Working in any new job can always be overwhelming, everyone and everything is new. It is where the rubber meets the road. You always set high expectations of yourself but you should give yourself time to adjust. Below are a few tips I've learned to make myself more organized, to make less mistakes (and you will make a few, but that is how you learn), and to better manage my time at work: - at start of shift, always check for new physician's orders and that they have been noted in the MAR - for new meds, check to see if the family has consented before you administer - make yourself a chart (cheatsheet) of residents and how they take their meds: for PO meds - do they take them whole or crushed (needs a pysician's order), prefer with apple sauce, vanilla/choc pudding, ice cream, etc... do they have swallowing problems, need to take vitals (HR, BP) before meds, etc... - know who diabetics are, fall risks, 1/2-person or standby assist, diets and consistencies - do frequent routine checks as it will save you a lot of work and documentation requirements that go with it (esp falls). at NOC shift, I check bed rails, O2 nasal cannulas are patent, IV sites are intact/patent, etc ... - CNAs are your eyes and ears - know what to do, who to call in case of emergency, i.e. fire - be familiar with your unit's policies and procedures - DONT LOSE YOUR KEYS TO THE MEDCART! LTC for starters can be a great working experience, but you must spread your wings. Goodluck!