new grad drowning.. seeking advice

[guest1054874]

Hey y'all, i'm an LPN, new grad, new hire, first job in a LTC facility. The facility is nice compared to stories i've heard of other places I could have ended up and had job offers at. I got a lengthy month long orientation with the option to take more time if I needed which I took advantage of. I'm working nights and weekends. I have been here about 2 and a half months and a month I have been on my own basically floating on different halls. Basically I love this place, love the job, and really want things to work out but sometimes I feel that I might not be cut out for it. The other night I made a med error luckily it wasn't serious but still has me terrified. I was prepping medications for a resident I had not yet met when another resident also a male who I also had not met called me to assess his life vest. When I left the room I continued to prep the other patients medication assuming it was for the patient I had just assessed. I gave the wrong meds to the wrong patient. It was my first med error and the incident has left me horrified. I am lucky he experienced no adverse reactions, the doctor, family, and management were notified and luckily were all kind and forgiving of the situation. I have anxiety and I get overwhelmed and I think it clouded my judgement. I'm hoping it will be an incident that scared me enough to avoid ever happening again. Other than that I am basically drowning every night. We have a decent nurse to patient ratio, I am responsible for meds and treatments for about 15-20 patients and at 10pm I am responsible for meds only for another 15-18. It seems every night I am drowning. Meds are almost always late, I am always having to wake patients to complete treatments at all hours of the night. I try to be thorough and I never take shortcuts or chart something I didn't do. I have a feeling a lot of other nurses check the box that small routine treatments are done when they are not but I won't. It seems I am running for the first 8 hours of my shift and don't catch a break to chart assessments and event until my shift is close to ending. I am writing to ask for advice from more experienced nurses. Did completing med pass and treatments on time come with experience? Any tips for avoiding med errors? When to notify doctor and family? How to avoid getting fired or written up? I am mostly quiet kind of shy and anxious, I also look really young for my age so patients sometime assume i'm incompetent or inexperienced. Which I am but we all have to start somewhere. Everyone tells me I am doing a good job but I feel overwhelmed. I don't know a lot of the meds I am giving, indications, interactions etc.. I'm not sure when to notify family and doctors of a patients condition. How do I know of a change in condition if I am unfamiliar with the patient. I am lucky we have seasoned nurses on night shift who are always willing to help and answer questions. This feels like a dream job and I want to keep it. Just looking for advice. Thanks for the work you guys are doing. Y'all are saints. Allnurses has there for me during school and reading others experiences has given me a lot of perspective and helped me on my journey. I figure i'd put myself out there and contribute to the conversation.

[Elektra6, ASN, BSN, RN]

This sounds like a good place. When you learn the residents you will find shortcuts to make it easier. I don't mean dangerous shortcuts, just you will learn who is a night owl and do them last or who goes to bed at 7pm. Helpful nurses are a blessing. Ask to observe any procedures you are not familiar with. At my place we had a book where you could log in small things the drs need to address without calling them constantly (things like itchy skin, med time change or family wants to talk to dr). You will probably get to know the drs too which is a help. Do not be afraid to call them if you need them. Use your nursing judgment when to call and bounce it off your supervisor or charge, you will get it. It does get easier. I promise.

["nursy", RN]

Two and a half months is nowhere near long enough to learn everything you need to know to function as smoothly as a more experienced nurse. You've started in a new place, had to learn about how the unit functions, learn about the residents, the staff, the providers, resident' families, the routines, etc. New meds, procedures, medical conditions. You have to develop routines and short cuts. Whew, I'm exhausted just listing everything. I'd estimate a 6 month time frame before you begin to feel semi comfortable, and at least a year before you feel like "Ahh..I got this!" And even then you will continue learning new ways of being efficient and a better nurse. And you will continue learning for the rest of your career. Give yourself a break...you WILL get there!