New nurse on tele

missnurse01, MSN, RN · Jul 18, 2012

Hello there! Does anyone have helpful advice for a brand new nurse (4 months in) on a tele floor? I have learned so much already but I feel overwhelmed a lot of the time because there is so much patient turn over. Sometimes I feel like I can't handle it, mainly because I am getting stressed out easily with all the admissions etc. Someone help!

The main thing is just keep at it, don't get discouraged. If organization is an issue for you (which is normal in a new grad) ask an experienced nurse you work with to help organize your day. On a busy tele floor, often you may feel like you are barely holding the dam back! It will take you at least a year before you are probably very comfortable. If the paperwork esp with the admissions is what is getting you down, you may want to take a blank admit packet or whatever you all use to review carefully and slowly every day at home for 10 min or whatever.

It just takes practice, you will get there!

good luck!

FMF Corpsman, MSN, RN · Jul 18, 2012

this answer is pretty much the same as i gave for a question the other day, but revamped slightly for telemetry. most everything you do as a nurse will require excellent organizational skills so get used to that, practice them on your days off if you have to, read books on the subject if you can, but develop them any way possible, because they will serve you well, for the length of your career. create a flow sheet on your computer just for your own use and save them so you can print it out and use them each day. on this flow sheet, you will need a space to put your patients name and room #, a space to put the physicians name and phone #, this will save you the time of having to look it up 15 times a night if you get slammed and believe me, on a tele floor, it’s entirely possible. depending on how many patients you are normally assigned, you may want to design the flow sheet to cover a single patient or 2 or 3 or 4, whatever works for you. if you have more than one patient on a sheet, turn the sheet to the landscape profile and divide the patients by double bold lines so you can more quickly discern between the patients. just remember, confidentiality. when you have completed your shift, destroy your flow sheet by shredding it in the machine or tearing it too bits by hand. also on the sheet, you will need to have a place for the patient’s current vitals. in the upper right hand corner, is the patients current heart rthyhm. always there, no exceptions. that way, you always know where to look. next line you might want to have an area for a brief history so you can put things like if the patient has a pacemaker, internal defibrillator, hx of any bypass surgeries, diabetic, etc. any little thing that might be pertinent to the care of your patient. next, you might want to have a space for their iv or hep loc and where you can write in if it’s due to be changed. next a slot for labs. all of these slots are just the titles, like iv’s, labs, etc. everything else you fill in during report or as your shift goes on. remember confidentiality; don’t forget to destroy your flow sheet at the end of your shift. second piece of advice, if you are not comfortable with reading rhythm strips, you need to get comfortable. rhythm strips and ekgs both, you should also be proficient at giving ekgs sometime in the near future. don’t be alarmed, it isn’t all that difficult, especially with today’s modern machines. they practically put the leads in place for you. you should have used some of the old machines back in my day when they used suction cups to attach to the patient and didn’t tell you a thing. nowadays, these new machines will tell you if your leads are in the right place and if your coffee is getting cold, and oh yeah, what the patients diagnosis is as well. (don’t listen too much to the machine and rely more on your own skills and that of your attending and your other physicians) but you do need to be able to diagnose a strip simply by looking at it, and that will come with experience. take some courses and if you are allowed, spend some time doing a ridealong with whoever is working the tele desk.

nursemud17 · Jul 18, 2012

Thank you so much to both of you! Anything helps at this point!

nursiegirl18 · Jul 18, 2012

All I can say is hang in there. 2 years ago I too was a brand new nurse on a tele floor. The first 6-8 months on my own were pretty overwhelming, and then I got my own routine down, as you will too, and things got much easier. Don't look at the whole picture, look at things you have to do in sections. Immediately following report, I go and do all my assessements and if there are 0700 or 0730 meds due, I pull them and take them with me to do assessment; otherwise, get your assessments done first, then go and pull your am meds. I have all my med times on my report sheet under each pt's name and a check box as to when they are due and check them off when given. I set a time aside just for dressing changes (we are a post surgical/tele floor) and try to do things in sections and not all at once. Admissions do come in, sometimes in the middle of craziness and what I do is do a quick assessement if I have to and go back to do the actual admission when there is more time. Just try to get yourself organzied and get your own routine down. I know that some of the nurses at my hospital have gone back to being with a preceptor again just for a few weeks to kind of get them better organized. I don't know if this is an option for you or not. Good luck to you! I promise it will get better, just give it time and don't give up!!!

nursemud17 · Jul 20, 2012

Thank you nursiegirl18 for giving me hope! I am starting to get my routine down better, and I think its just a matter of time management and organization.

ltlshamrock · Jul 21, 2012

Hello there! Does anyone have helpful advice for a brand new nurse (4 months in) on a tele floor? I have learned so much already but I feel overwhelmed a lot of the time because there is so much patient turn over. Sometimes I feel like I can't handle it, mainly because I am getting stressed out easily with all the admissions etc. Someone help!

It took me a full year to get everything under my belt, confidence, knowledge. Multiple codes, response teams etc. Hang in there, ask lots of questions, and do your research every time something new comes up, medications, procedures etc. You feel comfortable soon enough and then the new nurses will come to you for questions.

cam2012 · Aug 1, 2012

I am a new grad and working on a cardiac step-down unit. I am looking for a good assessment form that I can use to organize my patients. Any suggestions would be greatly appreciated.

Cindy