First day at new job New Grad- AFRAID

  1. 0
    OK... I graduated may/2013 and just got my first job on a long term care unit. My nerves are on overdrive. The biggest regret I have in my career path is never working as a CNA ... my first rotation in nursing school was LTC but we were far, far from nurses at that point so we really didn't get into the role of the RN on the unit.

    What are some key things / skills I should be reviewing? They know I have no experience and are giving me three weeks of orientation to start, we will re-evaluate from there.

    I'm just really doubting myself... our clinicals were mostly all Med-Surg ... I would be more comfortable walking onto the med-surg floor because I know the RN's role and what is expected.

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  2. 8 Comments...

  3. 1
    Hi RNla - just wanted to offer you some encouragement. Unfortunately, I don't work long term care so I can't offer specific advice. I would suggest that you start by becoming familiar with your facility's policies and procedures. Also, the experienced nurses will be a valuable resource.

    For what it's worth, I found this link on amazon.

    The Long Term Care Nurses Guide - Revised: Charles Kennedy RN: 9781448648894: Amazon.com: Books

    Good luck today
    Last edit by HikingEDRN on Jan 4 : Reason: Formatting
    RNla0044 likes this.
  4. 0
    I don't work long term but being afraid is very normal. I bet most new grads are afraid or anxious. I might worry more if you weren't. 3 weeks orientation with re evaluation at the end sounds better than other orientations I have heard of. Will there be other RNs in the facility when you are off of orientation?

    I'd focus on assessment and policies as previous poster said. Specifically criteria for transfer to acute facility, restraint and fall protocols.
  5. 0
    Make sure you ask tons of questions during orientation! No question is a stupid question! Even if you asked before & need clarification, ask again.

    Try to get your hands on everything you can while you're with someone. Ask if you can watch procedures being done, even if they're not your patient. (also, like PP said, know where to find your facility's policies & procedures)

    If you need to, carry a pocket sized notebook with you & write things down, so you can refer to it later when you're on your own. That way if you forget where to document something or where they put the incident report sheets or who to call when this or that happens, you won't freak out!

    Hopefully you're coworkers will be super helpful & supportive, it makes a big difference! Some of my friends got jobs in LTC after graduation & only had a few days orientation and were scared to death but are doing awesome now only a few months later. So it can be done! Just take one day at a time!

    Good luck!!! *hugs*
  6. 0
    Thank you so much for your replies, my first day is a little over a week... it is going to be a rough week! I'm just worried they are going to expect me to know more than I do. I will ask lots of questions and orientation is more like 2.5 weeks and going from there. It is a per diem position, mostly nights probably so they are pretty much going to let me fly on my own when I say I'm ready.

    I just haven't been doing any nursing since school... I hope it comes back quick.
  7. 1
    Congrats on landing a job! Many new grads never worked a day as a CNA and did fine (including myself). As new grads we tend to second guess ourselves, but definitely brush up on your assessment skills. When in doubt, ask questions. Never assume.

    I believe in LTC, a 3-4 week orientation is pretty common which I don't understand because you take on so many patients. The biggest issue is always time management, but give yourself time to get into your groove. Learn as much as possible from your preceptor and the season nurses in your facility.

    Make sure you have "broken in" your nursing shoes (if they're new). On my first day, I didn't read that memo and wanted to cut off my feet for wearing my new nursing shoes for 12.5 hours.

    Wish you luck!
    RNla0044 likes this.
  8. 0
    Quote from RNla0044
    OK... I graduated may/2013 and just got my first job on a long term care unit. My nerves are on overdrive. The biggest regret I have in my career path is never working as a CNA ... my first rotation in nursing school was LTC but we were far, far from nurses at that point so we really didn't get into the role of the RN on the unit.

    What are some key things / skills I should be reviewing? They know I have no experience and are giving me three weeks of orientation to start, we will re-evaluate from there.

    I'm just really doubting myself... our clinicals were mostly all Med-Surg ... I would be more comfortable walking onto the med-surg floor because I know the RN's role and what is expected.
    I had almost 4 years of solid CNA experience in LTC, home health, and med surg.... and I was terrified too.

    Just do the best you can. The only thing that makes those butterflies go away is experience.
  9. 1
    Review your shift everyday. Think of what you'd do differently/better and look up things you didn't know. Find a good resource person. Each day you will be more experienced then the last.
    RNla0044 likes this.
  10. 0
    This sounds horrible, but I was so scared as a new nurse. It was acute care and I had never worked as a CNA. Sometimes the only way I could even get in the car, drive to work, and walk down the hallway to the time clock, was thinking....."I hope I kill a patient tonight so I get fired and lose my license."

    Of course I never did, and HONESTLY it is REALLY REALLY hard to kill a patient with one drug or one nursing procedure. My thoughts just helped ease the pressure. Fast forward a few months (years, ha ha) and I love my job and career.

    I guess a nicer way to think about it is...face the worst, believe the best, do the most, and leave the rest.

    LTC nursing is really hard, not "dangerous" for you or patient care but hard in time management, a lot of patients, med passes, etc.. You can get a lot of specific advice in the LTC section of Allnurses.


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