first two days off orientation.... doubting my readiness

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I am a brand new Grad, no experience in Nursing. First job in LTC. Had 3 weeks of orientation with 5 different people on two different wings... I don't know if it's considered orientation or training, just kind of followed them around for the day. My first day off of orientation I did the med pass. Of course It took me alot longer than everyone else but I wasn't worried about speed. I just wanted to do it correctly. The next day I came in I was told I forgot to initial alot of the meds. I know I gave them all, I think I just wasn't being consistent with when I was initialing sometimes when I popped the pill and other times after I gave them all to the patient. I know now that I have to have a system and stick with it and do it the same way everytime.

Next day on another wing, I was doing desk and treatments. (There was another nurse on the floor with me doing meds) I felt lost all day like I didn't know what to do next. Its hard being in charge of CNAs that have been there 10 years longer than you have and being in charge of 24 residents you know nothing about. I started doing the treatments (some dressing changes that I have never done before) stopped to take lunch. Came back two doctors came in ( I was clueless about the two patients) I felt so stupid in front of the doctors not knowing what I was suppose to do. After that one of the residents got into a little confrontation with another. wasn't sure how to handle that...

When I got home in bed I had a panic attack because it dawned on me that I'm not even sure if I finished all my treatments!! Today before I go in I am suppose to go into the DON and tell her how comfortable I feel. ( havent talked to her at all since the first day on the job) I don't know if I need more orientation or just need to to the job and learn as I go. ( everyone says they didn't get much orientation at all, they are surprised i got 3 weeks) Should I tell her i don't know if I finished treatments or wait till I actually check the book myself before i say something for no reason?

I really like the job and the facility. I don't know if I'm ready or this is normal for new Grad.

Any advice/suggestions?

Thanks Bea

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Specializes in LTC.

First of all, breathe. Long term care is not easy and it will take a while to get a routine. Ask for more orientation and ask lots of questions. That is the only way you will learn. It really does take time. Good luck.

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Where I work new grads have to have a preceptor for 90 days. Alot of people moan and groan about it but I am actually really glad. I don't want to feel totally lost. I started as a tech this last summer and I shadowed another tech for a month. I felt so lost but it finally kicked in. When they finally took away my security (the tech I was following around) I HAD to do it on my own, and if stuff didn't get done it was my butt they were going to chew out. So its good to follow someone. Write down things, ask questions, go over it..so what if they get annoyed. They will forget as soon as your on your own. You can do it, but I would be honest. GL...I will be in your shoes next summer. :)

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Specializes in LTC.

Wow that sounds like me. Don't worry it gets better once you know the residents and the doctors and the facility. And it took me a good 6-9months to get quicker with the medpass.

I am a big believer in signing after you put it in the cup. Especially when you are new and don't know what those little pills look like. If the patient refuses just remember go back..circle your initials and write on the back of the MAR refused.

It takes awhile to get EVERYTHING done that you need to get done in 1 shift. There are some shifts that I'm lucky to finish the meds because we have admissions or orders to be picked up or labs or whatever is going on.

I had trouble getting treatments done. Focus on the major ones.. the ones that need dressing changes. Creams you can give to the CNA. I found it helpful when the treatments were heavy. To do them in the middle of the shift. I wouldn't tell the DON that you didn't do treatments. (There are somethings that happen on the floor..that should stay on the floor). Just tell her whether you feel you are ready to be thrown to the wolves or not.

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Specializes in Peds, School Nurse, clinical instructor.

Relax..this is normal for a new grad. Just take a deep breath and know each day will get better and soon you will have your system down...everything takes time but you will get it. :)

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Specializes in LTC.

Sounds perfectly normal for a new grad..breathe deepily. Sounds like they're working with you and being nice...I've been a nurse for three years and forget to sign all my little holes sometimes...It gets better! Just tell the docs...I'm new! It's not a shame to admit your new..just..don't go for a year and a half and say it

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Specializes in LTC.

i know this is off topic but i was always taught to give meds then initial the little holes

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just curious...it's been a 10 days since your post, how are you feeling now? What are your biggest challenges? Who has been the most helpful? What do you like best about your shift/job, the least? How are you coping with all the new stress? Any tips for others doing the same thing as you? Wishing you all the best in your new career, we need new nurses, don't give up!

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*nola* thanks for asking.... Things are actually going well. I am learning everyday that I work. I am seeing that with Nursing, you can't learn everything on orientation or even in school, it's practice and experience that teaches you how to be a nurse. I am still a little uneasy about making assessments and knowing what to do with abnormal findings. ex. One of the residents had a cough, lung sounds sounded a little coorifice. She had no other symptoms,no temp. I wasn't sure if I should call the doctor or just continue to monitor... There is always another RN on and a RN supervisor, so when ever I have these questions I call her.

I am always nervous about calling the doctors that they are going to ask me something that I have no clue about. But I read the SBAR thread here and try to have all the information I can when I call. Sometimes the families might ask something that I don't know anything about, I just tell them " I am a new nurse here and I'm trying to learn everything I can about the residents, if it's something I don't know, I tell them I will find out for you"

I talked to the DON and told her I was a little nervous about my ability and she told me I was doing fine for a new nurse and that it will come with time and practice and that I'm not expected to know everything, important thing is to ask for advice if I'm not comfortable with something.

So, Every shift I go in I learn a little more. I go home at night and look through my nursing books for things I wasn't sure about that day whether it be medication or proceedure.

I love getting to know the residents, when I have free time I look through thier charts to get to know more about them. I just figure I will always have something to learn... that's what I always loved about nursing to begin with!

So everyone that has these feelings of not being ready need to just give themselves time. Unless they absolutly hate what they are doing then go with your gut instict and make the right decision.

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