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New Nursing Job

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I am a new nurse who just graduated July 31st. I'm on my 4th (and last) week of orientation at my first job at a nursing home. I feel pretty decent about passing meds and doing treatments. The paper work is another story and I know it will take time to learn. I've heard it will take 1-2 years to feel comfortable as a nurse. But I'm completely terrified of being on the unit by myself for the first time (which will be in 4 days) and I'm feeling very depressed and beating myself up about everything. I work 3 twelve hour night shifts a week. A nursing home wasn't where I wanted to work but it's the only thing I could find to get my foot in the door. I feel like there's a lot I didn't learn in school and that I'm going to mess up or forget something. All the nurses are good for asking questions to but I can't help but feel sometimes like I shouldn't be asking those questions because I should already know them. I guess what I'm asking is for some words of advice and encouragement. It will get better right?

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 15 years experience.

Yes, it will get better, and no, you are not expected to know everything as a new nurse. On the other hand, the newbie who never asks any questions is the one who scares us experienced nurses the most.

You're getting off to a great start with the four weeks of new hire orientation at the nursing home. That's unheard of in the area where I live. Around here, new grads get three days of training before they are handed the med cart keys and cut loose to work the floor on their own. Back in 2006 when I was a new LVN, I received one 8-hour shift of orientation before being cut loose to work by myself.

So, consider yourself fortunate to have found a facility that supports its new hires with an extensive orientation. Good luck to you!

Been there,done that, ASN, RN

Has 33 years experience.

Never be afraid to ask a question. We've have all been there done that.

It's a good sign you feel comfortable asking. Good luck, let us know how it's going.

My supervisor called and said I will be on my own tonight for the first time (3 days early). Was supposed to train one more night tonight I will let you all know! And thanks for the tips keep em coming ! :)

Hey Kylee! How did that first solo shift go? I'm confident that you survived it! :yes:

Reading your post reminded me of the fear I had working my first solo shift in a 60 resident nursing home. I will share a little story about my first day, and I am pretty certain (and very hopeful) that no one can top it!

It was a Saturday day shift for starters, meaning that there was no administrator or DON/DOC on duty. As the RPN on duty that day, I was responsible for all of the residents. I was also responsible for the rest of the staff in the building; kitchen, housekeeping, laundry and the PSWs/HCAs. I was to do the 8 am and noon med passes (plus who ever required eye drops or puffers q2h) and lets not forget the majority of residents who needed an AccuChek before giving insulin. I was responsible for ALL treatments; any dressing changes, colostomy care, application of any Rx creams etc... The HCA/PSWs (I believe they had 4 on duty for the day shift) were responsible for basic ADLs and delivery of meals and feeding in the dining rooms or at bedside if indicated. The PSW/HCA was to document bowel function and dietary intake. I was to document in the nurses notes for every resident on their condition and including details of treatments etc. If there was nothing to report, an entry is still legally required for every client.

So I arrive for 7 am and was of course very nervous about how I was going to survive med pass, let alone anything else. Forgot to mention that I was to answer the phone and the door if the PSWs were tied up. I arrive; I am told that one of the cooks and a PSW have called in sick. (Saturday- coincidence?) Great I think; I am the one in charge, so I am the one who needs to find replacement staff, and last minute at that! I had 2 orientation shifts which included med pass, charting, tx procedures etc. I was never shown where to find phone lists etc. One disaster led to another that morning. Moments after being there I am told that there is NO hot water... WHAT?? I'm thinking OMG how are the residents going to have baths etc? I am led down to the basement and was told that I need to call the maintenance company and that I needed the key to the boiler room to give them access..... frantically trying to look at disastrous dog-eared and crossed out phone lists, I did not know who to call. Finally after trying to call the administrator and DON at home and praying for someone to return my call, I am able to locate the key and call the plumber. I'm looking at the time and nearly ******** bricks because morning blood sugars and insulins need to get done, let alone the cocktail of meds that every resident needed. (oh yes, most needed meds crushed and fluids thickened). Where can I find applesauce or jam to mix them with, and this small desert bowl is ALL we have for applesauce? Phone ringing off the hook, staff calling back to say no, they couldn't come in. A resident with a colostomy has ripped it off and is running naked in the hall with liquid fecal matter flying everywhere. Oh, guess what Nurse? That is YOUR job to deal with that mess, no one else is trained to give colostomy care. I AM OFFICIALLY IN HELL I thought. Next thing I know, a resident has fallen on the floor, face first, nose bleeding everywhere and of course hurting everywhere. Not only is this an injury and an incident report and V/S in need of taking, but it is also to be treated as a head injury and an ambulance needs to be called. OK, no, NOW I'm in hell!!!!

Could ANYTHING else go wrong? Oh yes, a second PSW has not showed up for her shift and the cleaner has now also called in sick. Little things like having to lock up the med cart every time I walked away, having to enter pass codes for the elevator or doorways at every turn, or having to dispense the closely counted and monitored gloves and incontinence products to the PSWs chewed up a chunk of time as well. A woman with a feeding pump is beeping on the second floor (who knows for how long at this point!), that needs to be changed and where exactly are the supplies and Ensure located? This is ALL the Ensure we have??? This isn't enough to get through the weekend!!! It truly was a shift from HELL, but somehow I managed to (barely!) survive it. I went home in hysterics and tears for sure and was so stressed it was unbelievable. Not sure what I was (or wasn't) thinking, but I returned the following day for more abuse. LTC facilities (privately owned) are notorious for using their nurses to the max and paying them peanuts. I was HORRIFIED to learn that my pay was only $1 more/hr than the cleaning staff. Sadly, that is the reality and it just is not right.

Well, my first night didn't go quite that bad. However, it was pretty bad. Get to work and have an admit, never done one, didn't know the paperwork to fill out, assessments to do, etc. Made my first ever call to a doctor (yikes!) . Get as much as I can ( and know how to ) done until it's time for med pass. Another resident falls. Time for incident report/skin/injury assessment/ notify DON/doctor and start neuros every 15 minsx4, 30x4, etc etc. okay back to med pass that is now a little behind.. Two residents get nose bleeds at same time. And not just nose bleeds, nose waterfalls. Okay who's am I pinching first? Get all that done and get back to med pass. ADON comes in the morning wants to know why the admissions chart isn't put together. Well, sorry for being thrown into this before my training was over and not knowing how to do anything , not to mention I care more about the patient well being than paper work. Anywho, doesn't sound that bad when I write it out. And definitely not as bad as yours, but still scary for a new nurse. I am still feeling overwhelmed and like I'll never get the hang of it. I cry a lot before coming to work, while at work or while leaving because I feel ignorant or like I did something wrong / didn't do enough. But I'm trying my best and asking lots of questions. Also looking for any other opportunities there may be.

All I can say is OMG!! I start my first job as a brand new nurse tomorrow!

How did it go Mainergirl2000? I just received a call that I am hired for a new acute care job! Yay! Best of luck to you also as a new nurse

sallyrnrrt, ADN, RN

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

kylee Renee, if your screen name is anything close to your real name, please consider changing to something more annon. :)

good luck with new job !

nursefromcali

Specializes in Ambulatory, Corrections, SNF, LTC, Rehab. Has 6 years experience.

I understand what you feel, I got my first nursing job in a public health under jail medical services and in county job. At first I'm so shock like super shock. I didn't expect that I'm going to work in a correctional setting coz the job posting is just "Department of Public Health" HAHA! oh well moving on days go bye and I kinda sink in to my job. And tbh, I never feel to be shy to ask some question even the dumbest question that I can ask them I do ask them. For me, in that way I learn and avoid mistakes. My conurses are okay with that and they are willing to help me. But right now, after couples months of working with them, I moved to a hospital and work as one of the Lead Nurses. Another challenge again, coz I haven't supervises anyone else before. I know they are MAs and LVNs but gosh it's very stressing to me, especially how to deal with doctors and some mean coworkers coz I'm younger than them they are intimidated and they don't want to follow me as lead. But again, by my hardwork and dedication I run our facility now in a nice way. Sometimes it's just stressful but try to relax and give time to your work to sink in to you. That's why we're a NURSE. WE CAN WORK UNDER PRESSURE. :)

You're right, I made this account when I was still in school but now should probably not blast my name out there while talking about these things do you know how to change it? I log in with Facebook so I think it just uses my Facebook name