First RN position

[nursephillyphil, BSN, RN]

Hi everybody,

This coming Monday I begin orientation for my first job at an acute care/rehab facility as an RN. I am a mix of excited, anxious and nervous. I know this is what I have been training for since my first semester of clinicals at school. I found out majority of the patients i will be with are elderly, so I have an idea of the types of meds I will be giving. however I also found out that I will be responsible for 20 patients, I will also be doing lots of wound care (apparently we get a lot of transfers from a local hospital and there are a lot of stage 3 pressure ulcers), central lines. How did many of you handle this kind of patient load? I know we have to do morning and afternoon med passes and according to nurses there, they don't finish morning med passes until lunch sometimes, and end up staying several hours post shift to finish charting.

Any tips regarding to help me would be greatly appreciated, but i am not looking to cut corners. thanks!

[Jmira.BSN.RN]

Congrats on the job!

[nursephillyphil, BSN, RN]

thanks jmira! still waiting on any advice from members haha

[HouTx, BSN, MSN, EdD]

Sounds like teamwork will be the key to success in your new job. Delegating effectively to your CNAs will ensure that you have more time for the 'nurse only' stuff you have to accomplish each shift. Whatever you do, make sure that you do not work 'off the clock' to finish up after your shift.

Best of luck!

[Ruby Vee, BSN]

Congratulations on your first job! Keep in mind that the first year of nursing is miserable, and no, you won't be alone when you leave your workplace wishing never to return. The only way to get through that first miserable year is to just GO through it. At first you're going to feel absolutely incompetent, but as the year progresses you will learn so much. And one day, the day will come when you realize that you Do have the knowledge and skills for this! (And then, five minutes later, you'll feel incompetent again.) Gradually, the feelings of competence will come more often and last longer.

I would echo the comment about teamwork. Get to know your CNAs. Chat with them now and again, even though you're positive you don't have the time for that. A few minutes spent chatting with your CNAs at the beginning will enhance your working relationship and save you hours later when you don't have to hunt them down in their latest hiding place. When you can, explain to them why you need them to do A, B or C rather than just doing it yourself. Some CNAs are motivated by understanding how their small contribution (getting a glucose check) or enormous one (cleaning up poop from a formerly constipated finger painter) is helping the patient or is taking an enormous load off your shoulders. Delegate but follow up -- make sure you the job gets done and done correctly.

Keep a small notebook in your pocket, or a list on your smartphone or whatever of the drugs that you give. Then look them up when you go home. I had drug cards on 3 x 5 cards, but technology has more options now. At first, you won't know hardly any of the drugs, so make a shorter list of the five most common that you have to give and look them up. The next day, look up five more. And so on. Before you know it, you'll KNOW those drugs you're giving, and when someone springs a new one on you it will take just a minute or two to look that one up.

Never forget that you're working with PEOPLE. People are wonderful and horrible -- sometimes the same people at the same time. When patients are rude, belligerent or manipulative, it's rarely about you. Ditto with families and co-workers. Look for the good in everyone you encounter, and you're far more likely to find it.

And please change your avatar. One of these days you're going to say something thoughtless, rude or controversial on this forum, and you don't want to be so easily identified that your boss can confront you about your posts. Or your CNA, who you've just ripped to shreds in a vent post.