destiny100

Working for agency now - 3-11 LTCF. Very slow passing meds, finding patches, shots - everything is a problem. Everywhere I go it's always a new place. I am a fairly new nurse. As agency I get no orientation, no mercy. Need tips on how some nurses pass their meds so fast - within an hour. Each of us has about 30 patients or more. Some patients consume a lot of time when I try to hand them their meds -- the darlins just talk and talk, asking what each and every med is, why they have to take it, or basically just fuss a lot before I get them to take their meds, or they take their time to get positioned in their beds to take the meds, or three or four will ask for this med at this predise time - i'm not familiar with these pts enough and just throwing my pt sequence out of wack, and my speedy flow of med pass is lost. So tempted to combine the 4p and 8p meds to save time. By the time I'm done with the 4p it's already 7p, sometimes 8p - so close to the 8 meds. Small, if any, time frame difference anyway.? In addition to the interruption on my med pass time the pts take, the aides interrupt with small things. Doctors call, new admits come in, one pt who had surgery three days ago starts bleeding and in pain while another pt impatiently standing at the door demanding her med now. Patients sit by my cart and talk and talk to me while I'm trying to concentrate on med pass. Shift nurse at times failes to tell me finger sticks, so I have to look each one up, going thru the entire MAR - this is first thing to be done before dinner and already throws me off schedule. All this is time consuming. I am normally a very fast person in everything I do, but with all the delays/interruptions, I find myself going back over and over again just be sure of each med before I feel safe putting it into their cup. Do a lot of nurses combine their 4p and 8p meds? Do some nurses just quickly throw the meds in the cup and mark the MAR after all meds are finished. Feel like writing up a sheet with their meds at 4 and 8, then just go down my one page list instead of paging through the MAR book. But this takes time too. Tried preloading cups clearly labeled in pts drawer, but a supervisor saw this and frowned at me. Where I worked before, I got the "system" under control because I became familiar with the pts and meds, but with agency its a whole new story. Afraid I didn't make a good impression on my first assignment. Feel very defeated, stupid, and not qualified to do the job. My supervisor says it will get easier in time - but every time it's a different place and pt, so don't see how. Finding things is part of the problem too. Any advise on how to control a fast med pass in a new place everyday? Agency hasn't called me with jobs for several days and am wondering if they're not too happy with my work. Or is agency work just not my cup of tea. There's gotta be a way to conquer this - lots to do. The pay is great and I can pick when I want to work. Why one nite all I did was pass meds, no wound txs, no nursing notes, got the skilled notations, no notes for report - nothing but meds. please help, thinking this job is not for me. but really want to help people, especially the elderly. Advise? Tips? Encouragement? Down low.