New nurse, new job....HELP!

  1. So I started this new job only about 2 weeks after I passed by state boards, thats pretty cool. But I'm in training right now and I feel like I'm the slowest person on the floor, I work midnight shift (6a-6p) its not the staying awake thats hard its the night med pass! I swear it took me forever to figure it all out, were are the drugs, who are the patients where are their rooms, it was a just a complete disaster! And tonight the charge says I'm ready to hit the floor on my own! I think she has lost her mind!!!
    But anyways I was wandering if anyone has any ideas that would speed up the craziness of my night between med pass (and trying to see how they take their meds, its not in their MAR, its just something that is passed from nurse to nurse and I guess the previous nurse thinks I can read minds or something), treatments, wound care, charting, making sure my aids are doing what they are suppose to do (some are really nice to me and understand I'm still 'green', and some think I'm a push over since I'm new and they can get away with everything!) and then another med pass at 5am, giving report and then charting my 24* report all with out curling up in a ball and crying my eyes out for a 30 patient hallway or beating my head against the wall! Any tips or tricks that has helped you guys in the past would be greatly appreciated!
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    About TraceyDiane

    Joined: Feb '13; Posts: 3


  3. by   MSdeltaPN2012
    I'm also a new LPN and 4 months into it. I work at a nursing home and my first day out of orientation was a complete mess. I asked for a few more days of orientation and that helped me a lot. If your not comfortable and feel overwhelmed as I did, ask for a few more days. I'm sure they do not want to see you struggle; they too have been there themselves. Once you get used to the patients/residents where ever you work, you will speed up some. The distractions are what hold me up eventhough I know each one of my 30 residents. Try to stay organized with a note pad or whatever you have to write on so you can keep up in report, giving report, and have times down for charting. I'm still learning the names of medications and what they are for. I promise you will get the hang of it. Good Luck to you!
  4. by   Maremma
    Well congratulations becoming a new nurse! I am not a very old nurse myself. I know how you are feeling. I promise you will pick up speed. The most important thing to focus on is accuracy. Speed comes with time. Indeed please do ask for more time if you are not comfortable yet.
    Then the first thing you should do is make a face sheet to put in front of every single MAR that tells you how each patient takes their meds. That way it will be right there in front of you for every other shift you work. Just a real basic piece of paper that says whole___, crushed___, in applesauce____ (or pudding or whatever your facility uses), Water___, juice____, thickened liquid_____. Make photo copies of the face sheet. Then you can just put an x next to whatever each patient uses as you go. This not only helps you it helps keep your patients safe if a strange nurse works the hall. You don't want a thickened liquids to get plain water for example.

    You can also make a sheet that lists all your chemsticks in your halls and keep it in the front of your 24 hour book or something. Then you can use that to highlight those patients on your census/report sheet at the beginning of your shift. I personally put a small "box of highlight under each patient I need a chemstick on for my ACD and second one next to it for my HS sticks. (I work second shift)That way I can just write their chemstick numbers right on the highlighted box and the amount of units coverage in a circles next to that in the highlighted box. Then I not only know I didn't miss anyone I also have it right on my census/report sheet for charting later.

    If you have parameter meds on some patients you can also make a sheet for vitals on and what times you need those specific vitals. You can type that up for yourself and make photo copies of that too. Then you can just hand it to your aids if you have them doing your vitals for you or in the least you have it and can grab them before you start pouring the meds for them or grab them a few minutes before you start that specific med pass. (If my good aids on she can handle getting them for me and back to me in time if not I grab them before starting second med pass.)
    My first med pass I hook up one patient to the dynamap go out and do meds on their room mate, the dynamap is done by the time I am done with the first patient and I have what I need to go out and just get all that patients meds without interruptions.
    If you have alert charting vitals you can hand write them on this same sheet so your aids can get them for you and have them all right there when you are ready for charting later or you can use a different color highlighter on your report sheet and put it next t their name to write over top of as you go if you prefer.
    You will pick up tricks that work for you as you go. It does get easier as you go.Give yourself the patience and time to let it all soak in. I think ALL new nurses feel overwhelmed at first. One day you will wake up and realize that you are more and more comfortable and you are no longer the "new nurse" but rather the nurse that is encouraging the next new nurse to come along!
  5. by   TraceyDiane
    Thanks everyone. Lastnight/this morning was my first run out of the gate. I think I did very well. All my meds got passed with in the alloted time, all my treatments were done! That is like the monkey on the back, after I get all of that done its basicly smooth sailing til 5am. The only thing that went bad was I forgot to write the patient's name on a order and I still had a ton of charting to do after my shift. Luckly the next shift nurse was right on time, which that never happens and I could give her report as soon as I was done with med pass. So I started my charting and was done and out of there 5 mins later than I should of been! I know a full moon is slowing getting ready to happen so therefore I know all my patients are going to lose their heads hopefully I'm ready when that happens. Thanks for the words of encouragement!
  6. by   kimemoji
    My first job was a skilled nursing facility. I was the slowest person then got really good at it after a few weeks. I worked the summer then was hired at Kaiser. I never will go back. Less stress in the clinic.
    Good luck.
  7. by   drofseg
    I work at a LTC facility as well. I had exactly one half days if training, then given the med cart. This place has 95 residents, only two nurses passing meds. There is no picture of them on their MARS or ID bracelets. Needless to say, i made my first med error, when i realized what i did, i fiund
  8. by   drofseg
    I work at a LTC facility as well. I had exactly one half days if training, then given the med cart. This place has 95 residents, only two nurses passing meds. There is no picture of them on their MARS or ID bracelets. Needless to say, i made my first med error, when i realized what i did, i found my boss, told her what i had did, the resident was ok, sick as a dog, but ok.

    I just dont understand how they can turn you loose to pass meds to people you have no clue who they are, sure you can ask them, but if they have Alzheimer's, they will answer to anything sometimes.

    I gave gone over to nights where to me is less stressful. I feel my license is in jeopardy working there, too many residents to not enough nurses, and too much to do with not enough time. I think i will be looking for something else, the money is good, but to me is not worth the safety issue.
  9. by   Stranded55
    That sounds really unsafe. Are you saying there is no way to identify your patients or which medications they are supposed to be taking?