New RN in Skilled Nursing Facility

[Sosckia]

Hello All, Just seeking some advice. I'm a new RN who just landed my first job in a skilled nursing facility. I'm currently on the 3-11 shift with a plethora of duties. Admissions being a big part of my day, along with charting, treatments/dressings, MD orders (writing paperwork, transcribing orders, faxing pharmacy orders, deciphering labs, faxing labs to MD etc) I have 20 patients with 2 major med-passes. My day seems endless and I barely ever get off on time. I'm very stressed out at the moment and am trying to figure out how to manage this without calling it quits. If anyone has any words of wisdom, please share - it would be appreciated.

-Danielle

[VivaLasViejas, ASN, RN]

First of all, congratulate yourself on the fact that you are a brand-new RN who happens to be managing well in a very tough situation! 3-11 shifts in SNFs are hell on everyone---that's when the staffing goes down and the admits come in, it's when relatively sane residents go off the deep end, it's when many faxed orders come in and you have to get them to the pharmacy in time for the evening run. If you're only slightly late getting off your shift, you're doing better than most of us!

Like any other nursing job, SNF has a steep learning curve, and you are going to have difficulties with time management in the early going. Don't be too hard on yourself; you are new and can't be expected to know everything right away. If you haven't already, find a mentor you can go to when you need guidance; also, listen to your CNAs---they know the patients far better than anyone else, and they are literally your eyes and ears.

Read everything you can about geriatric nursing and documentation, and brush up on your med/surg skills because you will be using them. And as hard as it is, trust yourself to do the right thing. Yes, it's stressful, and part of that stress is having a lot to learn, but that's true of anyone starting out (and for that matter, even experienced nurses).

Good luck in your new position!