New nurse blues!

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Specializes in SN, LTC, REHAB, HH.

I'm currently working the night shift at a rehab and long term care facility. on top of being sooo tired every night from lack of sleep; i feel that i'm not giving the best of care to my residents. i feel so lost. the report on my residents that i get is very scanty. when i come on i have to wait awhile until the nurse gets done with her work and when she finally does its like almost an hour later when i get report. getting report on patients in long term care is very different from acute care. no one tells me their admitting diagnosis. it makes me scared that i don't know these things. it takes me forever to look into their charts to get information. things are so chaotic i feel that i'm missing something or forgot to do something. i'm always asking questions. when i'm reporting off to more experienced nurses i feel like a complete idiot when they ask me about labs, meds, appointments etc..

I don't quite have a routine yet. can someone please tell me how to get it together so i can stop wondering if i'm cut out to be a nurse. :crying2:

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It takes a long time to develop a routine. I would, however, ask the offgoing nurse to give you report before she finishes her charting so that you can get going.

And hang in there. It'll come.

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Specializes in Trauma Surgical ICU.

I am on a renal floor at a large hospital and most nights I feel just as lost and wonder if I made the right decision to enter nursing. I love the patients and doing what I can for them but I don't care for the rest or the politics. The never ending list of non nursing duties etc is taking away from pt care. They say in time we will get it down. And there are days I have everything together but they are far and few. Just wanted you to know, you are not alone..

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Specializes in SN, LTC, REHAB, HH.

I'm trying so hard to hang in. a couple of the evening nurses are always getting off late because they are so behind. i didn't think it would be this bad in long term care especially on the night shift.

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Specializes in SN, LTC, REHAB, HH.

You know exactly what i'm going through. alot of things don't get passed on where i work and this makes it even worse. for the night shift i stay pretty busy for the first few hours. there are meds, iv antibiotics to give, tube feeders, and to top it off we do our own treatments! i just feel so sorry to have to go and wake these poor people up to give pain meds when they arent in pain and it should be prn. then a few hours later i'm back to do their treatment. its ridiculous.

my comment is in response to Sun0408

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Specializes in Home Health, Nursing Education.

Since it is LTC, can you make yourself a print out cheat sheat/brains that includes room for pts info... like admitting diagnosis, etc that you can fill into your print out. And then make copies of every shift. This way when she mentions a certain pt, you can follow her on your list and see that info for yourself.

I suggest this because since it is LTC, I am guessing that the patients do not change from day to day as quickly as they will in a hospital. This cheat sheet could be the organizer for you to write stuff on during report. And she DOES need to be giving you report when your shift STARTS. Not just before she leaves.

After awhile, you just may memorize some of the pts diagnosis, and then get to know the pts enough to just add new facts to your personal knowledge of them.

Of course I could be way off, here. In any event, I must organize on paper otherwise I go batty. And following someone else's cheat sheets do not help me as much as jotting out my own. Search on the search box at the top of the page for Report Sheet. Mayby people have shared their personal ones. You may need to keep yours in a binder. :)

Let us know what you come up with! :) Good luck. It is hard adjusting and finding that routine.... :uhoh3:

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Specializes in Trauma Surgical ICU.

OP, the other night I sat down for the first time at 2 am. Monday night I did not get out of shift report until 8:45pm. So that put me so behind that I was still giving 9pm meds at midnight. I had 2 DNRs and one of which had a cell phone to wake her up every time one of her 5 pain meds was due. I had several dressing changes, iv's to change, a transfer coming in, two going to hemo, two going to surgery that I had to get all the paperwork for and 3 total cares. Did I mention the confused pt that was knocking on another pts door about a bracelet or the number of times he kept asking me where his room was. This did not bother me, the part that did was when I was still charting at 8 am the next morning after giving report the charge nurse was tapping the clock because I was still there.. We will get better able to handle this and better able to manage out time for the most part LOL.. No matter what tho, there will be those kinds of days. I ask for help, I ask questions, as well as tips from the other nurses. We just need more time and experience to get it all down.. Hugs to you

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I work 3-11, when the 11-7 nurse comes in, I stop whatever I am doing (providing it isn't Res. care) and give her report, hand her the keys and count narcs. I go thru each Res. 1 by 1, I try to inform her of any change in condition, any medication or order changes, any new behaviors, HS Blood sugars, if HS snacks were refused. If any laxatives were given, when last PRN med was given. (This gives a good pic of what to be on the lookout for)

I also tell her any abnormal labs, any early appts that I am aware of, if someone needs a ua or ss that I was unable to obtain, if I changed a foley, when last tube feeding was hung.

I have 30 Res. and to give this info and count the narcs, takes less then 10 minutes.

I do this first because #1 it is rude to make her wait and get behind, and #2 if something happens, while I am finishing up paperwork, I want her to be aware if it was expected or not.

When you get report don't be afraid to ask questions yourself. If you knew that Mr. Jones was going to have labs drawn that day, ask about the results. If Mrs. Smith is known to have BS that drop during the night, ask if she had her HS snack. COMMUNICATE... It makes your job much easier :)

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Specializes in SN, LTC, REHAB, HH.
I work 3-11, when the 11-7 nurse comes in, I stop whatever I am doing (providing it isn't Res. care) and give her report, hand her the keys and count narcs. I go thru each Res. 1 by 1, I try to inform her of any change in condition, any medication or order changes, any new behaviors, HS Blood sugars, if HS snacks were refused. If any laxatives were given, when last PRN med was given. (This gives a good pic of what to be on the lookout for)

I also tell her any abnormal labs, any early appts that I am aware of, if someone needs a ua or ss that I was unable to obtain, if I changed a foley, when last tube feeding was hung.

I have 30 Res. and to give this info and count the narcs, takes less then 10 minutes.

I do this first because #1 it is rude to make her wait and get behind, and #2 if something happens, while I am finishing up paperwork, I want her to be aware if it was expected or not.

When you get report don't be afraid to ask questions yourself. If you knew that Mr. Jones was going to have labs drawn that day, ask about the results. If Mrs. Smith is known to have BS that drop during the night, ask if she had her HS snack. COMMUNICATE... It makes your job much easier :)

Thank you, thank you, thank you for your help. this gives me a good start on how to report and what i should be looking for. :thankya:

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Specializes in SN, LTC, REHAB, HH.
OP, the other night I sat down for the first time at 2 am. Monday night I did not get out of shift report until 8:45pm. So that put me so behind that I was still giving 9pm meds at midnight. I had 2 DNRs and one of which had a cell phone to wake her up every time one of her 5 pain meds was due. I had several dressing changes, iv's to change, a transfer coming in, two going to hemo, two going to surgery that I had to get all the paperwork for and 3 total cares. Did I mention the confused pt that was knocking on another pts door about a bracelet or the number of times he kept asking me where his room was. This did not bother me, the part that did was when I was still charting at 8 am the next morning after giving report the charge nurse was tapping the clock because I was still there.. We will get better able to handle this and better able to manage out time for the most part LOL.. No matter what tho, there will be those kinds of days. I ask for help, I ask questions, as well as tips from the other nurses. We just need more time and experience to get it all down.. Hugs to you

Sun, last week i didn't clock out until 8:50 am! i was so behind and very tired. i just wanted to cry. OMG i feel your pain. LOL, we will get through this. :)

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Just one more tidbit.... Don't be afraid to utilize your CNAs... Alot of times things get reported to them from the 3-11 CNAs, that the nurse may forget to tell you. Mr. Jones had 5 bms. Or Mrs. Smith was talking to her dead husband all evening. Grandma is getting harder and harder to transfer, think we may need to talk to the charge nurse about using the set to stand lift on her.... You never know, they may be getting a better report then you are. Ask them if any sig. changes/info were reported to them.... You might be amazed at what you find out.

Keep your chin up

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Specializes in SN, LTC, REHAB, HH.

Another good tip, thank you. a lot of times i don't get to talk with the cna's i work with about pt. care. i worked with a wonderful cna the other night and she was on top of everything. she reported abnormal vs instead of just charting them and walking away. before she left she gave me a quick report.

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