Well I just typed a LONG post and my dog deleted the entire thing so let me just make this short and sweet lol.....
I'm new to a busy med-surg floor, I was lucky enough to get hired immediately upon graduating so I've been here 3 months and on my own for 3 weeks. I feel that I'm a fast learner and I do manage to finish all my work/charting on time. Also my patients absolutely love me so that's probably my strongest point so far.
My concern is this...I feel that nursing school
prepared me to be an awesome CNA! Just not so much an RN. There's so so much to learn and I feel that I've forgotten alot from school, or maybe much of the knowledge I feel I'm lacking I was never really taught in school anyways, I can't remember. I want to be able to finish everything in a timely manner but also feel that I'm doing the best I can do to be safe and effective. I know some of this will come with time but let me give an example...
The PCAs on my floor inform us if a blood pressure is a little too high or low, which is great. But when it's a busy day and they tell me a pt. bp is 178/90, at what point do I say "oh wow that's entirely too high I need to call the dr"...I mean I know obviously if they had any prn bp meds i would give those but what if they don't have any prns ordered....If their bp is normally low I would be more concerned but what if it usually runs 140/80's.....I don't want to dismiss anything serious but I've seen so many nurses handle similar situations differently. Some will dismiss it and say we will keep a check on it, it's probably up because they've been moving around (for example) while others freak out and call the dr immediately.
Or if the bp is low, at what point do you call the MD?
I mean don't get me wrong if I need to, if something's going on I don't know how to handle I go to other nurses or the charge nurse all the time....this may sound bad but I don't care if I get on their nerves because I want to be safe. I'm not going to just wing it and hope I made the right decision. But I want to be more autonomous.
Besides BP, what about post-op with a temp? I had one of those the other day and I immediately thought "tylenol" but then I wondered if that would just mask the temp and we needed to know what it's really running...then the charge nurse told me not to give tylenol to get her up and walking. I had no idea or either forgot that this would help? I just feel lost on some things, I feel like I should better know how to care for my pts in some situations. Will this come with time? Has anyone else felt this way?
Sorry I guess this did end up being a long post after all
Sep 12, '13
It's very scary being a brand new nurse in a busy acute care unit. There is so much we don't know, and we don't even know what it is we should know that we don't. I guess knowing hospital policies and procedures, and asking lots of questions must suffice. Checking and double-checking. Hard to do all this, be safe and efficient, and finish it all on time, indeed.
Last edit by Flatlander on Sep 12, '13