WHY!!!!

[0hnoes85]

So here's some background for myself-

I was an LVN for 2 years (2006-2008) then moved to get my RN license (2008-2010 = 4 years).

Finished in Jan of 2010, didn't get my RN license until May because school held my transcript hostage until balance was paid off.

Spent all of 2010 looking for a job.. Even pre-licensure, took almost a year.

So I currently work in LTC under my RN license. Which I am very thankful for since it took a while for me to get a job. The nursing shortage they all were clammering about isn't effective until the baby boomer generation decide to retire, or the recession is over. I understand how important it is to hire someone with more experience and is very knowledgeable especially if the position requires quick critical-decision making/thinking process. HOWEVER, because in LTC... most of the staff nurses are LVN. LVNs do med pass, wound treatment, and sometimes are supervisors because of their strong background within the facility.

Well here's my dilemma... Because I am fairly new to the responsibilities of a RN, and have little to no outside experience of RN duties aside clinical rotation in school, I'll be put as supervisor. LTC facilities favor RNs for supervisors because of the expanded scope of practice. But doesn't this position require an extensive amount of experience? I can already forsee the amount of scolding I'll be getting from MDs and the DON because I am not affluent to the units yet.

Not only to mention- the people who work there aren't those who look for other's best interest. I personally don't like to engage in gossip, or even office politics. Since as a nurse, bedside care is far off from the admin and department heads politics. But here- all that is going on is complete BULLCRAP gossip. Yes, yes, it happens every where you go.. But it's all I hear from down the hallway. (And its not the admins! They are the staff nurses) Even the resident's family want to get rid of all the old-timers in the facility to hire new nurses who actually care. I spend most of my time burried in work... not only mine, but other's work. But who am I to complain? The company find it easy to fire a good nurse and hire a nurse who sits all day in the station and gossips about non-sense. My day usually consist of me staying over time to catch up in paperwork, but I clock out at the time I am supposed then go back to doing my work because it is my fault that I am behind and they shouldn't pay for it. I feel I have strong work ethics, and I do care deeply about my patients... But I feel that my co-workers don't. Half the residents that are on antidepressants and antipsychotics shouldn't be on them. They are yelling because no one is answering the call lights... No one is listening to them. And I am behind already but I do my best to answer the lights and talk to all the patients/residents to address their needs and concerns.

In this hectic work environment it is hard to see the bright-side. I have these "mentor" type nurses who do help me, but as soon as I turn my back, says something negative in a different language... And I am supposed to be their supervisor? I don't want to dislike my career choice because of a negative experience, but if these are the type of people I am going to work with day in and day out and these are the type of people who are caring for others, I don't want to be painted like them.

So someone who knows what I am talking about, give me some insight... On how to deal with these types of things... Or how I should go about being a "boss" to those who won't listen to me because I am younger than them. Should I leave so I can be happy, or should I stay and stick to it so I can keep the residents happy? I feel at times that I am not a nurse, in any respects because its hard to listen to a co-worker talk negatively about patients and other employees.

[mentalhealthRN]

I personally found that I wasn't willing to put up with that environment for myself. You can't fix that mess by yourself and can't make those nurses care about the residents. I was miserable and left. The negative environment was sucking the life out of me. I would seriously say--based on your post--you should consider this as well. Good luck to you.

[0hnoes85]

I personally found that I wasn't willing to put up with that environment for myself. You can't fix that mess by yourself and can't make those nurses care about the residents. I was miserable and left. The negative environment was sucking the life out of me. I would seriously say--based on your post--you should consider this as well. Good luck to you.

Thank you- I don't want to be seen as a job hopper, but in my situation I need to have another job in grasp before I can do a transition. In a way I don't want to leave the residents that I have given encouragement to stand up for themselves. But you are right.. I alone cannot make the other nurses care.

[IowaKaren]

I understand your feelings. I too am feeling the life sucked out me and LTC was my job of choice when becoming an RN although I am a staff RN on skilled unit. I don't want a management position, although as an RN I am considered management without any power. After awhile, you just can't delegate anymore work out with such tight staffing, even though you are told to.

[toninurse]

I was in the same situation awhile ago. Just finished school, worked in LTC as an LPN then an RN then RN Supervisor. First thing I noticed was that everyone acted like the residents were "things"...things to move around, talk about, laugh at, cuddle, mimic, gossip about, etc. Well, instead of letting my anger show...I provided the example "these people" (my co-workers) needed. When someone started to gossip...I held up my hand to halt the conversation, got up and left and made myself busy. When no one in the facility was documenting in the MAR where the last Fentanyl patch was placed as well as never dating or initialling the patch itself, well, I started documenting as I knew was the right thing to do and left notes in the MAR as to "where is this patch I can't find it", etc. I thanked my CNAs for all their hard work, I answered call lights and responded to alarms...I even helped take trash out to the dumpster. I do my job well, feel I am loved, and surprisingly many of the LPNs and RNs are completing their documentations in a similar fashion to mine and are dating opened insulin vials, patchs, and even saline eye drops. Don't be discouraged...you will find crappy circumstances in any environment but I think it is more prone in LTC because residents stay longer and you get especially close to them, their families, and their friends. Treat them with respect. And don't be afraid to question policy and procedure during the next nurses meeting, e.g. HIPPA laws, resident rights, dignity in dieing, behavioral health confidentiality, antipsychotics not approved for use on psychosis stemming from dementia, feeding, toileting, whatever it may be...bring it out so co-workers will have to talk about it. And don't forget the resident's MD is your friend, work close with the MD and discuss if not suggest an alternative drug. When someone is doing something wrong...they really have no defense and when they do it's normally in the form of a pathetic or subjective excuse. So challenge them to defend themselves or change. Afterall, how can someone defend gossiping???

[diane227, LPN, RN]

LTC is an extremely difficult area to work in. Also, since you are new and I am sure feel a bit uncomfortable about your experience level, it is more difficult. I suggest the following:

1. Get yourself a good geriatric care book (there are several listed on Amazon) and read.

2. Get yourself a couple of basic management books, just basic supervision skills for a new supervisor and read it cover to cover.

3. Speak with your manager and tell him/ her directly what you will and will not put up with.

4. Start your shift out with a pep talk to the staff. Let them know that you are in charge and you expect that they will carry out their duties in a timely, responsible manner. Let them know that you will not tolerate gossip and poor use of time. There is a lot that needs to be done and they should get it done. Before you have this little chat with them, make a list of the MINIMUM things you expect them to get done for each resident during your shift.

5. If you do not get assistance from your manager and you feel that care is compromised, then make a complaint to your state department of health or via the CMS hotline number.

6. Your employer CANNOT require you to clock out and then complete your work. This is strictly prohibited by federal labor law unless you are classified as an exempt employee, which I doubt. Your facility can be fined for violation of those laws.

And yes, I am one of those old baby boomer nurses but I can still run with the big dogs, even after 32 years. I am also a nursing home complaint surveyor for my state. Believe me, your complaint will be investigated.

You may email me privately and I can give you additional information regarding management and geriatric texts that you might want to consider.

[Kooky Korky, BSN, RN]

Get a year or two of experience then get a different job.

Meantime, do not keep working after clocking out. Legally, I think you put yourself outside the scope of protection by insurance if you mess up and hurt someone else or yourself while you are clocked out. Check with a couple of lawyers about this to be sure.

Also, get a real backbone and start confronting people when you hear gossip or see them lazing about not answering lights. Do it nicely, do it courteously, but do it. If you are the boss, act like it. yes, it's hard to develop new habits, but you have to do this.

You might also have to write up some staff or at least talk to the boss about them. Get a feel for how the boss would handle a situation before you make trouble for yourself or waste time writing up someone she wants to not fire or reprimand or counsel. Tread very lightly.

Understand that the bottom line is the facility's financial health and everything else will fall into place.

Some staff might just need coaching to be better workers. Don't look for too much to change too quickly. Put yourself and your need to make a living first, unless you think patients are truly being abused or neglected. if you think that, you must report the bad staff.

I wish you well.

[TonyaM73, ASN, RN]

I had to do the same thing after I graduated. I could not find work in any of the hospitals in my area, so I went to LTC with Rehab. It was the most stressful and hard on my self esteem job I have ever had, but it really honed my time managment skills and exposed me to quite a few meds and treatments for wounds. I have now been on a med/surg floor of a hospital for 3 months and I have been told that I do the work of a nurse that has been on this floor for a couple of years. (Boy did that make me glow!) Hang in there! It may be a terrifying ride for a year or so, but use the time to really work on those skills to make you extreemly marketable when you want to move to something else. The work was hard enough with so many patients, but the drama day in and day out really put me over the edge with long term care. I definately agree with one of the above posters when they said that they set the good example and some would follow. I did the same thing and showed my team that I was not afraid of hard work or the most disgusting jobs. I think that this really made an impression and after a while many did follow suit. Set the bar to what ever you would want for your loved ones and then convay that to your staff. Always try to stay positive and if you have to be negative...start with the positive and end with the positive. Good luck. This too shall pass and then you will be a better nurse and person for it.

[Erie77]

Hi there; I currently work in long term care and the comment you made of "My day usually consist of me staying over time to catch up in paperwork, but I clock out at the time I am supposed then go back to doing my work because it is my fault that I am behind and they shouldn't pay for it. I feel I have strong work ethics, and I do care deeply about my patients... But I feel that my co-workers don't. " People that work off the clock to catch up on work, and to it free, are only making it harder for their co-workers. For one it is illegal to work off the clock and two the more you do the more they expect you to do, only increasing the work load expectaions for everyone. If you can not get your work done in the expected time frame allowed it is obvious they expect too much. By working off the clock it makes it look like yes you were able to accomplish all that work in the alotted time, so why can't so and so do it? You are only adding to a bad situation. Where I work they expect us to do 2-3 peoples work in a shift and everyone of us stay over on the clock to get the work done. If they want to pay less over time than hire more help. And as far as your making comments about your caring more than your coworkers it sounds a bit like a superior attitude to me. Maybe you will seem uncaring once you get used, abused and burnt out too. Time will tell. Until then open you eyes and take a good look at the long term care situation. Namely workers are overused, over worked and unappreciated.