First year nurse in skilled facility needs feedback

[LuckyNinja]

I am a graduate RN currently working as a charge nurse in a skilled facility for almost four months. I recently have experienced many shifts or parts of shifts in which I am the only nurse on duty for a census of 35 to 37 patients. One of these shifts I lost a patient, they unexpectedly coded. I handled the situation per protocol and gave them the best chance at survival. However, I have received little support in regards to this experience, which was very upsetting. I was promised a full time schedule when I started. Some weeks I am scheduled for three shifts, some I only have one. I am finding it very difficult to learn on the job training with no resources in the form of other nurses, few regular shifts and very little direct feedback about my performance. Recently the administrator hired another nurse from a sister facility when there was no open position available. About the time their orientation was up, the administrator fired a fellow nurse (who was very competent) and gave the new hire a full time position leaving me with the scraps. The feedback I receive (when I illicit it) is that I'm doing well, but I cannot help fearing for my job and my license. I have little support from my DNS and would like to think that this is not the norm. If anyone can share with me their thoughts, words of encouragement and/or advice, that would be so helpful. I would like to imagine that after the first year it gets better, but I am hopeless at the moment.

[firstinfamily, RN]

Welcome to nursing and AN page!! I have never taken care of that many patients and with over 30 years of nursing, I would not feel comfortable doing so. Do you have nursing aides or LPNs to help you? I am assuming because you are the higher licensed nurse that is why you are the charge nurse? Are you doing all the treatments and medication rounds yourself or do you have a medication aide? If you have a team to work with that should help, you have to delegate tasks to those who can do them. This sounds like a rough start for you, I would ask about the full-time position and why you were not considered for it when you have been there longer, had the other nurse been previously employed at this facility? Do not perform any tasks that you have not been oriented to, even if you think you can do it. The facility has to show that they oriented you, so if they are not doing that they are putting you and themselves at risk. You would put your license at risk if you perform a task without being oriented. Do they have a nurse educator?? If so, use them as your resource person. If not, then it is up to administration to provide you with a resource person to learn from.