Overwhelmed...and NOT a new grad

[Annie Wilkes RN]

I have read many threads on newer nurses struggling at work. But not so much on nurses like myself who are not new grads. I am 43.

I just started working in LTACH. Today would have been my first shift alone. 7A-7P. I asked for more orientation and thankfully they are agreeable.

I was an LPN for 9 years and an RN for almost ten. Most of my background has been in LTC, with six years working in a hospital on a general medical floor.

This LTACH prefers to hire RNs with experience in critical care, but they offered me a job anyway, which I am very grateful for.

I knew it would be fast-paced. I knew it would be tough. Although I am learning a ton, I am very concerned about when I am on my own. Right now, I have my preceptor to back me up if I get into a jam. The thing is, I am very task-oriented. I feel like I need help with prioritization. I struggle with what to do if a procedure occurs in the morning before I am able to assess all my patients. I struggle with having to stop my assessments and/or meds and attend to the urgent need. Why can't doctors show up and write new orders after noon? Why can't procedures be scheduled after noon? I am struggling with knowing exactly what to do, what my job is during a bedside procedure. We have not done that yet. I would prefer to have more critical patients while I am orienting, then to have a patient take a turn for the worse while I am on my own. What if I get so upset that I cry in the middle of the nurses station or worse yet...swear?

I want to give exceptional care, leave on time with everything completed. I do not want the facility to be sorry hey hired me. I want this to be my last job...ever. Leaving only due to disability, death or retirement. Not due to quitting or termination!

Does anybody have any words of wisdom or advice on how to become more organized? How to think more critically? How to not care if the medications are administered late because one patient had an emergency or a procedure?

Thank you in advance.

Annie, RN

[BSNbeauty, BSN, RN]

First , I would advise you to delete your user name just in case someone you work with finds this thread and reads it.

Next , take a deep breath. Any new job will take time. If after 6-12 months you are still feeling this way then there is nothing wrong with finding a better fit. You have 19 years of experience right ? So I would move on and be happy if this doesn't get better.

[superT RN]

What does LTACH stand for?

[JustBeachyNurse, LPN]

What does LTACH stand for?

Long Term Acute Care Hospital. Long term ICU/PCU level unit for those who can no longer stay in an acute care ICU. Many are trach/vent dependent and not stable enough for a LTC vent unit or home with 16hrs skilled nursing

[Jules A, MSN]

What if I get so upset that I cry in the middle of the nurses station or worse yet...swear?

Just my personal preference but I'd much rather a nurse curse than cry. It sounds like they must think you have potential or they wouldn't have agreed to extend your orientation so thats a plus. Some of the things you are spending time ruminating over such as "Why can't doctors show up and write new orders after noon? Why can't procedures be scheduled after noon?"

are just a waste of time. Those aren't things you can change so I would focus on the things you can change and just keep plugging along. Good luck I hope this works out for you.

[caliotter3]

I would be very careful about how often and in what manner I disclose my self doubt to my supervisor and colleagues. Ask for help, but not often, and not for situations that you can figure out for yourself, perhaps, by consulting the policy and procedures manual. Whenever you provide negative feedback about yourself and your abilities, remember that you are also providing ammunition to those who may choose to use it against you.

[Annie Wilkes RN]

Thank you all so much for the responses. By the way, my real name is not Annie Wilkes. Did you ever see the movie "Misery" based on a Stephen King book? I got the name from the nurse character in that book. It also was made into a movie as well. It's pretty good! You all should watch it! (But I am not the kind of nurse she is!)

[BrandonLPN, LPN]

Stop kidnapping injured romance authors and keeping them captive in your home. I'm sure that is a major distraction at work.

[klone, MSN, RN]

First , I would advise you to delete your user name just in case someone you work with finds this thread and reads it.

.

Okay, this made me laugh out loud. Not a Stephen King fan?

[Annie Wilkes RN]

LOL Brandon! I know RIGHT?!?

[icuRNmaggie, BSN, RN]

My ICU friend tried LTC and said she never thought she pass meds to a whole hall of patients, but that now she is a hundred times more efficient and organized at med administration. She hated every minute but said she gained great time management skills.