Hi All I know this subject can be redundant and for everything else that is going on with a pandemic I feel like it's out of place, but I'm going to post this anyway! I will reach my 1 year anniversary as a nurse in mid April, and I feel like I should be more adept/confident/faster than I am....I am always running behind, and especially when I'm floated and don't know any of the patients. First of all, let me say I work in a Long Term Care Acute Facility, so the patients ratio is 1:20 on non vent floors and 1:10 or more on vent floors if they are short staffed (it happens often). On the non vent floors I'm pretty comfortable (though slow), because patients tends to be less intense (don't have to take BPs 3x per shift, every other patient isn't on contact precautions), but really that's on an assignment I know (even short term patients are there at least a month). If I don't know the assignment, I feel totally overwhelmed and incompetent. Types of meds are different, wound care is different, etc. Does anyone have advice on how to prepare for new patients and develop a flow so to not feel like your drowning? I look up general things about patients like wound care and starting tube feedings but there's only so much time before you need to get moving. Is this something that becomes more comfortable with time or am I missing something? The other nurses I work with are supportive but I still feel embarrassed that I feel so behind. And even though I am more comfortable with familiar assignments I feel like I am always behind. (Experienced nurses how are you so fast at med passes!) Technical skills....things I passed on a nursing school exam on a dummy but now feel totally ill equipped and terrified to do...IVs, Inserting GT tubes...I rarely do them so when they come up I have an anxiety attack and ask for help, but then never get the experience I need to gain confidence....how do I get past this hurdle? I want to learn the skill but am terrified of hurting a patient, and I can't bother everyone for everything especially when we are short staffed. Am I being too soft/lacking confidence? If so how do I change this? I don't mind the facility I'm in I just feel overwhelmed sometimes. I'd like to say it's just the patient to nurse ratio but I don't think that's it. I want to move to a hospital setting because I want to learn more but am sometimes worried if I feel incompetent in a LTC facility if I would make it in a hospital....I hear it's more difficult. Any advice to a new nurse who's trying to gain confidence/get it together/manage stress is welcome. Thanks!