Newbie vent/cry for help

[OhioRN92]

Hi guys, been lurking since 2013, finally decided to make an account. I know there are an incredible amount of these posts but it's time I add my own. A little backstory, and apologies in advance for the length, and for any typos as I'm doing this on my phone...

I worked as an STNA for about a year and a half starting early 2012, got into nursing school in 2013 and completed my LPN in 2014. Immediately entered bridge program and got my RN degree this past December, licensed in January. Since around Christmas I've been working back at the same LTC I worked at as an STNA, currently working on my BSN through OU online, projected completion April of next year.

I'm just...exhausted. And so overwhelmed. I am 100% aware that I went into this with big, gaudy rose colored glasses. I steeled myself for many disappointments and hiccups as a result of naivety and lack of experience. That aspect really hasn't been as bad as the total sense of defeat I get at my current job. I know this place very well, and spent many hours eyeballing the nurses when I was an aide, watching and asking questions, so I had an idea of how it was here. Obviously didn't understand the full breadth of it, but had an appreciation for the amount of work I'd do. I've also learned that the place has changed a lot, with new administration and the typical disconnect between them and those on the floor.

I feel like this I just going to be a lot of rambling. Currently I believe census on my unit is 27. The highest I have had is 32. I know there are many seasoned, AWESOME LTC nurses that could do that with their eyes closed, and I applaud you. I can not do that. I am the sole nurse for these residents, and between all the meds, sugar checks, PRNs, appointments, treatments, new orders, phone calls, changes in condition, etc etc etc...I'm drowning. I have no help anymore. It used to be myself and the brilliant 10 year veteran of the unit splitting it half and half, and I learned a lot and improved a fair bit. Then census dropped and they split us up. Well...census is back up (higher than before) and they never brought back in more help. I have a new DON, a new ADON, and no additional nurses available. The new DON/ADON haven't been trained on the computers yet so they can't help with orders or even printing out appointment packets (since I'm the only one that makes them ahead of time on my weekend to work), and even if they could they're in meetings 3/4 of the day and unavailable to me. The two nurses on the other end are swamped too so they're not able to come down during the shift and assist.

From the second I'm done getting report it's nonstop, which is totally fine, I love busting it out and being productive, I LIKE working. Every shift there is something I do better or more efficiently, or something I remember ahead of time that clears up extra time later, which is so cool, and just about the only positive thing I can think of in this job. There are times where I really rock a shift. There are more times that it all falls apart.

If I just had someone down there for even four hours, to help with getting orders in and maybe getting a round of blood sugars it would be so much more manageable. I really think as a new grad I have done well; having that many people to take care of and balancing it is so tough. But most of the time I leave there feeling so defeated...if I only had some support during the day maybe this or that could have been done.

Also, the availability of supplies/decent training makes me queasy. There was a code last night and not a single ambubag to be found. The one time I got to look in the crash cart, it was barren. Last night they needed the portable suction machine and it didn't work. I have a very unstable trache pt who is a full code and his airway became compromised and I had no nursing staff on my entire side of the building to call 911. Luckily, a well placed and impeccable PTA came to my aid in that situation, but I'm haunted by the "what if."

I also can't stand the talking behind people's backs and nastiness there. I had my first code a few weeks ago and luckily 4 other nurses responded. They quickly pushed past me and initiated CPR, etc. I had only ever done a mock code in school, last summer, so I felt much more comfortable observing as it was my very first one and let's be real, I was scared as heck and intimidated. I wasn't useless though; I didn't stand there open mouthed and stupid. I remembered from my mock code that we had someone writing, so I wrote. Time the code was called, time CPR initiated, time 911 called, time squad arrived and left...all while getting med list and face sheet etc ready for the ER. I found out during my 90 day orientation (which I received 5 months into employment) that one nurse said I totally froze and didn't help. I know better than to let that sort of thing affect me, but gosh that hurt...it was such a foreign situation for me, I did the only thing I knew 100% how to do, that would be of any use. Maybe I should have jumped in on compressions, I don't know...it still upsets me.

I've put in many applications to other places in the past weeks, because I felt myself being worn down, and I am afraid of making a mistake that could cost me big time. Unfortunately, without that magical one year of nursing experience I haven't heard much. There's so much more I want to say and get off my chest but there's just too much! I feel like I'd be doing myself and my resume a disservice by ditching after less than six months, not to mention they are already so short staffed that I fear for the residents if more of us leave, but I know my mental health and well being come first.

In addition, I feel like I'm losing certain assessment skills and things of that sort..or maybe just not having the opportunity to cultivate them. I barely have time to do a skin assessment, let alone a full systems check and a real in depth, critically thought out assessment. The depth of an assessment for me is "oh your SBP is 91? I'll hold that metoprolol." But that also makes me doubt my abilities; maybe I SHOULD have the time to do more, or maybe I'm not smart enough. There are times when I totally freeze and think "uh...what's next here..?" Yeah, okay I really am rambing, time to wrap this up.

I'll assume this is in the wrong section, but there was no "overwhelmed new nurse" option...I think I just need a pat on the head and some reassurance. Any tips or tricks for landing a different gig without that coveted one year of experience would be awesome too..but most of all thanks to all of you, for being such a wealth of knowledge and comfort, all throughout school and this transition into practice. For now, it's deep breaths, one task at a time, and 3 days off to bust out school work.