New nurse looking for advice

SuesquatchRN, BSN, RN · Dec 2, 2009

How many residents? Meds and treatments? Another nurse? How many aides?

We need more info.

:)

kimima01 · Dec 2, 2009

You have me beat! I, too, am a new nurse working in LTC. I have been on my own for 3 days and I have yet to leave work before 5pm. My shift is 6-2:30!! Although management is very supportive and reassuring, I can't help but feel completely lost and overwhelmed.

1uvakindmom · Dec 2, 2009

Sue -

I have 18 residents, 2 aids. Total, there are 34 residents. 4 aids, 2 nurses, and a unit manager. I have treatments, most are creams to the bum or making sure their geriarms/legs/safety monitors are in place. A few wound changes, but nothing dramatic. Is this enough? Do you need any more info? Thanks so much!

1uvakindmom · Dec 2, 2009

I just feel stupid, too. All these nurses know what they are doing, and I dont even really feel like a nurse yet!

PAERRN20 · Dec 2, 2009

I think 18 residents, 2 aides, and 1 LPN is a wonderful ratio for long term care! Hang in there. It gets better at the 3 month mark, then again at the 6 month mark, and by 1 year you should feel like a real nurse! But trust me- you probably will be lost the first 3 months. Getting out an hour after your shift ends isn't bad for your 2nd day. I know seasoned nurses who can't say that. It sounds like you are doing fine!

DPRN · Dec 2, 2009

You will get quicker after learning your residents. Once you know how each resident takes their meds (all at once, one at a time, crushed, applesauce, etc), you will get quicker! Please be patient.

LALVA115 · Dec 2, 2009

Hi! I am a new nurse, working my first job ever as a nurse. I am a LPN working on an Alzheimer's unit in LTC, 7-3 shift. I have been alone for two days now, and feel like I am so lost. I didnt take any breaks today and wasn't done until 4 pm today with all my work/paperwork. Will I always be like this? How long will it take me to get a little faster? I feel like I am in the way of the nurses who know what they are doing and need some advice to help organize my day. It makes things slower for us nurses since so many on my floor are feeds, so the nurses have to help feed, too. From 8-9 and from 12-1 we have to help feed! I dont mind, it just makes for less time to do things. Thanks!

You'll get better dont worry

Piry · Dec 2, 2009

Dont feel bad and count your blessings because having 18 residents only, you are lucky. As you go along and learn to manage and prioritize you'll be able to finish on time. All those nurses were like you when they started working, nobody starts a job knowing all. We all go through that in the beginning. Have confidence in yourself and your skills. Ask questions and ask for help when in doubt. Most of all, be nice to your fellow workers and have a good attitude towards them and they will learn to appreciate you. Take time to reflect in all the things you have accomplished up to this day. You are doing just fine.

SMUgrad · Dec 2, 2009

Dear 1uvakindmom (and all new nurses starting off in the SNF),

I hope that my story will help you to see that you are comforted by fellow new nurses because I do, thank you for sharing your story. My very first day working independently in a SNF, I worked in the long-term side, in the morning, with 33 patients, 3 of which were combative and verbally abusive and continuously refuse their meds, 3 hospice patients, 1 of whom who was gonna pass at any minute, 1 who kept climbing out of his bed and was in danger of falling and hurting him/herself, 2 who were addicted to pain meds and antianxiety meds, and CNA's who were also really busy, I was told to write up 3 CNA's although I have never written up anyone in my life not to mention all 33 patients have at least 10 meds to take at 9am and 12pm who either take their pills crushed, whole, or with thick liquids. After I was expected to be done with 9am meds, I needed to do treatments (yeah right!) all of this on my very first day :bugeyes: One resident had a nose bleed, another didn't get cleaned yet and I was told to get a handle on my CNA's. In the first 3 hours of my shift, the other nurse saw me and asked how I was doing, at the mere thought of the question, I could not hold back my tears. My stress level shot up so high, I think it would have reached a world record. She called for reinforcements and had to get the unit coordinator to come from the other station to help me just pass my meds, and the wound care nurse to do ALL of my treatments. I was so embarrassed. I took a quick 15 min break to run to the medication room and cry my eyes out but I had to quickly pull myself together. I was so lost, I didn't know if what I was doing was the right thing. I don't think I properly documented a few things. I was so overwhelmed that I was really in danger of making a med error (thank God I kept myself focused on that.) I was so angry and overwhelmed, I couldn't think:flmngmd:. I got through it and my MDS coordinator sat me down to talk to me about my day (I used up his entire box of Kleenex.) I stayed 5 extra hours past my 8th hour just to catch up on charting. On my second day at that station, my patient fell!:smackingf.

At the end of the day, I had to reflect on it and think to myself how can I do this differently? My MDS coordinator reminded me how incredibly spazzed out I looked but I have to learn to adjust other wise I'm gonna look like that every day and I refuse to stress! So, I got my computer out and made a sheet of who my patients were and what Tx they needed, who needed a BP + HR reading before giving antihypertensives and Digoxin and assign that to my CNA's. This will be my second week working independently but all I can do is reflect on my day and think of ways I can make it better.

Please, fellow nurses (especially new nurses in the SNF) keep posting your stories and advice. They provide me comfort and will help me get over my fear. Kudos to all of you who are working the SNF whether you're a new or seasoned nurse.:yelclap: I hardly feel like a real nurse myself but the skilled nursing facility has its own personality oppose to the acute settings. SNF nurses are very special! Not to say other settings are not but SNF nurses deal with so much.

-SMUgrad

doubletrouble5 · Dec 2, 2009

Hello! I'm also a new nurse. I've been working in LTC facility also for about 2 months. I was hired to pass meds to 50 residents morning and noon. My first day by myself I was still passing morning pills at 1pm! I cried twice and when I got a short break, I almost left and didn't go back. Now that I've been doing it for a while I get morning pass done by 9 usually (I start at 6am). I have gotten quicker as time goes on and so will you. I feel like I'm getting ready to start over at my job, because this month they have me as charge nurse. There is only one charge nurse during each shift. I'll be responsible for all the treatments for all the residents (creams, wound dressings), insulin and blood sugars, two tube feeders, all the vitals and assessments for MC residents and all the charting for the shift, any doctor calls that need to be made and the list goes on.... My employer has recently fired 2 charge nurses, so I'm really freaking out bad! Oh and they don't like anyone to get overtime. I have seen nurses clock out and then do their charting. I refuse to do that, if I'm there doing my job then I should be getting paid for it. Am I wrong?

Thanks!

carbaminohemoglobin · Dec 3, 2009

Honestly, good time management comes with a little more experience. Experience on that unit, experience on that shift, experience as a nurse in general.

Stick with it. You'll catch on and soon develop your own schedule.

Hope this helps!