I recently graduated and got my license. I start my new job in 4 days, starting with 3 days of orientation. I'm planning on having a boat-load of questions to make sure I'm as prepared as possible when I get on the floor. It's a LTC facility, and it looks like I'll be looking at a minimum of 25 residents. I know I can do all the skills, and we actually had a few clinicals at two different LTC facilities during school. However, we were only assigned 2-3 residents as students. I did have the opportunity to follow around several of the nurses there, and one of them had some really good advice on how to keep track of what you still need to do for the day. I'm planning on following some of her ideas, which should help out a lot.
You're absolutely right that school doesn't prepare us for the workload that is common at LTC facilities. That is one of my anxieties about starting this new job.
One of the things that may help is if people leave advice on how to deal with the workload. The nurse who gave me advice kept a piece of paper with her at all times (I plan on using a notebook and shredding used pages at the end of the day.) She used the front to take notes of things she saw needed done during her 9am med pass (this included who needed finger sticks, who had an oddly timed med due, who needed wound changes, etc.). She used the back to jot notes on her interactions with patients. If one had a complaint, she'd write the time, patient, and a quick reminder of what the complaint was. If one refused a med, she'd note that. If she did wound care etc, she'd note that. Once she had the time to sit down and write her nurses' notes or chart, she would refer back to that page to ensure she didn't miss anything. It's not meant as a write-everything-that-happens-down, it's merely a quick reminder to herself of what happened so that nothing would be missed, and her notes were insanely thorough at the end of the day. I know this is a simple thing, but I've noticed a lot of nurses try the "I'll remember this" method, and eventually something is going to get missed, especially as a new nurse. An experienced nurse who knows all the patients well may not need something like this, but it's a good idea for new nurses or nurses starting a new job.
So, anyone else have any tried and true methods to help things along as a new nurse? Are there any questions that are often overlooked that need to be addressed during orientation? Hopefully my post helps someone somewhere, and I look forward to hearing what others have to say!