First Day on Job Tonight. I thought I didn't make out alive

Nurses New Nurse

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I'm a brand new nurse just finished my orientation yesterday. Today I was on my own and I thought I wasn't going to make out alive. I didn't finished pass 9 oclock med until close to 11pm (ending shift). What took me so long wasn't that I didn't know what I was doing. What held me up was patients seeing me as a new nurse challenged me by asking what meds were in the cup. They gave me a hard time period. Okay, you might know that patients in LTC take gazillions meds. How am I suppose to describe each one of them for 24 something pts? I double and trouble check the Mars making sure they were all there and the right time. Another tonight challenge was how disorganized the med cart waw. I meant they didn't refill or order running out or low meds. They misplaced meds. I mean I am new for cry out loud. Besides that I have CNAs who didn't turn in their complete vs sheet. They left before I could get hold of them. I am stressed right now even after work sitting here at 2 am in front of computer venting. I know no one would understand how I feel than any of you. Any advice for me how to deal with these issues? Also, some older nurses there are nice and some really eat their young and will not help a nurse like me. They just have to cover their tail whether or not I am new. Please give some advice and input. Anything really appreciated! This nurse really need.

Specializes in LD,med/surg,psych,LTC(DON),home health.

Smile. Take a deep breath. You did survive as did your residents. :)

Take baby steps to address 1 issue @ a time. It will improve. For example...start with the meds. Yes, our wonderful geriatrics take many meds. Yes, any nurse giving any med should know what it is for and potential serious side effects. In time, you will be comfortable with this, which will be obvious to those around you.

Here is where the baby steps come in... make a brief list of the common meds you give...name-used for. keep list on med cart. can refer to quickly. Most of your residents only want basic answers to 'what is this med for/'....ie water pill, BP pill, vitamen, etc.

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I see you are also a new grad? LizAnn, I am trying but it is so difficult to manage when you work with some nurses who treat you as you are their subordinate. I firmly believe I am not. I am their peer although I am new. I still give them the respects they deserve as senior nurses but they do not go easy on me. Patients see me as young and new, they challenge me. I meant they can't be taken those meds for the first time right? Of course, but why would they tell me they never taken these many meds before? I am curious why really. Did the nurses who work this shift given meds or just signed off as they were given? Also, if they did give meds, it has to be the patients themselves playing game with me. Either way, I do not have time to for a few patients who think they know it all, because there other patients I also need to pay attention to. I am trying to see if I need to be firm yet understanding and caring. I am trying to develop that pattern so they don't walk all over me.

Specializes in LDRP, Wound Care, SANE, CLNC.

Welcome to long term care. I doesn't get any better. What will get better is your ability to deal with situations like that. Your abilities to prioritize , work with what little you have, multitask and you will get a rock solid, crash course in medications. Look at your time in LTC as RN boot camp, it's hard, fast and feels like it will kill you on a shift by shift basis, but you will come out a better nurse, if you let it teach you instead of break you down.

I am still learning after more than a year in LTC and value each lesson it have been taught. I have some mad prioritizing skills, and you will too.

Specializes in LDRP, Wound Care, SANE, CLNC.

Oh, and I have gotten in the habit of saying " here is your ... ( and saying the name of the medication)." And telling them about a new medication the first time I give it. It is said that teaching a person something helps you retain 90% of the information. Teach your residents about their meds and you will get a great education on top of it.

Hey, I was you once! I know exactly how you must feel! The med carts are always a disaster. The clean utility room is a mess. Even the linen closet is out of whack! You're just having a hard enough time knowing what the names are for the meds and what you need to know about them, let alone trying to FIND the suckers in there.

The fact that you finished at 11pm is not as bad as you think for a new nurse.

As far as some of these things, it is important to assert yourself. Make sure you make it clear to the CNAs that you expect vitals done by a certain time. If it's not done and there is not a legitimate reason for it, there need to be consequences. Hold people accountable.

As for the organization disaster, as you get more comfortable, maybe you can take a little bit of time each day organizing a little bit. Try to get 11-7 to assist. Don't expect things to better overnight. But they can get better slowly.

I've no doubt you're an awesome new nurse and that you're going to get better and better. The fact that you're so upset about finishing at 11 lets me know that you'll not settle for anything less than your best.

Oh, and relax as far as the testing from patients is concerned. That should die down once you get some confidence and experience or at least make THEM feel more confident in you. :)

Specializes in Acute Mental Health.

My first night in LTC was pretty much the same. I was finally able to pee, cry, and eat my lunch all at the same time at quitting time (for everyone but myself). It sucked so bad. I feel your pain and can tell you that it will get better. It did for me and I hear it's pretty much the same for most of us. Good luck and hang in there. You are not alone.

Specializes in LD,med/surg,psych,LTC(DON),home health.

sorry to say...but we in this profession tend to eat our young. :(

And why is that exactly?

Specializes in Acute Mental Health.
And why is that exactly?

Who knows!?! There have been a few threads on this very topic.

Aww, that sounds like my first night!! I didn't finish my evening med pass until nearly 11...the shift I was working I had ONE hour to do the med pass..so I SHOULD have been done @8p. You better believe I cried that night. Hang in there. Youre not alone. Good luck!

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