What school does not prepare you for

Nurses LPN/LVN

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So im a new Grad LPN as of July 17th. And now reality as hit I started My new job this monday and now asking myself ***..

In school they teach you everything you need to know to get started to being a great nurse. Many clinical hours spent in the hospitals doing skills and mastering them. My problem with this is LPNs no longer really work in Acute settings. Most LPNs do either home care or LTC no there is a huge difference in Acute and LTC and thats where my problem begins.

In school clinicals for our med pass we may be given up to 5pts...But we did not have to chart just sign off on the meds, we did not have to call doctors, we did not have to get labs or consults. In LTC the LPNs role is so much more then what we do in school. Yea they teach charting but omg what about everything else. I know there is a limit on what they can and can not teach but they want us to be great nurses and part of that is getting a job and being able to feel confident you can adequately perform.

Yes I can assess and treat and yes I can pass med and sign my book but there is so much more and I see it time and again in these threads how New Grads are overwhelmed because after 2days orientation they are on their own.

Does anyone not see an issue with this, yea you can ask questions but you are responsible and there is just so much room for error in the situation of LTC with a new GRAD on their on 20plus pts and no idea how to even start anything but a med pass..

Give me the med pass im good but im just so baffled at the pluses of the job. I feel like LPN programs should let you experience the hospitals and peds and ob but some time should be spent in the field we are to work. Let us get behind the desk with a nurse to see the paper work come in to get that early am report count the carts and the shifts end.

Im lucky enough my job is willing to train me a 3-4wks because the DON really believes in me and I know I will do great I graduated top of my class and Im just the kind of person to get what needs to be done done but for all those who have 2days orientation and are crying right now its just not fair. Some say you get use to it but dont you think things will be so much better if you were more prepared maybe nurses would not be cutting corners, or so grouchy.

I feel nursing programs, and new grad orientations should really adjust according to the times (sorry for this extremely long thread just wanted some thoughts on this because it has been bugging me)

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Specializes in Wound Care.

Omg I said all this when I was in school. I feel this is a big part of my training was left out and I'm scared :(

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Qsmoss. Same boat here. Graduated top of my class but during NCLEX review, I am really worried and ask myself what I did wrong because I am not doing so well on my review but I am studying everyday.

Good luck with you! Things can only get better as you gain more experience I hope.

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Specializes in retired LTC.

DING DING DING!! Give OP a cigar!!! You see the reality of the problem.

There is just NO TIME in nsg school to do more time, so unless a facility gives the newbie nurse sufficient orientation time, it's a setup for trouble. We used to call it "desk orientation". An opportunity to learn the paperwork that is facility-specific. Also the fine nuances that are unique to each place re their P&P and protocols. A chance to get to know pts AND staff (and some families) and how to hone people skills with time mgt/organization.

You can't teach all that in nsg school.

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Does anyone not see an issue with this, yea you can ask questions but you are responsible and there is just so much room for error in the situation of LTC with a new GRAD on their on 20plus pts and no idea how to even start anything but a med pass..

i hear you... i'm a new grad too and starting my new job on monday. the DON told me i will be training to pass meds to 30 pt during a 7-3 shift and learning how to manage the aids. everything is on the emr. i just wanted to jump in and ask her, can i at least get the meds down before ya throw me into the fire? the facility has an extremely high turnover, that being said they only pay $10 per hr. during orientation and only hire per diem. this looks like it's going to be a yellow knuckle ride. :nailbiting: gonna need a couple of paddle for this canon ride. happy, nervous and scared. here we go!!! glad to hear your rant... :up:

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Qsmoss - Breathe...relax...release...You will do just fine. I think the real issue is confidence. Like one of the above posters said, there is simply not enough TIME for us to learn everything we need in nursing school. Along with that, clinical is a requirement of ALL nursing programs, be it LPN, ADN-RN, BSN-RN. There is simply not enough space to be able to ensure of that either. Everyone has to get those hours where they can. That being said, I think you said it also, nursing school gives you everything you need to go out there and get the job...the job is what gives you what you need to succeed. And you have to make it the best for you. That is why it is so important to ASK questions, even if you think its a dumb question. You may get met with frowns or snarky comments, but I would say, 'With all due respect, I understand your frustration in having to train a fish out of water, but you were once in my position, and I still need to know the answer.' LOL But be confident in your abilities. Be confident in your capacity to absorb new knowledge. You were successful all throughout nursing, after all, look at you, licensed and with a job. The proof is in the pudding that you can MORE than just do the job. In time, you will be able to do it with your eyes closed. Just be positive and keep your motivation high. Good luck to you OP.

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Nursing school doesn't teach you the fine art of dealing with people...jack a** doctors, hard to deal with family members, patients that just can't be satisfied, co-workers that don't pull their weight on the floor...I could go on and on.

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Specializes in Emergency Nursing.

I've said the same thing too... now do you wanna hear something that is gonna really grate at you?

So I'm in my LPN-ASN transition now, and I hear repeatedly how the nursing instructors are telling all of the "traditional" (non-transitional) students how they will have 6-12 weeks of orientation at the hospital and their patients will be given to them one at a time. They all think that is the norm.

Even worse, I am employed at a hospital and truth be told, that is the norm!!! Its not fair for LPNs to get tossed to the wolves like in LTC when the majority of RNs which are employed by hospitals get such ritzy treatments! I truly think I even have some form of PTSD r/t my short stent in LTC. It was the worst experience of my life because I'm all thinking it was going to be just like in school.... I really thought I was going to kill someone or allow someone to die from the sheer amount of work and responsibility and lack of help.

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Even worse, I am employed at a hospital and truth be told, that is the norm!!! Its not fair for LPNs to get tossed to the wolves like in LTC when the majority of RNs which are employed by hospitals get such ritzy treatments! I truly think I even have some form of PTSD r/t my short stent in LTC. It was the worst experience of my life because I'm all thinking it was going to be just like in school.... I really thought I was going to kill someone or allow someone to die from the sheer amount of work and responsibility and lack of help.

true statement. i'm 3 days into orientation @ an ltc doing med passes to 30+ pt 1st shift and i can't believe what has to be done...scary. tube feedings, tx, heparin, insulin, wound care, call bells...ahhhhh!!! i was luck enough to have a wonderful trainer today. the universe has been kind. :saint:

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YES!!! You are right! I was just saying the same thing... to one of my classmates and we graduated this past May! Just graduated from a ADN program and not once did we step foot in a LTC facility. In LTC, LPNs do 'the same job' essentially. That is what I have been told over and over so far. I don't like this business of having 20 pts. either! I am still accountable! 2days of training seems unusually low to me. You should be getting at least a month. You might need to look around, if you know what I mean...

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Yes it's unfair that you're not focusing on all areas of nursing more thoroughly. Especially when this population is living forever these days! I remember crying everyday after work with a friend I graduated with. I felt bamboozled and almost embarrassed. I went through school and graduated thinking I was solid, a top performer and could step into any job confidently. I interviewed and yes, sure, no problem I can do everything you ask! Then I get to the cart. Somehow the LTC looked darker than I remembered in the interview... My RN was wonderful! Yet I cursed my teachers for not preparing me more! I knew nothing! Is this a liquid or a tablet? I can't find it in that guys meds. Wait, there's house stock? Ugh! I forgot about the narc drawer. And in the end, when I realized my RN was snickering the whole time, I realized it was actually an eye drop I was looking for... I don't know if it was easier to be a unlicensed grad nurse with an RN supervising me or licensed and out on my own. I had someone there every step of the way until she was sure I could independently do it her way. Looking back, I don't think nursing school could have prepared me for what LTC nurses do even if there was a full semester dedicated to it. In my opinion it's a specialty. You must stop the thinking that you are solely responsible for each and every resident on your assignment. Your license does not really hang in the balance if you miss Mr Smith's sniffles and he ends up with pneumonia next week. There are two other shifts and many other disciplines coming in contact with him. I guarantee someone will catch it if you miss it. You've gone from not knowing a lot about nursing to being great at graduation. Now you shouldn't be expecting yourself to be great at something you've never done. Just remember that in a year this will be old hat. Stick with it and you will be training and supporting a new grad. I don't know you, but your DON does. She thinks you are worth the investment so you must be special! Just remember your basics, ask questions even if you think they're dumb, don't be afraid to ask another nurse to put their eyes on your patient to see if they agree with your assessment (I still do this) and never be embarrassed to ask to be educated again if you forget something. We can't always remember how to do an infrequent procedure or what that lab value means. Give yourself a break! It's a rollercoaster, but it's also one heck of a ride!

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I'm just staring nursing school this January so I can just wish you luck in your new job.

And most importantly, have faith in your abilities. It may look overwhelming but if you don't show confidence, and don't trust yourself who will?!

I'm rooting for you. You can do it!! :)

Sent from my iPhone using allnurses.com

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