overwhelmed in first rn job

  1. 0
    So as the title says i'm feeling overwhelmed at my first RN job. I just ended my first week and physically/mentally i'm EXHAUSTED. We have a 20 pt load which i have never dealt with, we do have cna's who take care of peri care, I/O's, meal % documentation, etc which leaves med passes, assessments, treatments, etc up to us. I am currently orienting, but between patients continuously calling for PRN pain medication, trying to assess them, perform treatments, and trying to find time for charting I am finding myself stretched very thin. The nurses keep telling me it'll get better and i'll get faster with my work but I still feel so incredibly slow and inefficient, i'm doing my best but i feel like it's not enough. If anybody can lend some good pointers or even just some words of encouragement that would be highly appreciated.
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  3. 6 Comments so far...

  4. 1
    Woah, 20? Is this at a LTC facility? Even in an acute care setting at a hospital where one can easily receive a 7-8 patient load, as a new nurse you can become mentally, physically, an emotionally tired. When I started out I thought I wouldn't make it pass orientation and would often come on allnurses for an escape and realized these were normal feelings. Transitioning from the student to the primary nurse will be a challenge, especially when it comes to time management.

    Hang in there, seek feedback from your preceptor, and you will find your own groove. Also don't hesitate to seek advice from seasoned nurses in your facility. If they've successfully managed to take on 20+ patients without safety being compromised they'll surely pass on that key to success.

    Sent via iPink RN's iPhone using allnurses.com
    nursephillyphil likes this.
  5. 1
    Hi. I work in LTC too. I swear when they say it will get better, it will. You will soon learn to walk in, look for edema and listen to breath sounds as you wait for residents to take their medicine. Pay attn to those wincing or out right complaining of pain. You can take care of those PRNs there or at the next med pass.

    Ask them if they have pain to avoid everyone asking you at different times.
    If someone has a 1700 and 1900, save them til last and give them both at 1800.
    ALWAYS STAY AHEAD. - this saves you from the dreaded charting for hours at the end of your shift and you save time to eat.

    I hope this helps. I have been in LTC for only 3 months and I feel much more comfortable.

    NOW a fall, sending out a resident or family issue will ALWAYS happen at the worse possible time! Which is why you always want to be ahead.

    OH and I do all my accuchecks first. I make a checklist of who needs to be checked then come back and prepare their insulins with their PO meds to give before supper (I work 3-11) instead of checking each person and going back and forth.

    HTH
    nursephillyphil likes this.
  6. 0
    thank you guys, ive never dealt with this kind of pt load and im doing my best to adapt, ill take your tips into my shift tomorrow and see how i manage. Thanks again!
  7. 0
    It will get easier. In a while you'll be a pro ;-) Time management is key. It really helps to make yourself a schedule and try to follow it. I'd write one out every night and tape it to the desk and check things off as I did them like: 11p- get vs sheet for cna, 11:15-test glucometer, 11:30-accuchecks, 12a-med pass, 1a-txs, 2a-chart etc etc. 20 patients is actually pretty good for ltc, I've had up to 55 before. Good luck.
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    Yes, this will get easier each week into your time on the job. Absorbing all the names/faces of the residents is what I found to be the greatest challenge and the second was learning the routine. After you get familiar with these, your nursing skills will take care of the rest. It will seem to take longer than you would like, but keeping your wits,patience level and notepad with notes well stocked will be great assets to you! Congrats on your LTC job.
  9. 0
    Quote from nursephillyphil
    So as the title says i'm feeling overwhelmed at my first RN job. I just ended my first week and physically/mentally i'm EXHAUSTED. We have a 20 pt load which i have never dealt with, we do have cna's who take care of peri care, I/O's, meal % documentation, etc which leaves med passes, assessments, treatments, etc up to us. I am currently orienting, but between patients continuously calling for PRN pain medication, trying to assess them, perform treatments, and trying to find time for charting I am finding myself stretched very thin. The nurses keep telling me it'll get better and i'll get faster with my work but I still feel so incredibly slow and inefficient, i'm doing my best but i feel like it's not enough. If anybody can lend some good pointers or even just some words of encouragement that would be highly appreciated.
    I've never done LTC, so I don't have any tips for you. What I will share is that feeling overwhelmed at your first nursing job is normal. So is being mentally and physically exhausted. I used to cry all the way home from work, and all the way back to work the next day. But my husband tells me that "Dudes don't cry," so that won't apply to you.

    You're going to feel slow and inefficient -- it's part of the whole process from nursing student to nurse. Hang in there -- we've all been through it, and you'll get through it too. In a year or so, you'll actually feel competent much of the time. Something to look forward to!


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