Good evening. New Here! 1st job outta school, no training, and feel I should escape

Nurses LPN/LVN

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Good evening fellow LPN's. First post - but hoping for some advice.

As my first nursing job - I nabbed a position not too far from the house. I was told I would have 4 days orientation, but then a day disappeared. It actually turned out to be a day of training with all the interruptions in our training. Now I have been thrown out on the floor. I am on nights, so I am "trying" to do the med pass. But the "other nurse will be there [too]" that I was promised, has decided she is too busy texting and gabbing to answer any questions. I am scared with my lack of training and support that I will make a mistake on the meds and of course, things won't be able to get done in time. Also, they don't even identify which patients need crushed and there is no way of identifying the patients, except ask CNA's or go on the patient's word, but they are impaired. I am only very part time, so I am not there enough to learn them. I was hoping it would get better, and I am sure it would in time, but - I am afraid of what will happen in the meantime. I have been offered another position, but the place has a bad reputation (just like the one I am at), but they have promised four weeks of orientation, and evening hours (no med pass except narcs). So WWYD?

Good evening fellow LPN's. First post - but hoping for some advice.

As my first nursing job - I nabbed a position not too far from the house. I was told I would have 4 days orientation, but then a day disappeared. It actually turned out to be a day of training with all the interruptions in our training. Now I have been thrown out on the floor. I am on nights, so I am "trying" to do the med pass. But the "other nurse will be there [too]" that I was promised, has decided she is too busy texting and gabbing to answer any questions. I am scared with my lack of training and support that I will make a mistake on the meds and of course, things won't be able to get done in time. Also, they don't even identify which patients need crushed and there is no way of identifying the patients, except ask CNA's or go on the patient's word, but they are impaired. I am only very part time, so I am not there enough to learn them. I was hoping it would get better, and I am sure it would in time, but - I am afraid of what will happen in the meantime. I have been offered another position, but the place has a bad reputation (just like the one I am at), but they have promised four weeks of orientation, and evening hours (no med pass except narcs). So WWYD?

I dont know about your facility or the floor your on but the med pass should not be that significant. My suggestion get there early go through the mars and tars and flag everything you need to pass/tx.'s you need to do, also start a little early if you can do what you got to do just be safe about it. The bigger issue with a new grad on overnights is that you are probably supposed to be check all the new orders for mistakes and check monthly renewals for mistakes, thats what most new grads struggle with the most the paper work. Also if your facility is SBAR interact II use it (most facilities are).

SBAR

http://interact2.net/tools.html

The SBAR flow sheets and symptoms pages will let you know what is crucial and requires immediate action and a call to the doctor overnight/ transfer to hospital.

Take your time with the paper work learn how to get the labs ready on computer (if you have on) and if the computer is down (if needed).

Good luck to you, it'll get easier.

It is overwhelming but each day it will get a little (a real little ) easier. Come in early and ask the previous nurse about how pts take their meds (crush/whole, apple sauce/pudding, etc. Accept that you cant do it all. Prioritize and make sure you have bs and insulin done. If you dont know how to fill something out, look in the chart (nurse notes, lab refill forms, medicare sheets, etc) and look at how they did it. If no nurse is helpful, call your supervisor amd arrange an appointment to sit with her and get all your questions answered. Good luck! Id try to stick with the place your at because wherever you go, itll be hard in the beginning. Relax, deep breaths- you are new and its alot to take in. Just remember, you can do this. People do it every day. Let us know how it goes!

May I suggest speaking with the DON and shift supervisor about your concerns? They can't fix it if they don't know what the issues are. When you are new you do need a good solid training. I agree with the other posts as well.

You have had some great suggestions! I would just like to repeat what roxjerseygirl suggested. I think you need to make an appointment with your supervisor or DON (preferably supervisor because it's important to follow the chain of command) and tell him/her that you don't feel that your training is adequate and your afraid of making a grave mistake. Ask them for at least 3 more days. If they don't grant you that, then I would leave. Your license is at risk every time you step out onto any floor. Of course you aren't going to have confidence in the beginning. It comes with experience. It sounds like the facility is problematic if a nurse doesn't know who's pills to crush and no way of identifying a patient except to ask a CNA. What happens if the CNA tells you this is MR BIG and it really isn't...could be an honest mistake. That honest mistake could leave you being sued because he died from an allergy to a medication you gave him. Okay, yes that was a worst case scenario but it could happen.

I need advice on paper work to handle new admissions

I really appreciate it. I get cut short everytime I try to talk to the DON. I feel that I am expected to do and know it all. I like the idea of trying to talk to her again. The other job is full time though and this one is only pt which again doesn't help me learn the patients.

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