Hello...I am an LPN and have recently re-activated my 10 year+ inactive license. I was able to do the clinical aspect of my re-activation/skills check list at a nursing facility close to my home. Needless to say it has been quite an undertaking refreshing my skills, and trying to learn the new meds out there...but I am vigilant and eager to be the best nurse I can be. My license is now active, and I am eager to work. The facility that I trained in is quite a busy place, there are 2 halls of long term residents, and then those post surgery, and admitted temporarily for PT, and post Op care. In doing my orientation I have spent time on both halls, one of which was literally more than I could handle. (I admit this with great humbleness, as I really thought I had what it takes to be a task oriented, caring, organized, observant, "get'er done" type of a person.) I found myself to tears in a moment I grabbed alone in the bathroom. It was just so much...so fast! One wing of the facility has 45 beds, all of which the charge nurse is responsible for. I have observed/shadowed several of the staff during my clinical time, and my orientation time, and they seem to be able to handle the load. (some do run over the shift to chart, much to the shigrin of the admin.) My question is...how does a new nurse with visions of Florence Nightingale, and wanting to be the best nurse she can, manage such a load as 45 patients? What time saving techniques could help me? In a single day shift there is the 8:00am med pass (VERY HEAVY), and then the 10:00am treatments (eye drops, ect.) then the 11:00 am accu checks and insulins, then the 12:00 Noon Med pass, then heavy MDS, and ABT charting, and faxes/labs/orders/POA calls, Dr. visits, ect... to answer to, then the 2:00pm med pass (neb tx's, G/T flushes, straight cath's, ect...) I never sat down. I went as fast as I could (using caution in passing the meds), and yet there was NO WAY I could even get to the charting till what was my scheduled time to leave. (I need to note admin is NOT wanting ANY to work over there scheduled time. Quite labor conscious in these times.) I felt like a failure, and did not handle the pressure of that work load well at all, and I am a confident person. Did I mention I was shadowed by the ADON? How do you manage your time? Are there shortcuts I didn't do? Is a 45 person patient Load a normal load in nursing homes? I feel so inadequate, and "green", and yet as I said I went full bore. I did not feel I gave very good care, or observation to those people, but rather I was task oriented ALL day long, and still didn't get to the work I needed to get too. (ADON did much of my charting). Also, in MDS charting how can a facility like this expect a "new" nurse to chart on the residents that she knows virtually nothing about, save for maybe there room number (maybe)? I was not the nurse I want to be in this environment...I had no time to smile, and ask them how they were feeling. I was simply doing the "work", and even then I fell short. I love being a nurse, and I genuinely care for those people, but how do you balance it all? I need to add that I did 100 hours clinicals with the facility, (just on skills however, never in the med cart). My orientation has been 2 days, on both wings. My initial orientation was the same however, after my first day passing meds, missing many in the time allowed, and my obvious slowness...the ADON appologized to me. She never realized this was my first time in the cart. She was angry at staff, but I didn't realize anything was out of the norm for orienting. On what was to be my last and 4th day I spoke to the DON about my not being ready, and feeling very lost. At that point the ADON took over my orientation. The ADON spoke to DON and Admin. and approved 4 more days for me to orient. So I got 2 days in each hall, passing Meds, and conducting myself as the charge nurse. Yesterday (4th day) I was told my orientation was complete. I was also told I was doing myself a disservice by not accepting a Noc shift (sorry, but not interested in 3rd shift), and also by my voicing that I could not at this time accept being a prn charge nurse for this incredibly busy wing, but felt more comfortable at the other.Yes, I now recognize residents faces, and some names, however, I have literally spent 4 days in the med, and treatment carts. Prior to this time I was handed meds to "get to know faces", and told what res. needs what treatments, and given the meds/supplies. Is there a standard time for orientation into a facility? How can this place possibly think 4 days is enough? They want me PRN, but how can I keep up my learning when I have only had this limted exposure? Should I just skip this facility all together? Was this perhaps a test I failed? In accepting a position as prn is it within my rights to ask for more orientation?