New grad - starting new job- 1 yr gap since graduating

[JuneLeeRN]

Hello everyone. Thanks in advance for reading and replying. I need advice, & words of wisdom. I graduated with a BSN in dec 2012 and passed my boards in feb 2013. I took some time off and didn't look for a job immediately. I had a baby in June of 2013- and immediately started looking for work. I took a position as a per diem RN at an inpatient detox facility in July 2013- and I was let go prior to completing my 90 day probationary period. I was hoping this job would work as I enjoyed it. It was a big blow to my confidence. I felt like I did my best under the circumstances but still failed. The reason I was told for me being let go was time management- I was taking too long to do admissions. I'm starting in LTC facility in a week- and I'm scared !! It's been over a year since nursing school- so I'm a bit rusty with the skills that I had. I've always been a great student (A's) but I feel like I lack confidence in my clinical abilities. Any words of wisdom on handling a 20 pt load, making a great impression on fellow RNs, MD, LICSW; winning over cna and other staff members would be appreciated. Even if you think it's obvious post anyway. I've been out of the work world for awhile so any advice is appreciated. Thanks.

[mander]

I don't know what you're doing in your new position, but I just started as a sub at a LTC in September as my first job. I can pretty much take as long as I want to on admissions. They aren't that complicated as long as you address everything. I am pretty slow myself so the fact that I ever admitted anyone made me feel better. I sub as a unit manager, treatment nurse, and once in a great while med nurse.

I am still lacking in the leadership skills department so I can't really give you any solid advice on how to win over CNAs. I feel like I never will with some, since we both have different priorities. As long as you let them know if someone has an appointment and tell them any relevant info they should know within a timely fashion you should be good! With the MD, always tried to be prepared with extra information. Sometimes ours doesn't ask questions and other times he throws us for a loop and asks the most obscure things. (Like if we call for a finger stick over 400, sometimes he'll tell us how many units to give and other times he'll ask about other meds depending on his mood.) Pretty much with the MD try to be prepared or know who to ask in a hurry. As with fellow nurses I don't have solid advice there either. Everyone is different. I just try to get a feel for everyone's personalities so I know who I can go to for help and who I should avoid! As unit manager you just go with the flow and try to take on issues as they come. Address what you can when you can. I have been told I am incredibly calm while others get stressed out over little things. I tell everyone, it's just paperwork, no need to upset everyone. (Even if I am panicking inside.)

Before I ever put a cath in or flushed a cath, or changed a complicated dressing I always asked someone to show me how they did it. Sometimes people appreciate being asked, but also you can just see it to refresh your memory.

I don't pass meds much so I am extremely slow with that. Sometimes residents get angry with me because I'm not there in time. I have also ran into some problems with timing my meds. For example some people get meds 4 hours apart, but my morning med pass takes me that long to get through all of the residents. I try to get to those people first if possible (after fingersticks and insulins). That's all the advice I can really give in that department since it's not really my thing.

Good luck and I am sure you will be fine!