had each others back. But when is that going to all backfire? Considering that an RN license is considered "higher" than an LPN/LVN license, I felt like I was in a very dangerous position and that any thing that could go wrong would fall on me because, even though I lack experience, my license would be weighed heavier being that I was the only RN for a 98 bed facility during that shift...
sammy2415
27 Posts
I am in the same boat as you guys, work in Sub Acute+ Rehab in north part of the CA, I feel every day we put people’s life and our license in jeopardy. Some times I am wondering why there are no nursing comities to close these places. I am much worried about patients care than about my license, because I do my best to not make any mistake, but still I am sure we are all walking on the egg shells. I have seen it over and over. It is looking like that nobodies care at all.
People in this kind of facilities sometimes they do not have any families and we are the only they can trust, but with very limited support and too much work even computer will crash…….
I hope there was some place we could go and bring these problems up and get the nursing comities attention........