Hi everyone,

This is just a venting session. Any advice or words of encouragement would so be appreciated right now

Im a new grad RN and got a job at a subacute rehab/ltc. I started orientation this week and orientation is around 13-15 shifts. My orientation schedule consists of all the 3 different types of 8 hour shifts so I get a feel for each shift and what goes on, although my shift is for nights once I am off orientation. Census is anywhere from 15 patients during the day with 3 nurses, then 30 during the evening with 2 nurses and 40 during the night shift with 2 nurses. The facility is computerized for the most part, thank god. My preceptors so far have been awesome and they welcome any questions and guide me every step of the way when it comes to skills and meds.

But me saying I am very overwhelmed is an understatement. I just dont understand how I am supposed to give all of these meds because in nursing school you are taught to look at contraindications of meds, actions, etc but there is NO time to look any of that up and the only thing in the computer is for the most part, parameters of certain meds. The documentation and knowing how to put orders in the computer and what documents you need for a patient who is getting transferred, or needs labs or is being discharged is all too much! I just dont know when I am supposed to "get it" and get a routine down. My orientation will end at the end of the month and I am just praying that I can do this. I heard the DON will need to watch me do my skills to make sure im doing it right and that pharmacy will be watching me do a med pass to make sure I am giving meds right.

Ughh I just dont even know where to start or to end. HELLLLPPPP!

You will get to know the contraindications and side effects of the medications the more you give them. I would write down the medications you see the most and study them. As you remember them, you can start working on learning the not so common medications. You will get to a point where you don't have to look them up. Also, see if there is an easy way to look them up from your computer system. We can right click on our medications and get medication information right there on the computer if we need it. Maybe your system has something similar. Ask the nurses for tips and tricks to successfully getting through the medication pass for each shift. The first year is the hardest in nursing, but it will get better. Hang in there!

If the DON and pharmacy are that invested in your safe practice, I'm going to hazard a guess that you'll receive support. That, and your preceptors sound like a great place to start your career.

Your feeling competent is going to take time, like months or longer. Hop over to the"first year of licensure" section and see for yourself just how common it is to feel like you are right now.

Meanwhile, you can make a list of the 25 or so most common meds you'll encounter and get them down pat (presumably, just like nursing school, right?) Ask those supportive preceptors their tricks and modify them to fit you.

Thank you both for your replies! It means alot to hear your advice and I hope soon enough I will be able to get on my feet on my own and be a great nurse.

Agree with PP's.

After a while, you will probably discover that most of your patients receive the same types of meds... You'll gradually 'memorize' information about those common meds as you administer them. After that, coming across new or unfamiliar meds will not be a common event.

BTW, Congrats on the job!!!

Been a nurse a long time. I worked at a SNF right out of school and it taught me so much about medications. Give it a year or two and they become 2nd nature. You will be able to carry and improve this skill with every other nursing position you may get in the future.

Definitely hang in there. In no time you will know the meds you give every day like the back of your hand. I still have to look up the occasional weird med that comes down the pike, but for the most part the days of toting the drug book around are long gone. :) Good luck!

In acute care, then yes, you need to be mindful of drugs you are given at a higher level. In sub-acute/LTC, you need to know what you are giving (and the rights of medication administration) however, these are daily meds that the patient more than likely has been on for some time.

It is overwhelming, I am sure, but you WILL get this! The first few weeks and your head spinning is NOT unusual!! Keep plugging away, it will become easier and easier as time goes on.

Best wishes, and you got this!

Thank you everyone for the love! Much appreciated!