First day on your own?

There has been a lot of good advice give already (ask the other shift about the way they take pills etc.)

I am just going to add that I do NOT suggest getting into the habit of pre-pouring. Not a good thing to do at all...I would rather have medications given a little later than the hour window if necessary (especially if the order is for a once a day med) than to pre-pour and accidentally make a total error where a whole cup goes to the wrong patient. Not a good habit...

And don't forget to check name bands religiously until you get the hang of who the residents are. And even check after you think you know who they are!

Also, as far as who takes their pills what way...look at their diet and fluid consistency and go from there. Crushed and non-crushed...unless you have a cheat sheet, sometimes finding that out is trial and error! :S

but is this really how it is? YES

Does something just click one day and then you are able to do it? YES

I'm freaking out over here! NORMAL

Here's my tip: Talk to the CNA's before med pass and ask them to bring you the diabetics prior to mealtime. Mine are all on wheels and have to be brought to the dining room. Then, duck into an empty room and accucheck/insulin/pills.

but is this really how it is? YES

Does something just click one day and then you are able to do it? YES

I'm freaking out over here! NORMAL

Here's my tip: Talk to the CNA's before med pass and ask them to bring you the diabetics prior to mealtime. Mine are all on wheels and have to be brought to the dining room. Then, duck into an empty room and accucheck/insulin/pills.

I like this idea. I did this one day when I was horribly behind due to the usual crazy 2 hours before dinner and continuous interruptions. So I had a CNA bring out the residents who needed a fingerstick.. lined them all in the hallway and I got it done in about 5 minutes.

Also have a list of the residents and room numbers and use that as your report sheet. Some places don't use report sheets if not develop your own. Make a blank one with the room numbers or just something to write the pt name. diabetic Yes/NO, etc. other notes.

I had one place that didn't use report sheets- I guess they assumed everyone to just know and memorize what happened in the course of a day. What I did was grab a piece of note book paper (I had learned ahead of time when I came early) that I always carry in my bag- since you never know when you will need paper...

What I did was quickly write the room numbers then after each one I wrote down- Patient's name. Then I added this info with blanks where I could write yes or no-

Diabetic (fingerstick times also)-

Vitals (do they just need heartrate, full vitals, blood pressure, oxygen saturation, or none- so I can look ahead of time)-

Pills (whole, crushed, applesauce, pudding. I've learned some that are regular diet may have a hard time swallowing pills without it being in pudding. I acutally have one- she is regular diet, has no problem with food but takes her pills whole in pudding for ease)-

Ect. (this part was for the regular report info, or any extra questions I had about the patient)

At our place, all residents have their picture in the MAR. Under their picture, special instructions are written....crushed, whole, thickened, etc. Saves a LOT of time.

at our place, all residents have their picture in the mar. under their picture, special instructions are written....crushed, whole, thickened, etc. saves a lot of time.

that's a fabulous idea!

At our place, all residents have their picture in the MAR. Under their picture, special instructions are written....crushed, whole, thickened, etc. Saves a LOT of time.

Maaaan I wish ours had that. It would make it sooo much easier. Granted at the bottom of the MARS we have the diet type. But that's it. But it would be amazing to have their pictures with all of the instructions- especially how they take meds!

I'm desparately trying to get into nursing school an running into road blocks. What I'm reading hear is very discouraging is this what nursing is really like?

Yes, the pictures with each MAR along with special instructions allows everyone to stay organized and our residents to receive safe care. Works great for new staff too because they have a visual of each person. The pics are updated regularly if and when the resident's features change.

everyones advice is greatly appreciated! i'm feeling slightly more confident. tomorrow will be my second day on my own, but it should be a little bit better because now I know what to expect and there will also be a charge nurse with me on the unit :) the pictures and how they take meds on the MAR sounds sooo helpful. one of my main problems is not knowing who is who, and if or not they can take their meds whole or need them crushed and put in applesauce or pudding or with juice or water or whatever. i've seen a few pictures of residents on our MARS. But these pictures were SO outdates they threw me off even more, because then I was doing a double take because the resident looks NOTHING like they did in their picture from 10-15+ years ago.

i am going to try my best to organize myself for tomorrow and get through my med pass (no matter how long it take me) without freaking out or wanting to break down. i can't explain it but when i'm in the situation it just feels SO overwhelming, when there are a million things that need to be done and it's all you. i can't thank you all enough for your advice, you can believe that i have went through every single post and have written down everyone's ideas and i'm going to incorporate as much as i can to get me through this weekend!