my first day off orientation.. vent

[nursiemellie]

i started working at my mom's nursing home about a week ago. I had about 6 days of orientation, 5 days doing the 7-3, then 1 night doing 11-7. and today, i got thrown into 3-11, and didn't really know how things went on that shift.

it took me forever to count narcs, i don't want to miscount something and be in trouble for it. i didn't even verbally recieve the report from the previous nurse bc pts were already on my back asking for their meds. there were 39 pts on the floor, the most being 40. i started meds at around 430, trying to do the fingersticks before the residents ate their lunch, and it was really difficult, since i don't know them and what the routine was. i started at 3, and got out at 2am, i couldn't believe it. some meds i ended up skipping over (supplements), i was giving 5pm meds with the 9p and 10ps! and hearing all of them yelling "nurse nurse nurse, my pinky toe hurts, she said she wants me to die nurse nurse nurse" all day long drove me crazyyy. at 10pm i was still doing meds, and had a whole other half of the unit to go! since the next shift was going to come in, i decided to break from the meds and quickly right up the daily reports for the oncoming nurse. after that, we still have to document that on the nurses notes, but i just went to continue the meds. thankfully almost everyone at the facility knows my mom and is on good terms with her, so everyone there has been so helpful. my mom was working 11-7 so she stopped by my floor to see how i was doing, and ended up helping me finish passing meds and writing my notes for me. the nurses aides were really good as well. my knees and feet were, and still, are screaming! i didnt eat anything for the past 8 hours, nor drank anything. i feel like textbook nursing doesn't really exist based on my experience, i feel like shortcuts are necessary to get things done, i know i didn't give each resident every single pill that was prescribed. i felt like asking the CNAs to pass meds for me bc i felt like i was drowning. i know this is all a learning experience, and it will only get better with time. i wouldn't say it was a disaster, but the meds were so time consuming it was unbelievable. next time i'm working is tomorrow night 11-7, and my mom will be there also on a different floor so anything that i'm not sure about i can ask her, and that makes me feel more comfortable. plus, the night is quieter and gives u more time for paperwork.

just wanted to tell everyone how my first day went. the 7-3 nurse was a fellow orientee who was on his own today also, and when i asked him how it was, he gave me the look of death and i didn't believe him.. but now i do!

[TheCommuter, BSN, RN]

I'm sorry that your first day off orientation went poorly. Hang in there and remain strong!

In order to survive at a nursing home with high patient loads, you are going to need to adopt a behavior toward your residents that I like to call "compassionate assertion." In other words, you will show the residents that you care about them while, at the same time, you'll gently tell them, "No."

For example, I saw that residents were approaching you during your med pass with nonstop requests for pain pills. With 40 patients, they will unfortunately need to wait. Gently remind them, "I have 40 patients to give routine medications to, but once I'm done, I'll get to your pain pill." Some residents will be annoyed by this, but you gotta do what you've gotta do. Basically, you need to finish your routine meds before you even think about giving out PRNs. Whenever someone makes a PRN med request, you write it down on a notepad so you won't forget.

[lpnQT25]

Wow.. thanks for the helpful info.. I recently gave up a prn N.H. job because of this same grief! My situation never got better due to the prn status. I think I was so worried about pleasing & txing each patient .. instead of prioritizing them.... I work in acute care and my 6-8 acute needy patients are enough for me! I will keep your advice in mind if I ever go back to long term..

[caliotter3]

The Commuter gives good advice about not letting your med pass be interrupted. Eventually, most of the residents will learn not to ask for PRNs during your med pass. Just keep with it. It will get better, a little bit at a time.

[nursiemellie]

thanks a lot everyone for your input. my 2nd day off orientation i did 11-7 and it was MUCH better. i even got out before my mom did . i think i like the night shift way better compared to that 3-11 i had! i keep telling myself that it will get better, because i know it will, and i'm just learning the ropes now but soon i'll be like a pro lolz. thanks again!

[MsLady06]

Thx for posting your story. Mostly everyones first day is horrible. On my first day I came home and fell in bed LITTERALLY. My mom was asking me to somethings and I couldnt respond I was so tired. Now I'm used to it so I work 3-11 and do OT 11-7. Sometimes it can still be hectic...but some days go better than others. Atleast you got your mom around...my mom is a nurse too but refuses to let me work @ her job lol

[medchick]

I work on a NICU and my first day off orientation they gave me the sickest baby in the place. Was getting dopamine and dobutamine. No urine output. Third spacing like crazy. She was a transfer from another hospital and when the NNP called to check on her she was very shocked that the baby even made it through the transport. She is still alive but may not be for much longer (very sad situation).

[NurseElaine]

I will also be starting my first day of orientation this week. I've been around SNFs for a while so I am prepared for just about anything as far as "orientations" go:rolleyes:. I am however, going in with a good attitude and plan to make the best of it. Sorry, your first day didn't go so well, hang in there!!

[changeofpaceRN]

Wow, well, try to hang in there! Everyone keeps telling me it get's easier (which I have yet to see a slight improvement). Can you specify what shift you want to work? I'm still on orientation and they are giving me 6 weeks thank goodness. That's why I'm glad to have this board so you can vent to people who understand. I try to talk to my family about my day and they just don't get it. This is why I wanted to work the 11-7 shift so I can get my feet wet before I'm thrown to the wolves! Good luck!

[BigB]

Hang in there...I have seen LVN quit after two days of orientation at bad LTC facilities.

[nursiemellie]

i thought i wanted the 7-3 shift, because that's when i feel i'm more alert and i'm a day person. but after that 3-11, i'm SO glad i haven't done 7-3 lolz. because it would have been much busier. my schedule for this and next week is still 11-7. i like it. i feel its a good way to get familiar with the paperwork and the routine of things because it's quiet and you can sit down lolz.