Hello fellow nurses, I have been a LPN in LTC for years and now I am a RN working in a stepdown unit that is very busy. I am still on orientation day shift. I feel overwhelmed and I am not sure I will ever get the hang of this place. When I worked in LTC 7p -7a I would have two halls by myself and two aides with a total of 60 residents to pass an extreme amount meds to, get/ take off orders along with various other tasks and I did it well with little thanks. Now I am here, because I wanted to increase my skills and knowledge base, but I am so busy here I don't have time to think. I usually start off well getting my assessments in and am meds for 5 patients, but then everything gets insane with tests, discharges, admits, transfers, caths, OR patients and keeping up with new orders, careplans, computer charting, ADL's, tele strips, meals VS and consents. my example : start 5 pt then I transfer a pt out to another floor which takes time to do the computer screen and call report by the time thats done it is time to get a pt from the cath lab and get report and set up room, then get that pt while I am sending another to OR AHHHH! Its time to pass meds again to the other patients. UH oh! cath lab patient is going out to another hospital for heart surgery! plus vs q 1 hr, Now I am told to discharge another of my patients plus reconiliation of meds and teaching needs to be done as well as discharge computer screen and iv taken out. Tele strips are due to put in computer but that will wait because transfer team has arrived for cath pt. Meds are due for other patients and I must transfer another of my patients to another floor to open up beds, because I am getting an ER admit with chest pain. Then I get a call that my OR pt is coming back too. Then I am told I am also getting a transfer from ICU that is a trainwreck!( trach pt, vent, large, the whole nine yards and contact iso to boot). Meanwhile my ER patient ( admits take time, lots computer screens to do and paper work and wants tylenol and a consent for stress test needs to be signed) and OR patient (vs needs to be done and wants pain meds) arrive at the same time! bEgged Icu to keep pt until I could get her done! Old retired nurse who is the hospital's bed checker said icu pt needed to be moved now! Icu needs the bed for a pt that has been in the ER all nite! Its 5pm now! Pt comes. I Try to catch up on meds and computer charting, tried to get new admits assessment in computer and meds but I don't think I did the computer screen just right, it's time to give report to on coming shift that asks a lot of questions that I can't really answer yet and I haven't had time to look at the very thick chart. At this point I feel I barely know anything. My preceptor did help with the cath patient and helped with the vs and passed some meds on the OR pt. This my 3rd week on the floor they tell me that the charge nurse is so busy her self that you have to do everything yourself. By the way last week was worse. I wanted to be a nurse because I wanted to care for people in their time of need but all be dang! if this ain't too many needy. I am suppose to go to nite shift where I belong very soon, I hope it gets better and safer for me and my patients.