baumgardner229

I learned that this order was written incorrectly and has been corrected.

I'm trying to understand why a patient would have both NovoLog and HumaLog scheduled at the same time. Both are fast acting, with NovoLog being just a little faster and hangs around longer. Should these two insulins be given in separate injections or combined into one? *For the record I didn't combine them, I gave separately.

Learning a lot at the LTCF & rehab. I spend most of my time on the rehab floor. It is by far the busiest floor and not only are the residents there for therapy they also fill beds with LTC residents as well as those that might need transferred to the memory floor. The biggest challenge right now for me seems to be conquering the med pass. "I SUCK". "I AM SLOW" I always feel defeated and totally exhausted when I finally am able to finish it. I always seem to need some assistance at some point. I have 17 plus residents, with a mix of crush w/applesauce, peg, BS, insulins, nebulizer, IV's etc. I cannot seem to get a routine that works for me. I tried starting at one of the hall and just moving my way down. Thought this would help, but really it didn't. I tried to do all my BS first, so I could get all the insulins given before breakfast came. This sort of worked but we had a fall and interrupted this and put me behind and administering insulin AFTER breakfast was eaten I just have to find what works I guess. Not being real familiar with everyone is not helping right now either. I'm still feeling like I'm scattered and I cannot get all the pieces put together. I try to review everything in my head and have it all planned out, I know the steps for a procedure and then...my brain goes into a deep fog. I think my nerves are sabotaging me! I keep going back, so at some point everything will just fall into place and my confidence will begin to grow. The administrative part, like new admissions, new orders, incoming labs I'm doing ok, slow but I think I got this part. I really have not had any emergency situations to deal with yet (yikes), so I will tackle those as they come up and learn from each I guess. Until next time, thanks for all the support!

I'm a "new" nurse as well. I just started working in LTC back in mid-August 2017. I'm learning the administrative part, OK, I think (admissions, new orders, etc.), the I struggle with the med pass. Usually, 17-plus residents are on the rehab floor. The rehab floor also excepts those residents that are more long-term and require more assistance and those waiting for the memory unit. Many of the residents on this floor have many meds, peg tubes, and IVs, and I really did not see most of this in school and feel that the nurses have to teach me everything. I feel somewhat awkward or embarrassed when I have to say I do not know this or that. Some look at me like, really?? I do my best, but seeing something once does not make me a pro. I need to build that confidence up and really know it. I do not want to hurt anyone. I always go and ask or ask if the nurse will watch me do something to ensure I am doing it correctly. I always start med pass off good, but then as everyone mentioned, "stuff" happens, or it takes me forever to be able to figure out what is written; the writing on the MAR is horrible...I waste so much time trying to understand what is written (an error waiting to happen). I seem to get comfortable with the residents that just have pills and take them with water. I can get the BS and insulin done as well. But those that need nebulizer treatments, eye drops, crush w/applesauce, or the peg just throw me off. I do not know the MAR well enough, but I think I need to know these residents and either do them first or last since they give me the most trouble. I am still trying to find my "way" of doing things. The school did not prepare me for this, LOL I will take note of all the tips that were posted as well. Good luck to you!

Hi, just an update...I started Aug 9 PRN for LTCF, rehab floor. I work two evenings per week and one weekend per month right now. There has been good and bad days...I am trying to stick with it. There is so much I don't know, and at times makes me feel kind of dumb, and to be honest it has been a bit overwhelming at times. I'm kind of quiet, and a bit shy, which I do not understand me at all because that really is not my personality :/ I guess with it being a new experience, and me a new nurse with lack of experience I will just have give it some time...I am also struggling a bit with time management. This facility is not the most organized which makes learning even more complicated Some of the staff just assume I know stuff that I do not and I can sense some tension when I am not going as fast as they would like...I take notes, I go home read them, re-write them and look up stuff I did not know or just not familiar with. When my nerves get the best of me, I kind of get stupid, and forget what it is I do know guess this will pass in time, I just need to be patient and keep showing up.

Great tip! I actually picked up something that would fit into my pocket that I could keeps notes in. I wrote down several things that were procedural and few things I wanted to read up on. I planned on writing this all down before my next shift so that I am ready to go. Though I was stressed, I did actually learn a few things being forced to figure them out for myself...not my preferred way to learn it but, I learned and will not forget it. I know it should get better each time I work, I guess the anxiety is getting the best of me right now and I have zero confidence...even things I know I couldn't remember :0 then that made me feel like a real dummy. I am off tonight, and I will be looking up things in my books and getting notes started...thanks again for the great tip.

I wanted to share an update with everyone, I recently started working at a LTCF, on the rehab floor. I felt extremely over whelmed and I realized real fast how much I didn't learn in nursing school. To be honest, I was worried I wasn't going to make it the first night and thought about just quitting. Not what I was expecting at all and nothing like clinical. On my way home, I was thinking maybe I'm not cut out for this, even though I wanted to be a nurse and help others so badly...I know not having enough staff makes it difficult to help new nurses, and that left me to figure things out on my own. I was scared to death!!!! I guess I was expecting training of some sort, skills sign off but, that is not what is happening thus far... and worries me. There is so much I have not seen yet or don't know, and feel like everyone expects me to know it because I am an RN. One LPN said to me "they didn't teach that to you in RN school?" Oh geez, I didn't even know what to say...hopefully, things will continue to improve for me and the feeling of "you really suck" will go away

Thank you! I will do that for sure.

Hi. I actually have not started yet, my orientation is in two weeks. I definitely will post an update once I start.

Hi everyone! Wanted to give you an quick update...I found a LTCF that accepted me as PRN and said they will work with me. I start orientation in about two weeks :) very happy and also nervous!! I'm more than thankful to be getting this chance!

Thank you everyone for your positive responses, I really appreciate it. I will keep looking until I find something that works for me until I can do this fulltime :)

Thank you for the response - I will definitely look into these and see what I can find. I just applied to Patient First this afternoon. They have a part-time position available and I am told they would work with me. Fingers crossed! Thank you.

You are close, I will be fifty this year. I thank you for the positive response. I will keep looking for a part-time/PRN position. I just applied for a position at Patient First, so maybe this one will work out for me. I have 3yr and about 7mo to go, and my 30yr will be in :) I will look at home health and long term care facilities as well. Thank you so much! I have much to learn about being a new nurse, and eager to learn.

Hello. I am new to this group. My situation is unique and I am looking for advise..feeling frustrated. I live in Pa. I graduated May 2015. It took me 2 attempts to pass NCLEX, definitely was not what I expected but, I studied and took it again. December 2016 I passed. Now for the challenges... I currently work for a local health insurance company, been there 26 years. Went to nursing school fearing that I was going to be laid off which, did not happen. Now, I have a job that pays well and that I love but I also want a nursing career that I would like to get started. My problem is, I really want to get my 30 years in at the insurance company (some perks for when I hit retirement age). I thought, I could work as a nurse part-time or PRN until I could go fulltime. This is not going as planned... I thought I had a PRN position, had multiple interviews, shadow experience and told that they would work with my schedule no problem - then I heard nothing. I decided to reach out the HR dept to see what was going on and I was told that I was not going to be offered the position and told I should seek fulltime instead since I am considered a new grad nurse. I will keep looking for a position that will work for me right now until I can go fulltime but, my question is what if I don't find that position? The longer I go without a job, I feel that my chances of ever getting hired as a nurse get critically lower. I didn't want to just give up...I really think I could do nursing part-time and then move to fulltime. Any suggestions?