First day on floor

For the first month or so working in a similar facility I kept a large legal pad of paper to write down all the important stuff like who needs finger sticks, tube feedings etc. Hopefully your facility has a treatment binder for wound care and creams/ointments. Know what you are responsible for in a shift and plan your duties around that. So a shift from 3-11 would look like this: get report, count narcs, check mar for new orders, make rounds give prns if needed/give scheduled meds, dinner time finger sticks, treatments, charting, MD calls if needed, restock supplies, give report to night nurse. This is really just off the top of my head but that's what it looked like for me.

Block out a general schedule. For me, It went something like this: Report, check for new meds and do the vitals/assessments I needed to do. Then it was to pass the meds scheduled between 4 and 5. My supper break, then the mealtime med pass. Then I may have a few minutes to prepare for treatments and then I do the bedtime med pass along with treatments. When this is done, I am able to do any charting that is needed. I would have a few meds to do at 9 and then it was making sure my work was done for the report to the night nurse at 10. One has to be flexible as there are always things the might interrupt the routine such as falls and change in condition. At my job, you were allowed to stay after your shift, on the clock, to finish paperwork. Whenever I had an evening with something that came up, I would tell myself that between 2 and 10 p.m., my focus was the residents and their needs, paperwork and charting could be done after I hand over the keys to the next nurse.

I agree with previous posters. It may all seem overwhelming at first, but before long, you will know the residents by name, face, and meds so much so that you'll feel that your shift is extraordinarily routine.