New job, new nurse and really nervous

Specialties Geriatric

Published

hey everyone,

i'm currently a registered nursing student and in our program if you complete 2 semesters of clinicals you can take the lpn exam. well i did, passed and applied to a job posting for a lpn in a sub acute rehab floor in a nursing home and got the job.

i'm very excited but also very nervous. i mean, this is my first nursing job and from my understanding of a rehab floor it's really like a med surg floor of a hospital meaning you will use/learn a ton of nursing skills. i'm sure all this will be very helpful in my nursing career but i haven't used them or mastered any of my skills yet because this is my first job. i have a preceptor for 5 days and then i'm on my own...

my fears are the other nurses not being so nice and expecting me to know everything. i hear so many horror stories about nurses who eat their young and how mean they can be. i know i shouldn't worry about that now since i haven't even started officially but it's on my mind.

does anyone have new nurse job experiences or advice on what to expect as a new nurse?

thanks!

Specializes in LTC.

Hi: I graduated in May 2010 with a BSN and 3.5 GPA and was unable to find anything until I took a job at a local nursing home. I have now been there a little past 3 months. Unfortunately, in medical environments in general, there is alot of backbiting. I was a medical transcriber for 25 years and saw the same thing in that environment. What you must recognize is that nursing homes, and indeed all of medicine in this country, operates under a capitalist model. It is all about the money. Being precepted for 5 days when going onto a rehab floor is grossly insufficient (I got 3 weeks of precepting for a LTC floor) but there is not much you can do about it. The job market in general, even for nurses, is so tight right now that you have to take what you can get and suck it up. Point is that they want you to get out there working and start being productive from day one. Alot of nurses and even aides will expect you to automatically know stuff that you do not know. What you (and all of us) learned in nursing school is basically not helpful in the real world. We learn to do things the right way and by the book. In real life, it is not that way. People find ways to cut corners to save time. In general, you will find that the expected workload is more than can be realistically expected from a person. But again, that is the capitalist environment we are in. As far as nurse's attitudes towards you, it all depends on who you get as coworkers. Some of my coworkers have been very good with me, but they cannot provide much help because they also have 20 patients to look after, medicate, do treatments for, do copious documentation on, pick up MD orders, etc. And we are not computerized so alot of things must be done in triplicate and by hand. It all has to be finished by the end of your shift, with no going over time. Then there are other coworkers who do not want to help me or give advice and make it very clear that they dont want to. They will finish their work and sit at the nurses station texting and will not offer to help another nurse, even though it is unofficial facility policy that they do so. I have also run into "education discrimination". Many nurses at LTC facilities are LPN's, with an occasional RN. Most of those RN's are 2 year grads. I am the only BSN in the place, including supervisors and the DON. I wanted this title placed on my badge, as I felt I worked hard to get it. But I obviously pushed some people's buttons by doing so. However, nothing stops them from going back to school to do it themselves. Jealousy is a factor in these situations and you should be prepared for it. You should also prepare to be mandated to stay if people call in. I realize that some states have prohibited this practice but it continues nonetheless. The bottom line is that you should be nice, but not a doormat. Do not let people bully you or intimidate you. Be assertive and professional and keep your residents concerns first and put all that other petty stuff at the back of your mind. Keep focused on your residents and it will be easier for you.

Specializes in ER.

It is normal and understandable to be nervous. I used to work in Subacute, am in ER now. The most important thing I learned working in SNF is time managment. You will be taking care of many patients. I took care of 26 subacute, more like acute , really! And I covered nurses in LTC, too. Boy! Too many patients to assess, too many meds to pass, too many phone calls from patients' family, pharmacy calls and doctors' orders to take care of. So very important to really prioritize your tasks. Go and see medically complicated patients first like diabetics and on vents. Get organized. I made a list of all my patients---diagnosis, diet, precautions, fingersticks for blood sugar, lab specimens to collect...etc etc. What I enjoyed most there was I get to know the patients since they stayed there for a long time, hence LTC. Good luck!

I think Tankweti's statements are true. As a new RN going into a LTC, I wouldn't emphasize educational level. My first job was at a LTC. After two months, they had me as charge over the whole facility. I also had my own unit of 25+ patients to handle. I think it did irk some experienced LPNs that I was charge. But most of them would be very helpful. One in particular was a bit hard on me at times. I remained humble and shifted my questions to other LPNs. I also let them know that I respected their experience. --On rare occasions, I was acutely aware that I had learned things in school that an LPN colleague hadn't, but for the most part, I learned TONS from them --All in all, as a new grad or even a new nurse, I'd rather have an experienced LPN on my team than (I can't believe I am saying this) another new grad. --When the stuff hits the fan, experience can really be helpful. --I guess it is important to have a balance on the team....experienced nurses with the newbies. I should also mention that I work with experienced RNs and LPNs now along with new grads. I learn from ALL of them. I like a well-balanced team. I am not a charge anymore. In my charge, I like experience. ...hm...I guess most of us would. --So if you are going in as an inexperienced charge, it might be easy to understand that some folks won't be as jazzed about it. ---But accept it and show them that you will bring your best to the team. Draw on their strengths and appreciate them. You will learn a lot.

oops...just realized you are LPN...I focused on previous poster.

I think you will be fine and learn a lot, just like me. I have found most folks want to help. Some folks are too busy to help. Very rarely, there will be some that just don't want to or just feel irritable...maybe they are burned out. If you find someone is cranky, give them the benefit of the doubt... nursing is stressful. Change your approach, and/or choose another person to help you...

I am now in acute care. I miss many aspects of LTC. I am in acute care as I am trying to "round out" my experience.

I learned about managing dying patients in LTC....pain, anxiety, breathing, emotional support... If you ever have a patient that is in the dying process and is in anyway uncomfortable (and you can't help it), draw on the other nurses on your team and the provider to find ways to make them more comfortable. I did not learn about managing the dying process in school. Things you might see prescribed --dilaudid, morphine, lorazepam, atropine, oxygen (NC/face mask), suctioning... Remember you can call on pastoral support....and sometimes if hospice is on the case --on hospice... In LTC, you are the one present --and you often must advocate for the patient to the provider. They may not have adequate pain control, etc., ordered. You must advocate for it.

Specializes in ER.

Oh, and about being nice. My attitude is I am there to work and not make friends, but if it happens that I develop friendships along the way, then that is a good thing! Stay away from gossips and politics. Some nurses will try to get you on their side to gang up on another nurse they don't like, try to stay professional and don't get involved on either sides. My respond to them, " Hey, nobody is perfect" and just change the subject.

Hi Koko. I remember being there as well, I learned what got people fired and what kept people employed. First let me give you some advice . Don't talk and don't joke. Watch what goes on and learn who's your friend and who's your enemy (those that will screw you over). Remember that if you get fired, most likely they'll report you to the state board of nursing. So if you ever get written up A) ask for someone impartial to witness it (you can request it per the federal board of labor relations), and deny it in writing if you can if its untrue on the write up sheet, get NSO (it's about $45 a year for new grads). Remember, nobody is really your friend, when it comes down to it, you're on your own. If management wants you gone, you're gone. You can never be perfect and they will find the mistakes and nail you for them. So do your best to make them happy. If you get a written warning and you feel it was unwarranted because they were targeting you, then remember that's a prelude to being fired. Quit. Jobs maybe hard to come by, but Nursing Licenses are even harder. Which, gets me to the next point, save money for being unemployed and needing an attorney. If you don't know how to do something, ask for help from someone you know and if you can't get help look up procedures. This advice is for a worst case scenario that happens to more nurses than you'd know.

If a CNA brings something up to you (like a red mark on the coccyx or a slight temperature, change in LOC) not only should you address you... DOCUMENT IT. Skin tends to be a big deal in rehab so if the red mark is unblanchable or the bruise is new...you need to call and doc and check for orders.

Tankweti don't talk about your baccalaureatte degrees...in fact....don't talk....I'm telling you...they are sneaky. Don't **** them off.

Nurses eat their young. Nurses shoot their wounded. Corporations wil eat you up and spit you out like your nothing and will ruthlessly lie and trash your career if their profit margin ever gets threatened. Don't trust them.

I'm investing and going to school in another field. I now realize why 1/3-1/2 of all nurses quit.

Congratulations on getting your first job. Currently I'm a new grad looking for work and I am nervous too. So I think what you are feeling is normal. Practice some of your skills and basic communication on your family members or friends. Look on youtube at some of the skills videos, do some review on what you think your weak points are. But you will be fine, trust yourself, you made it this far and have done well. Be proud of yourself, you are a nurse! Smile, relax, and remember to keep your sense of humor. Good luck.

Hi Koko. I remember being there as well, I learned what got people fired and what kept people employed. First let me give you some advice . Don't talk and don't joke. Watch what goes on and learn who's your friend and who's your enemy (those that will screw you over). Remember that if you get fired, most likely they'll report you to the state board of nursing. So if you ever get written up A) ask for someone impartial to witness it (you can request it per the federal board of labor relations), and deny it in writing if you can if its untrue on the write up sheet, get NSO malpractice insurance (it's about $45 a year for new grads). Remember, nobody is really your friend, when it comes down to it, you're on your own. If management wants you gone, you're gone. You can never be perfect and they will find the mistakes and nail you for them. So do your best to make them happy. If you get a written warning and you feel it was unwarranted because they were targeting you, then remember that's a prelude to being fired. Quit. Jobs maybe hard to come by, but Nursing Licenses are even harder. Which, gets me to the next point, save money for being unemployed and needing an attorney. If you don't know how to do something, ask for help from someone you know and if you can't get help look up procedures. This advice is for a worst case scenario that happens to more nurses than you'd know.

If a CNA brings something up to you (like a red mark on the coccyx or a slight temperature, change in LOC) not only should you address you... DOCUMENT IT. Skin tends to be a big deal in rehab so if the red mark is unblanchable or the bruise is new...you need to call and doc and check for orders.

Tankweti don't talk about your baccalaureatte degrees...in fact....don't talk....I'm telling you...they are sneaky. Don't **** them off.

Nurses eat their young. Nurses shoot their wounded. Corporations wil eat you up and spit you out like your nothing and will ruthlessly lie and trash your career if their profit margin ever gets threatened. Don't trust them.

I'm investing and going to school in another field. I now realize why 1/3-1/2 of all nurses quit.

AMEN!!!!

What are you to going to school for now?

Hi Koko. I remember being there as well, I learned what got people fired and what kept people employed. First let me give you some advice . Don't talk and don't joke. Watch what goes on and learn who's your friend and who's your enemy (those that will screw you over). Remember that if you get fired, most likely they'll report you to the state board of nursing. So if you ever get written up A) ask for someone impartial to witness it (you can request it per the federal board of labor relations), and deny it in writing if you can if its untrue on the write up sheet, get NSO malpractice insurance (it's about $45 a year for new grads). Remember, nobody is really your friend, when it comes down to it, you're on your own. If management wants you gone, you're gone. You can never be perfect and they will find the mistakes and nail you for them. So do your best to make them happy. If you get a written warning and you feel it was unwarranted because they were targeting you, then remember that's a prelude to being fired. Quit. Jobs maybe hard to come by, but Nursing Licenses are even harder. Which, gets me to the next point, save money for being unemployed and needing an attorney. If you don't know how to do something, ask for help from someone you know and if you can't get help look up procedures. This advice is for a worst case scenario that happens to more nurses than you'd know.

If a CNA brings something up to you (like a red mark on the coccyx or a slight temperature, change in LOC) not only should you address you... DOCUMENT IT. Skin tends to be a big deal in rehab so if the red mark is unblanchable or the bruise is new...you need to call and doc and check for orders.

Tankweti don't talk about your baccalaureatte degrees...in fact....don't talk....I'm telling you...they are sneaky. Don't **** them off.

Nurses eat their young. Nurses shoot their wounded. Corporations wil eat you up and spit you out like your nothing and will ruthlessly lie and trash your career if their profit margin ever gets threatened. Don't trust them.

I'm investing and going to school in another field. I now realize why 1/3-1/2 of all nurses quit.

OH Geesh! This makes me feel much better??

hi koko. i remember being there as well, i learned what got people fired and what kept people employed. first let me give you some advice . don't talk and don't joke. watch what goes on and learn who's your friend and who's your enemy (those that will screw you over). remember that if you get fired, most likely they'll report you to the state board of nursing. so if you ever get written up a) ask for someone impartial to witness it (you can request it per the federal board of labor relations), and deny it in writing if you can if its untrue on the write up sheet, get nso malpractice insurance (it's about $45 a year for new grads). remember, nobody is really your friend, when it comes down to it, you're on your own. if management wants you gone, you're gone. you can never be perfect and they will find the mistakes and nail you for them. so do your best to make them happy. if you get a written warning and you feel it was unwarranted because they were targeting you, then remember that's a prelude to being fired. quit. jobs maybe hard to come by, but nursing licenses are even harder. which, gets me to the next point, save money for being unemployed and needing an attorney. if you don't know how to do something, ask for help from someone you know and if you can't get help look up procedures. this advice is for a worst case scenario that happens to more nurses than you'd know.

if a cna brings something up to you (like a red mark on the coccyx or a slight temperature, change in loc) not only should you address you... document it. skin tends to be a big deal in rehab so if the red mark is unblanchable or the bruise is new...you need to call and doc and check for orders.

tankweti don't talk about your baccalaureatte degrees...in fact....don't talk....i'm telling you...they are sneaky. don't **** them off.

nurses eat their young. nurses shoot their wounded. corporations wil eat you up and spit you out like your nothing and will ruthlessly lie and trash your career if their profit margin ever gets threatened. don't trust them.

i'm investing and going to school in another field. i now realize why 1/3-1/2 of all nurses quit.

wow!! my first piece of advice to the op is don't believe everything u hear/see (such as above) i can't imagine going to work everyday and not talking/joking with my res and coworkers. i have been in nursing administration for 12 years and have fired several nurses for many reasons (attendance, poor performance, etc...) i have only had 2 that i had to report to the board and that is because they were blatantly stealing medications from the facility.

true - you or anyone else for that matter, can or ever will be perfect. administration does not expect anyone to be perfect. they do however expect you to put the res best interest first and do your job safely, show up for work when you are supposed to, treat your coworkers with respect.

true - skin is a big deal in ltc. it is often cited during state surveys and the public has access to records which show your facility performance in wound prevention. it is always important to catch any skin issue at the earliest possible stage and begin treatment to prevent it from getting worse.

to the op - good luck in your new position. try to go into it with an open mind and make your own judgements about the people you work with and the management/corporation you work for. i have never regretted working in ltc and would never choose another profession. i have made some of my best friends at work and rarely have a day where i don't have some fun :)

to the person who posted this post i'm sorry you have had such a bad experience but i truly believe that you are in the minority and perhaps it is best that you are looking into other options

Sorry OP I don't mean to scare you. Nursing can be a rewarding career emotionally and financially. You'll have good days and bad days. Nursing school fills your head with all sorts of ******** and misrepresentation on how things really work. Nursing is as much as an Art as it is a science. I've worked for a few companies so I know how things work.

I gave you the worst case scenario's because I think your company is one of those ruthless megacare corps. Think about it, you have 5 days of orientation. Five!!??? That is outrageous. Dangerous. The advice I'm giving you isn't meant to scare you but it's meant to protect you in the event of a worst case scenario or to prevent worst case scenarios from happening. Take care of yourself OP because in the end.....nobody else will. These scenario's are the most common reasons I've seen for people being fired or disciplined and I don't want the same to happen to you. I'm trying to look out for your best interests. Be safe and good luck.

Goodluck to you first & foremost .... I'm a returning nurse (I stopped working for 17 yrs), plus, a foreign grad so I'm REALLY, REALLY NERVOUS & SCARED!!! I got my RN license 2 yrs. ago & got my very first job here in the US today ... but now i'm having second thoughts if I'm really ready for the job .... the orientation i had today was so OVERWHELMINg:crying2: that I'm already thinking of quitting this job & find another one (a "simpler" one)... because i feel that my knowledge & experience in handling patients on mechanical ventilators or someone with tracheostomy were not enough... I think i need to start at an "easy field" (if there's one, i don't know,maybe) for now or volunteer at a hospital or nursing homes just to get myself back on track .... PLEASE lighten me up on these my dear colleagues!!! THANK YOU & again congratulations & GOODLUCK to you!!!

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