I'm recently hired on a medsurg floor, from hospital statistic, near 45% of of hospital's RRT calls comes from our floor.. I'm terrified just thinking about when I am off orientation. I can feel my brain freeze just thinking about - eg. What if my patient suddenly become more lethargic? What should I do next? What if his RR suddenly increased? (check temp., listen to lung sound, elevate HOB if pt have trouble breathing...etc but what to do next?) I realize I am no longer a nursing student and can't just go "get the nurse".. I am the nurse now! AH!
The last thing I want is "freeze" when I see my patient has a change in condition, or hesitate what to do.. it really helps me when I hear other people's story or experience, what situations they encounter and how they respond/take action to solve it...
So I was wondering if you could share some of your experience on what are some of the change in patient condition that you have encountered on the floor and what did you do? eg. what did you do when pt had BP dropping, increase in respiratory rate, decrease HR, ALOC change.. besides to just call the doctor; and what are the things we can do/trouble shoot before calling the doctor?
per CNA pt had drop in BP --> double check BP, temp., lower HOB, trendalenburt position, check for any bleeding if post op/wound.. anything else?
*I am aware every patient/situation is different; therefore the way to respond varies. But still appreciate to hear other people's experience =)
Oct 10, '12
by Esme12, ASN, BSN, RN Senior Moderator
A month ago you felt you were being micromanaged and smothered. The first year is the hardest. ((HUGS))
The biggest thing I can tell you is to call for help. Get a trusted co-worker. Get your charge nurse. Two heads are always better than one. Even after many many years of being a nurse I will go to a trusted co-worker and ask then to listen, look, hear and give an opinion on a patient.....even if I already know the answer it helps to get a second opinion.
The next important advice is do not panic.....in the hospital you are NEVER alone. Remember your ABC's and call for help.
RELAX......it is overwhelming but it will all be ok.
Organization is key....I share these brain sheets all the time.
brain sheets.......here are a few.
mtpmedsurg.doc 1 patient float.doc
5 pt. shift.doc
day sheet 2 doc.doc
critical thinking flow sheet for nursing students
student clinical report sheet for one patient
I made some for nursing students and some other an members (daytonite, RIP) have made these for others.....adapt them way you want. I hope they help
Last edit by Esme12 on Oct 10, '12