New LPN trying to get into the swing of things...

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    Although my shift ended at 10:30pm tonight, I did not clock out until 11:20pm; however, staying over doesn't bother me. I'm having a hard time falling asleep tonight and wanted to get some thoughts off my mind. I'm a brand new LPN. I graduated this past May and work at a long term care/rehab facility. I have had 7 days of training so far and am not yet finished with my orientation. I'm feeling so discouraged tonight. I had the med cart to myself tonight and began my 8pm med pass at 7pm. I didn't get finished until 10pm. I put the CNAs behind because they were trying to wait for some residents to get their meds before they helped them to bed, but they ultimately couldn't wait any longer. We have pictures to identify the residents, but I am still learning who is who and the pictures can be somewhat misleading. This facility does have several halls to it and this was only the second time I've been on this particular hall.

    I keep running the shift through my head. I had one CNA ask me if resident A, B, or C had their meds yet and I had to meekly say "no". I managed to stay calm throughout the shift, but I can't help but feel discouraged. I was a CNA before I became an LPN (I worked at a different facility though), but I wonder if I have it in me to supervise the CNAs and be a more authorative figure. I can be very soft spoken at times. I realize I have only been a nurse for 7 shifts and some days will be better than others. I guess I just needed to get some things off my chest tonight so that hopefully I can get some sleep.

    Thank you for listening to me ramble. Nursing has always been my passion and I really want to do my best and be an advocate for the residents. It will be nice when some of this "newness" wears off

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    As you get more familiar with the residents, your medication passes will speed up. This should take a few weeks.

    I vividly remember my first medication pass to 30 residents. It took nearly four hours. I had started at 7pm and did not finish until 10:30pm.
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    Quote from TheCommuter
    As you get more familiar with the residents, your medication passes will speed up. This should take a few weeks.

    I vividly remember my first medication pass to 30 residents. It took nearly four hours. I had started at 7pm and did not finish until 10:30pm.
    Thanks for responding. I really do feel blessed to have this job. I interviewed with the facility right before I took the NCLEX, and I was officially offered the position within a week of my initial interview. I have to remind myself that they hired me for a reason. Although I have my education, my skills will get better with time. I will definitely remind myself to take everyday as a learning opportunity.
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    U DIDN'T DO ANYTHING WRONG IT TAKES PRACTICE AT A NEW FACILITY(GETTING TO KNOW THE RES AND THEIR ROUTINE), EVEN WHEN U BEEN A NURSE FOR A WHILE. TAKE UR TIME SO YOU DON'T MAKE ANY MED ERRORS AND JUST KNOW YOU'LL GET BETTER WITH TIME, BE PATIENT WITH UR SELF.:kiss
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    It will get better with time and even once you've been there a while there may still be nights that it takes 3-4 hours to do a med pass because of whatever else is going on with your patients. I was at a facility for 5 months, knew my patients and still had nights like that. Don't get discouraged it happens to everyone!

    Sent from my iPhone using allnurses.com
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    Hang in there
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    I think every new nurse is discouraged at first. You are not alone! Give yourself time to get used to everything. Speed comes with time. The important thing to remember is that you want to focus on accuracy first.

    Human brains store repetative information in such a way that eventually it becomes an unconcious act. You do not want to be "storing innacurate practices" in that memory bank! It makes no difference what job we are doing or what repetative acts. If you want to be an actual good nurse you MUST remember this; ACCURACY first before the unconcious mind starts to take over and throws monkey wrenches into your work every day! Better to train your brain the right way in the first place than to have to try to retrain it after it starts creating bigger problems for you later!

    Once the unconcious mind has something burned into it it will actually "start witout you"! LOL You will be reaching for things before you even conciously think about it etc.

    I remember my "training" at an old job. I already understood this principle and so was being very careful to do that job accurately. I remember the manager making a disgusted face and telling the person training me "Oh she is going to be ANOTHER slow one!" I of course knew better and refused to let her discouraging words affect my "method" for learning this new job. I simply looked her right in the eye and said "Not true. I simply know it is essential that I master accuracy first. wait and see"

    Indeed she lived to eat her words! I became "the best of the best". I would be sent into one store after the other to help open them and train new employees and shift supervisors.

    Although ther were others that were "fast" sadly the "crap" they put out at the end and the mess they created trying to do it only created even more work later and unhappy customers with lots of complaints.

    The BIGGER problem was RETRAINING them to ACCURATELY do the job. All their bad habits were already "burned into their databanks" Overwriting that is far harder than putting it in on a fresh clean slate. I had brand new employees "outrunning" the long term ones within weeks due to this very problem.

    Acuracy first, speed will come naturally.
    straitgirl77 likes this.
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    I really appreciate everyone's encouraging words! Today actually went pretty well. One of those days where it feels great to finally be a nurse

    And Maremma, your advice is really helpful. Tonight I actually caught some discrepancies between the MAR and the medications that were available. Had I focused too much on speed, I would have missed it; however, I am making sure to go over the 5 rights in detail since everything is so new to me. Majority of the staff that I have come in contact with have been very supportive and helpful. I really do love the facility and am glad to have been offered the opportunity to be a part of the team.
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    It WILL get easier. In a short time, you will be flying through those meds. Trust me, I've been there! As others have said, accuracy is the absolute most important thing right now. Until you become familiar with the residents and their meds, it's important that you take your time. Don't ever try to rush. Everyone has a learning curve so don't beat yourself up over it.

    As someone that has a loved one in a LTC facility, I would MUCH rather have you take your time and be right than to hurry and make a med error.

    It also sounds like you have very supportive co-workers. Be good to them - they are worth their weight in gold!
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    Hi Charisma,

    Chin up, my friend - I am in the exact same boat as you! I graduated in April & just started my very first job as a LPN. I've been on orientation for about 4 days & just took my first stab at the med cart by myself. I felt like such a failure on Friday - I only had the cart from 2-6pm, but I had to ask for help & two other nurses were helping me finish the med pass at 7:30. There were some other factors involved that I can't elaborate on without identifying my facility. Fortunately, I finally got out of there around 8. The CNAs are testing me, the other nurses are testing me, & I tend to be soft-spoken at first, so I'm probably getting a little snowed by some people right now. But anyone who knows me knows I'm confident in my abilities & my decision-making, & I am straight-forward - & once I get my bearings in a setting, I evolve into the alpha female.
    I left very discouraged & overwhelmed, feeling like HOW am I going to do this? HOW can I possibly end up doing this for 12 hours when I can't even manage 4 hours? I felt like an idiot when it seemed like every one of my patients was somewhere other than their rooms & I was trying to do a med pass. How was I supposed to go & track down each one? Whenever I need something or need them to go get someone, the CNAs always say - "Well, you can always go get it/them," The first time, I fell for it. I bought their "busy" demeanor & I sprinted off to go do it myself, but I realize now that I've got to put my supervisory hat on & ask for what I need. They may be busy or look busy, but I've got a job to do & I can't go hunt down every little thing or every patient that I need. Sometimes they have to help me.
    The part about trying to figure out who is who from the pictures in the MAR cracks me up - don't they know nobody looks like their photo? I've even had 2 or 3 patients look like each other - thankfully they are on opposite ends of the hall or I'd be in trouble.
    Hang in there, my friend, & know that there are others riding the crazy wave with ya. Here's to finding a mentor - a competent, compassionate, knowledgeable, experienced nurse who will not eat us alive.


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