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New grad just hired

Welp, I've read almost every relevant thread to what I'm about to post. I'll just set the record straight. I just recently passed my NCLEX in June (California LVN) and got hired 2 days ago at a SNF. It was by a long shot because we all know the whole "requires one year exp" ordeal most employers prefer. I took my NCLEX 5 times. Was awfully discouraging, but my wife and I had a baby and I knew this time was going to be the holy grail attempt and passed it. It has been about 5-6 years since i graduated so bear with me. I am lucky knowing that the DON hooked me up with a job and is giving me 3 weeks to get this going. The last time I ever gave meds through a G-tube, or inserted a foley, give IMs, etc was in school. So my point being is that I'm a bit nervous because I was working as a CNA and a mental health worker around San Diego and my DON during the interview was makin sure that I get it through my head now that I'm licensed. I catch on very quick in practice. Have any of you been in my position as far as not really forgetting your skills? I still remember the whole "determine placement of the g-tube" and "irrigating"... I will be 0700-1530 shift so I will be doing the opening morning med passes. I know im fairly organized, but I was organized in terms of being a CNA LOL. I feel a bit afraid to delegate CNAs too because I once was one too. And I would like to be admired as a licensed to be fair and understanding. But my license is on the line once my background check clears and I'm going to be at it for 3 weeks orientation. What is the typical AM shift like for the common nursing home? I will be in charge of a med-cart for 25 pts in the AM. Thanks guys.

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

What is the typical AM shift like for the common nursing home?
The typical a.m. shift is fast and furious since you'll be passing medications, dealing with two mealtimes (breakfast + lunch), performing wound care, obtaining finger stick blood sugars, covering meals with insulin, administering breathing treatments, charting, and so forth.

sallyrnrrt, ADN, RN

Specializes in critical care, ER,ICU, CVSURG, CCU.

For LTC, your orrientation time is generous....I don't know how many three day orientations I have seen even for new grads. time mgt. will be your saving grace

best wishes

Edited by sallyrnrrt
Sp

Hey guys thanks for the replies I think I have an idea of how that shift is going to be considering I have breakfast and lunch BS checks lol. Insulin coverage left and right.

yes Sally my orientation I'm blessed to say 3 weeks. I've read all over this forum 3-5 days or just a whole week. I'm very lucky but I know I have to give it my all to get my routing down.

Thanks for your replies folks!

Adele_Michal7, ASN, RN

Specializes in Pediatric.

Don't let yourself get overwhelmed. Ask a lot, A LOT, of questions. Write things down. Take your time. Take deep breaths. Bring a pencil bag to work with a few highlighters, scissors, your favorite pens, etc. Get a storage clipboard.

You will get the hang of it! I graduated and passed my NCLEX-PN from April-May and got hired in July at a SNF. The day shift is, well, like a roadrunner. I had to pick up time management skills ASAP! Here is some advice: 1. Your morning priorities should be the insulins, mobile patients (they will take off!), IV check-offs, and continuous feeding/breathing treatments checks as soon as you arrive 0700. 2. Your next priority should be the immobile bolus feedings, immobile meds, treatment checks (wounds, skin, etc..) 0830-1100. 3. Depending on when their lunch comes, if you have over 6 blood sugars to do I would start 15 to 30 minutes earlier! You don't want to have to call the MD for readings over 400 because they get very unreasonable! 4. HOPEFULLY your morning meds are passed then....HA! 5. Do your afternoon med passes/breathing treatments/feedings. 6. Catch up with labs/MD phone calls/orders. 7. RUN to breakroom and wolf down a small sandwich (do not bring huge meals!). 8. Run back, prepare for the first wave of afternoon family coming to harrass you while you stay late charting. :shy: Oh, keep paper to jot down notes in short hand for each patient so charting isn't difficult and you can answer the MD's inevitable questions!

Adele_Michal7, ASN, RN

Specializes in Pediatric.

You will get the hang of it! I graduated and passed my NCLEX-PN from April-May and got hired in July at a SNF. The day shift is, well, like a roadrunner. I had to pick up time management skills ASAP! Here is some advice: 1. Your morning priorities should be the insulins, mobile patients (they will take off!), IV check-offs, and continuous feeding/breathing treatments checks as soon as you arrive 0700. 2. Your next priority should be the immobile bolus feedings, immobile meds, treatment checks (wounds, skin, etc..) 0830-1100. 3. Depending on when their lunch comes, if you have over 6 blood sugars to do I would start 15 to 30 minutes earlier! You don't want to have to call the MD for readings over 400 because they get very unreasonable! 4. HOPEFULLY your morning meds are passed then....HA! 5. Do your afternoon med passes/breathing treatments/feedings. 6. Catch up with labs/MD phone calls/orders. 7. RUN to breakroom and wolf down a small sandwich (do not bring huge meals!). 8. Run back, prepare for the first wave of afternoon family coming to harrass you while you stay late charting. :shy: Oh, keep paper to jot down notes in short hand for each patient so charting isn't difficult and you can answer the MD's inevitable questions!

I couldn't agree more on having paper handy! The times you DONT have paper and a pen handy will be when you're are sitting in front of a phone, about to take a STAT telephone order. Or you'll have a SW/family member/random person in front of you giving you important info that needs to be jotted down for later.

In fact, I actually can't breathe at work unless I have my favorite pen on my body somewhere.

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