I am right there with you. I am working at a LTC facility and this is my first nursing job. I have been working there for about 10 months and I have gotten quicker, mostly because I have become really familiar with the residents on our floor. I have learned a few tricks that have made me a little quicker. Our CNA's don't do our vitals for us either, so I would say before you start your first med pass and do your accuchecks, take as many vitals as you can so that will be out of the way. Also, cluster your tasks together, this really helps. Keeping your med cart stocked so you won't have to go back and forth for supplies will help also. Also, if I know a patient will be difficult, I usually try to get everything done with them in one shot..like morning accucheck, morning meds, and vitals. But don't feel the need to rush. Like you said, you don't want to make a medication error. Like my trainer told me, speed comes last. Accuracy is the most important:) Hang in there!