Quote from abbysmom
hello--i'm a new nurse--off orientation end of september, working nights. i am on a busy post-surgical/oncology floor with overflow from other services. i usually have 7 patients overnight, and as you night nurses know, someone always spikes a fever, gets a little loopy, cannot sleep because of pain, or needs narcan because they aren't handling the anesthesia well. whatever. people think and say that nights are easy because the pts are just sleeping--which is just not true. anyway, i'm doing well dealing with all the unknowns, giving meds, keeping people comfortable, getting the piles of documentation done, labs drawn, etc. all night--i do not sit down for 12 hours. then i get into report and get a barrage of questions about a patient's long term history, why is the medical plan for this and not that, what is the discharge plan for the patient, etc. i know i should know all of this, and sometimes i do, but sometimes i've just been focused on handling the pts immediate concerns like pain or nausea or fever or respiratory status or urine output for the 12 hours (with six other pts). i don't get this information at report when i come on, so am i supposed to read everyone's entire charts when i come on so i can get their entire history? anyway, then i leave report feeling like a bad nurse. i know i'll get better at knowing my pts' total histories (which usually you can only do by reading a 100 pages of notes in the chart, because no patient wants to tell you their whole story at 11 pm) but my questions are these:
1) does anyone else feel utterly stupid when it is time to give report even though you did a good job taking care of the pt for your shift?
2) if any experienced nurses are reading this, how long before i should expect to get better at this? i'm tired of leaving work feeling defeated and stupid, even though i took care of a lot of patients and got them through the night more comfortable, safer, and handled all complications that arose.
3) when do the bad dreams that i have when i go home and sleep stop? i dream of iv pumps beeping, people going septic, forgetting patients altogether and leaving them in their own xxxx.
thanks for any input.
I've been in orientation since the beginning of August and I'm going on my own in November. ahhhh!! scary! Giving report has been a big challenge for me as well. I'm starting to get much better at it through (or at least I'd like to think so, haha!). Even though I'm with a preceptor still, I'm pretty much taking all the patients and reporting on all of them. Sometimes I really do feel like a mumbling idiot! I mean, I've been with the patients 12 + hours.. you'd think I'd know a thing or two about them! Anyway, I find what works for me is using my "brain sheet" that I used to get report from the beginning of shift. I make changes on that same sheet of what "new" has come up during my shift, cross things out so i dont get confused, etc.... I like to keep copies of my orders throughout the day on each patient. Here is a list of stuff I usually tell: Name, Age, DX, Dr., Allergies, History (at some point during my shift i regroup and look at H & P, *IF* I have time, if not then i usually report on the history that i got about the patient at the beginning of my shift), IV site/fluids, Blood sugars/coverage during my shift, activity status, voiding or foley, dressing changes, drains, oxygen, important VS changes, crucial labs, pain level/last time medicated for pain, and any other crucial patient needs or changes, as well as family concerns. Is the patient oriented? Diet? how are they eating and drinking? how is their output? I think its important to point out the abnormals than the normals. Its so easy for a nurse to go and look at the normals... ya know. Hope this helps a little bit...
Oh yeah and I can relate to the whole dreaming thing! I usually dream the night before I go into work... usually my dreams are about getting fired and losing my license for killing a patient. Crazines