Discouraged after first day training on new job :( - page 3

I've had an extremely hard time finding a job as a new grad LPN. I sent out applications and resumes to all of the nursing homes, hospitals, group homes, doctor's offices, homecare agencies and... Read More

  1. by   CapeCodMermaid
    You won't have to assess 30 patients from head to toe every day. There simply isn't time. Skilled patients are charted on once a day after the first 72 hours. Most facilities split the charting between 1st and 2nd shifts. Always follow YOUR facility's policy. Call the doctor with any change in condition, abnormal lab, fall, allegation of abuse, and any time you just 'know' something is wrong. Some docs like calls...others like faxes. You'll soon figure out who likes what.Be ready to really listen to the nurse who is orienting you. Bring a notebook to write down questions as they come up so you don't forget to ask.Give yourself some time to learn the routines and the patients. Don't expect to learn everything on day one or even day 10.
  2. by   Tinkerbell04
    I just got hired at a skilled nursing facility. It does seem overwhelming but not impossible. I was given three days of training; I am on my own tomorrow, but I do not work every day. I graduated in 2010.
  3. by   SP1CEGRL
    WOW......just came back to this thread and about a year and a half after posting it.....i can see what a long way i have come. i was right.....that first shift was awful. i only did about 4 or 5 patient's meds before i completely lost it and was crying at the med cart. one of the CNAs was nasty to me as well. luckily, my supervisor ended up coming down and helping me pass a lot of my meds. other nurses from different floors came down and took care of my charting, and did treatments for me. i cannot express how much this helped me when i was brand new and just wanted to walk out of the door and leave nursing forever. now, i'm that nurse who always goes down to check on the newbies and offer my help and advice whenever i can. just hang in there it will be okay. as a newbie always try to get there as early as you can, have the nurse from the shift before you give you whatever information she can to help you! print out a list of all the patients, highlight your diabetics, go through and have her tell you who takes pills crushed/whole/in pudding/in applesauce/with juice/thick liquids. these things seem silly but will really save you so much time and save you from having a patient who is now choking on a pill or has aspirated thin liquids and now needs suctioning. hang in there, it will get better! it took months to finally feel comfortable and there are floors that i still don't feel as comfortable on, and always worry about charting last. i would stay behind for months doing my charting, sometimes for an hour or so after- just to make sure everything was done and anyone who told me it would get better, i really didn't believe them but i have to say everyone was right.
  4. by   itsa307
    I soo needed this thread. Last night was my 1st after 4 days of orientation. It was rough even though I had already made a cheat sheet of how each resident took their meds but I made it though it. I needed to hear that it will get better. I don't feel like nursing school clinicals prepared me at all for handling this client load but I will get into the groove soon.
  5. by   bellaluv
    I was googling about medpass and came across this thread. I am SO glad I am not the only one that feels this way about LTC! This is my very first nursing job after graduation. I am an LVN in an RN bridge program and I took this job to gain more experience. It took me 7 months to land this job. I am grateful to be working in this economy, but needless to say, I am completely traumatized right now!

    I had 6 shifts of orientation which I really think was not enough. My first night I was stuck on NOC because they were short staffed and I was told that I was going to handle 59 patients (supposedly on the slow unit), but that another nurse would be floating between two units to help me. Well, just my luck, another nurse called in sick so that one floater nurse only helped me for 1 hour that night. I had 16 diabetics who all needed BS checks and insulin before breakfast, all medpasses before activities, and some that needed to be ready for dialysis appointments. Not to mention I also got stuck with doing med recycling and replacing 200 or so medications for all 3 shifts between 2 medcarts. Another nurse started the process, but I was pretty much responsible for 70% of it...and I had no clue what I was doing. Unfreakingbelievable.

    I didn't leave until 10:00 am the next day. I was supposed to be off at 7:30am! I was in tears. My next (and most recent shift) I was on the floor by myself again, but on AM (day) shift. I started the day off with my cheat sheets, etc. but somehow didn't finish passing morning meds hours later, which made me late for noon meds. I didn't leave until 5pm, and I was supposed to be off at 3:30! Again, I was in tears. Both days I didn't eat lunch, didn't pee, didn't take a 5 minute break. I was literally standing for 8 hours straight until my charting had to be done after I punched out.

    I am now scheduled to work the PM shift in 2 days and I am not sure if I even want to go back. I am thinking of ways to make my medpass go faster, but HOW? I don't want to give insulin too early in fear of someone going completely hypoglycemic on me...but if I don't start FSBG checks earlier my medpass will fall behind. I am so confused. Experienced nurses, any tips you can share to make med pass easier?

    I was lucky enough to have another nurse help me with my labs during my AM shift, but I was reminded that next time I would have to do all the follow-ups on my own. I was grateful for the help, but how in the world can anyone fit all of this into 8 hours and go home at a decent time? Please help. Thank you.
  6. by   Victori Ismine
    Cape Cod Mermaid - I've worked in a few LTC facilities and the common thread with the training is that it's random. You follow this nurse, then you follow that nurse, then you figure out something that works for you...if you stay around long enough. Could you - or anyone else out there with a good training system - tell me how you structure your training program to give each new grad the best chance possible? Do you have a high retention rate? And what kind of orientation do you give "old" nurses? I'd like to help my facility develop a better training program and retain good nurses. It feels like the revolving door lately...
    Last edit by Victori Ismine on Dec 27, '12 : Reason: want to direct to cape cod mermaid
  7. by   Chio2009RN
    Not possible, just learn to priortize, I have being doing it for 3years now and still gets off late on very busy days, you will need good coworkers for it to work. Teamwork is the key. Hang in there.
  8. by   Chio2009RN
    been, i mean.
  9. by   Maouie
    How are things now? I'm starting at a skilled nursing facility in two weeks and graduated almost 3 years ago.
    Very nice of you to come back years later to let us know how it went! New nursing starting 1 week orientation some and trying to prepare myself for what's to come.
    Thanks everyone for responding..although years ago information is still relevant.
  11. by   shejack
    Very good question.How do you give meds,check breath sounds,pulses etc... I see no nurse who have the time to do that,because they have to give meds before the pt. leave their room.The cna will not let you know that the pt. is gone😒
  12. by   Whit2389
    If they are understaffed then odds are they will end up wanting to float you from hall to hall. If I were you I would request two days of training on each hall, then inform them of the hall you feel most comfortable on and tell them you want one more say of training on that hall. That's what I did and I found it very helpful to learn how the entire building functions as a unit. Each nurse does things differently and it was helping seeing how each nurse did each thing differently. I also ended up training on a different shift one time since there wasn't anyone to train me on my primary shift. This was helpful too, and also gave me the comfort of knowing I wouldn't freak out if I had to work a double on a shift that is not my regular shift.

    If you don't like passing medications then see if you can switch to 3rd shift. Most medications are scheduled during the day, so night time med passes are much smaller. Usually a few pills passed right before bed (ambien, anti anxiety, etc..), and then in the morning you may have thyroid pills and protonix (anything consumed on an empty stomach), plus prn pain meds or duonebs through the night. This leaves more time to go through patient charts and get to know your patient and learn about their disease processes. Once you become comfortable with knowing your patients, becoming more oriented to the unit, etc.. you can switch to a different shift with a heavier medication load.
  13. by   Whit2389
    Btw, I too just started my first job at a LTC facility. They told me 3 to 5 days orientation but I told them I definitely wanted 5 and would let them know if I was ready then. I spent all of 4 days taking extreme notes, asking a million questions, training with 4 different people. Tonight is my first shift on my own, and while I am SUPER nervous, I do feel prepared. I trained on 2nd shift and hated it. Third seems to much better for someone new at LTC.