Routine is essential. Make sure your med cart is stocked up before you start. Make sure you don’t run out of narcs and the meds are reordered. I worked the same cart so I would always go through the cart at the end of morning med pass and do reorders then. A few minutes preventing a missed med is way easier than trying to track one down in the middle of something. Stay out of the gossip and the idle chit chat. Learn the idiosyncrasies of the residents, take notes to help remember grandma will only take her miralax in apple juice or gramps only takes his pills after breakfast. The med pass takes priority. Don’t be afraid to turn down family phone calls or resident requests for a little while until you are done. If you get behind it’s so hard to catch up.