I wish I could express my thoughts to you about my first 2 days working as an RN, but I can barely wrap my head around what has just happened to me on my first shifts! The first epiphany I had during the first hour of my shift - throw out everything I learned in clinicals in nursing school. The 5 med rights? Two RN insulin checks? Reliable patient identification? What are these things? The second - nepotism is a huge part of nursing in my geographical area and will be something I will have to learn to manage to make my job not too difficult. I'm sure I'll come up with a whole lot more epiphanies in the months to come.
Basically, at this skilled nursing facility, I have around 30 patients with everything from young adults with cerebral palsy, brain injuries and multiple sclerosis to elderly patients who are living out their last days. There are a lot of psychological issues as well social and medical. My job is to give all these patients their medication (what is that? about 350 pills, powders, shots and syrups?) which takes the first 4-5 hours of my shift. I haven't done it by myself yet, and it will literally take me about 7 hours to give them. The key is to know your patients so that when med time comes, you know exactly how they like it ("Sir, would you like a minute side of applesauce with your digoxin?"). However, I have no time to get to know my patients since I'm getting to know the place and giving meds all day. One of my patients today I didn't even meet until 3pm! My job description should really be "surly medicine cabinet" because that's what it takes to get those med down!
Also, I just read this great book by Echo Heron called Tending Lives which is a compilation of stories from nurses all over the country. If you really want to know what it's like to be a nurse, this would be a great place to start.
(Oh and we have a new family member. I love it!)
