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One month on the job and still not getting it.


I'm a stale grad RN, having finally found a job at an LTC after 2 years on the job hunt. I am so grateful to have a job and am finding that I love working with the elderly... I feel really fulfilled and I know I will learn a lot at this job. But this job is hard for me. I've been working for about a month now, having been oriented for 12 days. I would have been oriented for less time but I kept messing up the med pass, forgetting to sign off that I had given a med and the DON put hard pressure that I needed to get it down or lose my job. Particularly since I am an RN working at the skill level of an LVN. She told me she expects more out of me. I certainly hope it's not perfection. My boss stresses me out. Turns out she's not the nicest of bosses and has a reputation of being a witch with a B, who will fire you at a moments notice. The nurses here are great and have really helped me and have gotten my back and covered for me when I have made mistakes. The thing is, I don't want to make stupid mistakes anymore, like forgetting to sign off a med or even forgetting to document the time for something. Stupid, stupid mistakes. The devil is in the details for me and nursing is so detail oriented - I doubt myself, if I have chosen the best career for how my brain works. I'm just wondering if after a month, should I have gotten it down by now? I really want to be good at my job... and then I find out that the nurse on the PM shift caught my errors I didn't even notice. I'm so scared of getting fired - especially since it's taken me 2 years to find this job. Really, should I have gotten this by now? And a 2 hour med pass for 40 residents seems like an impossibility. I don't know how my co-workers do it. I'm tired of feeling stressed and anxious. I know it will get better and I will get better... but should I be there already? Or is this par for the course for starting LTC nursing? I wish I could give you more info on my boss but all I know is that she intimidates me and I try to stay out of her radar as much as possible, but i have this fear that I will end up on her radar if I don't get this job down and SOON.

What kind of med mistakes are you making? Just curious!

I think you will get it with time! LTC is very difficult I believe. That's what I do too and it's been almost a month for me, I was on my wing for about 2 weeks after orienting & they pulled me to the skilled side to work! (Short staffed on nights/No RN supervisor). Have faith in yourself, don't rush, and don't worry about the time it takes for your med pass. When I fear started it took me 5 1/2 hours usually, now I'm at 3 hours on a wing I just got pulled to! It comes with time!

CapeCodMermaid, RN

Specializes in Gerontology, Med surg, Home Health. Has 30 years experience.

It's been ONE MONTH. How can you think you'll get it after one month. Take a breath and do one thing at a time. You will get faster.

I have been told that it takes most new grads at least 6 months before they start to feel comfortable. Ive been working for about 6 months now and still have tons of questions and not always certain of what to do, I often ask another Nurses opinion and call the Dr if in doubt. I dont get nervous before I go to work anymore but I do get a little wigged out when a resident goes downhill or I am faced with a new situation. One of my biggest problems right now is trying to leave my work behind when I get home so that I can get sleep. I rethink my night over and over again, and worry that I forgot something, etc. Give yourself some time , it will get better.

listen please,,, it took me a good 6months to start to feel any level of comfortability in LTC as a new grad... Unfortunately, your boss is putting this insane amount of pressure on your after just one short month. that is unfair to YOU!! it sounds like your not making actual med errors, it sounds like your missing intializing in the MAR? if thats correct, set aside 1/2 hour each night, and go over your MARS to make sure you signed out everything. also are u using your report sheet? jot down everyting on that sheet for documentation later... before you go to work make a sheet for yourself. for example when I started, I would designate my times like this: 3-30 get report/count narcs, quick round 3:30-4:30-take off all orders/labs, 4:30-5:30-give 4pm and 5pm meds... 5:30-7:00 treatments/assessment due, 7:00-7:30 BREAK!!! yes TAKE YOUR BREAK!!! 7:30-9:30-give all meds intialize 9:45-10:30 go over your MARS/TARS make sure you initialed EVERYWHERE!!! 10:30-11-finish up any documentation... its not an exacty b/c anything can happen to throw you off, BUT if you at least have a scheduled of how you like to run your shift, this may help... breathe and relax, the more upset you get higher the chance you WILL make an error... please be kind to yourself!!

Forever Sunshine, ASN, RN

Specializes in LTC. Has 7 years experience.

You won't get it after a month and you won't get it after two months.. hell it took me a good year to get it and still even sometimes I feel like a fish out of water.

And as far as your med pass... don't rush. If anyone says they get a 40 person med pass done in 2 hours.. I believe they are lying or prepopping or throwing out the pills or whatever, a heavy 40 person medpass cannot be done in 2 hours. Plain and simple. Start your medpass as early as you can.. for 4:30 start right after you count if you can.

Check your mars and tars after your medpass is done for the night. Sit in a quiet room.. no interruptions and make sure all your boxes, parameters, injection sites, etc are filled in. I was sloppy with this in the beginning and after the DON wrote me up for it .. its a mistake and a lecture I still have never forgetting. I think of it after every box I sign. lol

When I work after a new nurse I don't expect them to be anywhere near perfect and if its a silly little mistake like forgetting to sign boxes I'll let them know .. check your book after you are done with meds because.. you can get dinged for this.


Specializes in Geriatrics, WCC.

I'm sorry that you are having problems but, has no one else noticed that she has only oriented 12 days as a new grad? Any of the new grads that i have hires, I try to get them in there full time during the week (5 days/wk) for at least a couple weeks. then i put them on the evening shift for about a week and at least a couple shifts on nights. During this time, I make sure they have oriented to each floor/unit in the building, just in case of call-ins or vacations they will know where things are in the building.But, what it comes doen to is at least a month of orientation. I check in with them and the nurses they are orientating with to see how they are doing. If more time is needed, I give the extra. I don't release them on their own until they are comfortable with the job. The job is tough enough without the mentality of "eating our own". I also want to keep and grow the staff I do get.