new grad in nursing home help!!!

[NurseDR16]

Hello,

I am a new grad nurse and I'm having trouble adjusting to my new job. I took a per diem nursing position at a nursing home and I'm having difficulty with med pass to 45 plus residents. Now because I'm new, I know that I do not know everything and I know that it will take time to adjust to; however, each resident is on 10 plus medications and I fear that there is a high risk for medication error. I am also a float nurse so I do not know who the residents are and how the residents take their medications. I try to go half an hour early before my morning shift but I do not know what floor I'm on until 5 minutes after the shift begins. The nurse manager once sent me to a floor to do med pass, but half an hour into my shift I was sent to another floor with a heavier med pass. I fell behind on most medications and the supervisor just told me to do the best I can.

Also, I have not been trained on passing med during orientation. I had 4 days of orientation and only 2 were one on one with my preceptor. I asked for an extra day because I felt that not everything was covered but it did not seem to help. While working one or two shifts after orientation some LPN's and RN's advised me to cut corners with medications. They said that "even the regulars on the floor do not finish the entire med pass within their shift and they don't know how you are expected to do so".

I feel that for a new nurse it is important where you begin your career and the right orientation is necessary. I am thinking of resigning but I need experience to find another job. I do not know what to do. I have not gone for like three weeks or so and I 'm really scared to go back because I feel like I'm risking my license. Please help me.

[CelticGoddess, BSN, RN]

I started off in LTC and it took me a while to be able to finish my med pass in the window. A lot of patients do have more than 10 meds a piece plus breathing treatments, plus eye drops plus insulin, and on and on an on. It's hard, that is for sure.

You won't lose your license for not passing meds in your time window. Make sure you are safely passing meds. You'll learn the residents (It can take time) and that will help improve your pass. You'll also learn how to speed things up safely. It's sad that you only got 4 days of orientation but that is typical of LTC. I got 3 days. I was precepting after only 3 mos.

Do your best, be safe and go ahead and start looking. If you are only per diem, you have a good reason to put on your applications or when you interview. Don't quit until you know you have something though. And don't burn bridges. Give notice when you quit. It's a small world. Best of luck to you.