New rehab nurse with no experience

  1. 0
    Brief about me:

    New lpn grad in Dec. 2012, Licensed in Jan. 2013, first hospice agency job lasted for 3 weeks. 2nd job is at rehab center.

    I had 2 weeks of orientation. Yesterday was my first day on the floor by myself doing 3-11 shift, which known to have the most admissions. (I oriented doing admissions for 2 days. And it took me the whole 8 hours to do 1 admission. It was very stressful, I was hoping to change shift or change floor because they also have a LTC floor with slower pace. ) luckily I didn't have any admissions the last 2 days. However it was my first time going thru the whole cart with 18 patients. One thing that stresses me out the most is the nurse aids. They don't seem to respect me I guess bc I'm new and nice. Anyone have tips or advice how to be stronger when dealing with them? I guess I am new that's why I don't have much confidence. Another thing is calling MD's, im afraid i say things wrong or doesnt makes any sense or even pronouce meds wrong. we had to look at labs and call md for abnormal values and know what meds they are on. So much i dont even know! i forgot what are the labs are for! But day one I didn't get out until 1AM. I live about 30 min away too so i was kinda worried. I did not take any breaks, havnt have dinner ever since I started this shift. Maybe it's a good thing for my upcoming wedding. but yeah I was really thinking about changing major!

    Day 2 i got a little bit organized, learned a bit from day one and tried to do the bs check first. My pts were so happy and excited that I'm the nurse for day. That made my day, proved me that I need to be there to be a good nurse for them. There were no labs nor admission for me today, so just med passing.

    Day 3- off day. "I want to be at work" feeling.

    How to be organized? What should I do first or last? How to be confident? How to talk? What to review or study? What do I need to know? How to be faster? Thank youu!
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  3. 12 Comments so far...

  4. 0
    You bring back memories! It comes with time. There were some days in the first two weeks on my own where I was crying in the med room and conteplating quitting. It was very overwhelming. 1am isnt that bad, my first 3-11 shift on the rehab floor I was there until 2am.

    Organization: You have to find your own rythm on this one. Some nurses call them shortcuts, but really you need to find what works for you and what doesnt. For instance, I find that I save time if I do blood sugar checks during med pass rather than before or after.
    Confidence: Also comes with time. I was terrified of calling the doctor when I first started. I still dont like calling the doctor because I work nights and I have to wake them up, but the confidence is there. I lacked confidence in so many places, as an authority figure to the CNA's, in my assesments, in my pronounciation skills. I still pronounce meds wrong sometimes but I just laugh about it. My co workers either think Im stupid or hilarious because I pronounce ALOT of things wrong. If its something that really bothers you then just look up the medication or disease before you call the doctor so you know how to pronounce it. I just dont care all that much
    Review: I dont know that anything specific is going to help you. You should review your labs, know what they are for and what an odd result means. For instance, if the patient has a BUN of 42, but Cr and GFR are normal you know the patient is dehydrated. You should also know your diuretics because that is the main med that goes with an CMP (besides any potassium supplements). The rest will come with time. This job has taught me more than school ever did. I work as an LPN but have my RN Degree so that should tell you something.
    Faster comes with organization.
    Dont be to hard on yourself, give some time to adjust and you will be fine. Best of luck.
    Last edit by tellis6645 on Mar 22, '13 : Reason: addition
  5. 0
    Disclaimer: I also cant spell apparently
  6. 1
    I'm pretty new also. I got my license in Oct 2012 and started working the 7-3 shift at a LTC/Rehab facility since Dec. I've have good and bad days. When I work on the LTC side I am able get out on on time, but that seems impossible on the rehab side. You get faster as you go, learning your own little routine and what works best for you. I hate calling the MD or ARNP. I always practice what I'm going to say before I call. (ADVICE: if you're leaving a message make sure you know the call back number for your facility so that your message doesn't sound like "you can call me back at . . . .ughhh *turns to other nurse* whats our number ?") I also asked a lot of questions whenever I am unsure of something. With the CNA's, I just talk to them as my equal. I give them the same respect that I would want to be treated with. I always thank them when they give me vitals, or answer a call light and etc. I try to make them feel appreciated because without them, my days would be super crazy.
    future_nurse215 likes this.
  7. 0
    Quote from tellis6645
    You bring back memories! It comes with time. There were some days in the first two weeks on my own where I was crying in the med room and conteplating quitting. It was very overwhelming. 1am isnt that bad, my first 3-11 shift on the rehab floor I was there until 2am.

    Organization: You have to find your own rythm on this one. Some nurses call them shortcuts, but really you need to find what works for you and what doesnt. For instance, I find that I save time if I do blood sugar checks during med pass rather than before or after.
    Confidence: Also comes with time. I was terrified of calling the doctor when I first started. I still dont like calling the doctor because I work nights and I have to wake them up, but the confidence is there. I lacked confidence in so many places, as an authority figure to the CNA's, in my assesments, in my pronounciation skills. I still pronounce meds wrong sometimes but I just laugh about it. My co workers either think Im stupid or hilarious because I pronounce ALOT of things wrong. If its something that really bothers you then just look up the medication or disease before you call the doctor so you know how to pronounce it. I just dont care all that much
    Review: I dont know that anything specific is going to help you. You should review your labs, know what they are for and what an odd result means. For instance, if the patient has a BUN of 42, but Cr and GFR are normal you know the patient is dehydrated. You should also know your diuretics because that is the main med that goes with an CMP (besides any potassium supplements). The rest will come with time. This job has taught me more than school ever did. I work as an LPN but have my RN Degree so that should tell you something.
    Faster comes with organization.
    Dont be to hard on yourself, give some time to adjust and you will be fine. Best of luck.
    Thank you so much for your advice! You just boost my confidence to another level. and it is always wonderful to hear experiences from other nurses. Quick questions. What is CMP? Sorry everything I learned from school is totally gone or hiding somewhere in the back of my brain right now. Lol I will definitely look it up tomorrow though. Also just want confirmations, why are u working as a LPN with a RN degree? Are u saying they paying u as a LPN wage instead of RN?
  8. 0
    Quote from Kashh
    I'm pretty new also. I got my license in Oct 2012 and started working the 7-3 shift at a LTC/Rehab facility since Dec. I've have good and bad days. When I work on the LTC side I am able get out on on time, but that seems impossible on the rehab side. You get faster as you go, learning your own little routine and what works best for you. I hate calling the MD or ARNP. I always practice what I'm going to say before I call. (ADVICE: if you're leaving a message make sure you know the call back number for your facility so that your message doesn't sound like "you can call me back at . . . .ughhh *turns to other nurse* whats our number ?") I also asked a lot of questions whenever I am unsure of something. With the CNA's, I just talk to them as my equal. I give them the same respect that I would want to be treated with. I always thank them when they give me vitals, or answer a call light and etc. I try to make them feel appreciated because without them, my days would be super crazy.
    So I heard different people says that they may put me in LTC side because its slower and more calm for me as a new nurse. I also heard that I'm gonna stay on rehab side because I learn more and there's much more admissions for me to learn and do (which I really need help on! So long and hard, especially if its handwritten). So from what I'm seeing so far is I'm staying on rehab side. Sigh but I think I prefer LTC first though bc rehab can sometimes be very overwhelming I don't get home until 3 am last night.
    Wow that advice with knowing the phone number ahead is wonderful to know! Lol anymore tips I should know when talking to MD? So I called a pt family last night at 1am, felt bad but I had to call them and let them know that pt's jtube noted not in pt. it kinda worries me how I chart on daily notes and 24hr report. Bc certain way u say it may mean its ur fault etc.

    Cna, trust me I be super nice to everyone equally. And thank everyone when they give me something or help me with something. I asked them nicely, or sometimes even sounds like I begged them for it. Sigh it's just so hard to deal with it. I just don't know how to be hard and firm. Nurses there are super nice and help me with anything. They even told me I should report the cna, but I'm not gonna do that until after a couple more times.

    It's been two weeks since I started 3-11 shift, I must say I only eat lunch. I don't have time to take breaks or eat snacks at work. I know it's not good but I try to do everything in time. Sucks thing is they deduct meal times out of my shift anyways.
  9. 0
    I'm a new nurse also. You sound just like me. It does get better. I work 2-1030, but they changed hours due to low census and I work 3-1030. It was rough today, but I got everything done and was actually out on time. You'll get your own grove. I found out that for myself, doing treatments before I start med pass helps a great deal. No one likes getting their dressing changed at 2200 or later.

    Some CNAs will take advantage of you. Give them a courtesy now and state that you are giving them a courtesy about their behavior or whatever it is they are doing wrong, but the next time it occurs they will get disciplined. It's better to be firm now, than trying to at a later date and they don't take you seriously. I'm sort of experiencing that now. I've been at my job for almost five months.

    As for talking to MDs, my facility uses SBAR, situation background assessment and recommendation. It helps a great deal. You're organized. Just be aware, you are going to run across the occasional grumpy MD, don't take it personal.

    Good luck! Hang in there, it does get better!!
  10. 0
    Hi everyone with kind words and encouragement and stories. I just wanted to update you all how it goes. So today is my last day of my 90 days probation. DON called me to come early yesterday to see her. But when I came in she left already; she left the letter of separation for the unit manager to give to me. I was indeed in shocked and tears. I couldn't control myself bc this is quite unexpected. Don should have mentioned it was bad news or something so I can come prepared. Sigh. All it says was "unsatisfactory performance", I really want to know exactly what I've done wrong or not good enough. They knew I'm a new nurse. And I've gotten better and faster, I see improvements. I mean it's all a process of learning. There are 10 years experienced nurse who makes mistakes or behind some days too. Especially when nurses called out and only 2 nurses on the floor taking care of 60 pts on rehab floor.

    I was quite happy how unit manager tried to help me finding me another job and have me her info. Another nurse also called to talk to the don on my behalf. I felt blessed, because I know I've done the right things for people to look after me like that. And the only reason I was upset is having to leave those people. The sweet patients who gets super happy when they see me, I didn't even get a chance to say good bye.

    Overall I've learned a lot! I am also now IV certified. I got better talking to MD's. It was a great experience. But I just don't know where else would I be next? Am I really not a good nurse in the geriatric field? I really wanted to call the don and ask bc I want to learn from my mistakes but the unit manager said no. :/

    I really had longterm plans for the facility. Going back to school to get my RN while working there, and will continue to work there with my RN! And continue to get my masters and above, and still work in that facility. But now my dream is all over. I'm not sure if I'm in denial right now or depression. I don't know how to tell my mom. I just don't want her to be sad for me. Looking for school is quite stressful as well. Having to look for a good school that's less competitive. Bridge lpn to rn? associate degree of nursing? or bsn? Ayahhh wish me luck everyone!
  11. 0
    Wow, that stinks! Very unprofessional of the DON to be a no-show at the meeting she requested with you. Having never been in your position, I don't have a lot of direction or advice to give you but to hang in there & keep working toward those goals. It's good to hear that you have 2 potential recommendations from the manager & co-worker (you did ask them if you could use their names on future applications, yes?).

    Also, it sounds as though you are being very positive, ie self-evaluating your new skills & realizing that the last 90 days was not a complete waste. As far as telling your mom, family, friends... just tell what happened, straight to the point like you did here. Try not to let it get you down for too long.

    Best of luck to you!
  12. 0
    I'm so sorry to hire of your termination....but from what I read....it looks like its their loss...if you keep ur attitude and willingness to learn will be an asset anywhere

    Sent from my iPhone using allnurses.com


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